A case report highlighting the successful use of a persistent median artery as the pedicle for a radial forearm free flap, stressing the importance of recognizing this variant.

Radial Forearm Flap Based on Persistent Median Artery

This case report describes a radial forearm free flap (RFFF) harvested using a persistent median artery (PMA) that traversed a bifid median nerve in a 69-year-old woman post oral cancer surgery. The flap was viable and preserved motor and sensory function. As PMA prevalence appears to be increasing, awareness of this variant is critical for flap-based reconstructive surgery.

PSYCHIATRY

Longitudinal findings suggest overprotective parenting may contribute to increasing problem behaviors during adolescence.

Overprotective Parenting and Adolescent Problem Behaviors

A two-wave longitudinal study of 588 adolescents examined the bidirectional relationship between overprotective parenting and adolescent problem behaviors over a two-year period. Using reports from adolescents, parents, and teachers, the study found stronger evidence that overprotective parenting was associated with subsequent increases in internalizing and externalizing problem behaviors than for the reverse direction.

Teacher–student relationships may partly explain links between children's genetic propensity and educational performance.

Genetics, Teacher Relationships and Educational Performance in Children

A longitudinal study of 63,032 children from the Norwegian Mother, Father and Child Cohort Study found that higher genetic propensity for educational attainment was associated with less student–teacher conflict and more positive teacher responses at age 5. These teacher–student relationship factors partially mediated associations between genetic propensity and reading and math performance at ages 6–8.

Family, health and neurobiological factors were associated with prospective loneliness in children followed for three years.

Risk Factors for Prospective Loneliness in Children

A longitudinal study of 9,602 children from the ABCD Study identified multiple environmental, health, and neurobiological factors associated with loneliness during adolescence. Among children who reported loneliness at baseline, 71.6% experienced loneliness again over the following 3 years. Parental psychopathology, developmental history, family income, and general mental health showed particularly strong associations.

Attention problems were consistently associated with poorer mathematics and reading achievement across childhood and adolescence.

Attention Problems and Academic Achievement in Children

A study across two independent cohorts found that attention and social problems were uniquely associated with lower mathematics and reading achievement beyond overall psychopathology. Attention problems consistently predicted poorer academic performance across developmental stages, while social problems showed stronger effects among girls and during adolescence in boys. Bidirectional associations were observed in clinical samples.

Twin data suggest relative birthweight may be associated with later cognitive performance beyond genetic and shared environmental factors.

Birthweight and Later Cognitive Performance in Twin Study

A longitudinal study of more than 2,000 twin pairs from the German TwinLife study found that within-twin differences in relative birthweight were associated with differences in later cognitive performance. The association remained after accounting for genetic and shared environmental factors, although it was not significant in the subset with data from both assessment waves.

Prenatal alcohol exposure was associated with greater sleep disturbances among adolescents aged 12–13 years.

Prenatal Alcohol Exposure and Adolescent Sleep Disturbances

A study of 10,336 adolescents aged 12–13 years found that those with prenatal alcohol exposure had greater parent-reported sleep disturbances than those without exposure. Sleep–wake transitions, excessive daytime sleepiness, and sleep breathing were most affected. Evidence for a dose-response relationship with low-level exposure was limited.

A family-based intervention improved family functioning, caregiver mental health, and parenting among at-risk adolescents in Lebanon.

Family-Based Mental Health Intervention for Adolescents in Lebanon

A multi-site randomized controlled trial in Lebanon evaluated a brief family-based mental health intervention delivered by non-specialists to families with adolescents experiencing psychological distress. The intervention improved adolescent-reported family functioning, caregiver mental health, and parenting, but did not significantly reduce adolescent psychological distress. Benefits to family functioning and caregiver well-being declined at 3 months.

Global data show hunger is consistently associated with increased worrying and suicidality among adolescents.

Hunger and Adolescent Mental Health: Global Study

An analysis of 410,213 adolescents across 79 countries found a consistent association between hunger and poorer mental health. Experiencing hunger was linked to a 12-percentage-point higher prevalence of worrying and a 7-percentage-point higher prevalence of suicidality. A dose-response pattern was also observed, with more frequent hunger associated with greater mental health difficulties.

RHEUMATOLOGY

Deep learning enabled accurate automated measurement of flexor tendon thickness on ultrasound in systemic sclerosis.

AI-Based Ultrasound Measurement of Tendon Thickness in Systemic Sclerosis

A proof-of-concept study developed a deep learning pipeline to automatically measure finger flexor tendon thickness on ultrasound images in patients with systemic sclerosis. The system successfully measured tendon thickness in 100% of images and showed strong agreement with expert measurements, with an intraclass correlation coefficient of 0.83 and mean absolute error of 0.25 mm.

CARDIOLOGY

Greater serum uric acid variability was associated with increased cardiovascular events and mortality in a meta-analysis.

Serum Uric Acid Variability and Cardiovascular Risk

A systematic review and meta-analysis of six cohort studies involving 160,640 adults found that greater variation in serum uric acid over time was associated with increased risks of all-cause mortality, cardiovascular disease/MACE, and cardiovascular mortality. Serial uric acid measurements may provide additional information for cardiovascular risk assessment beyond a single baseline measurement.

Left atrial appendage strain and strain rate may help predict atrial fibrillation recurrence after catheter ablation.

Left Atrial Strain Predicts AF Recurrence After Ablation

A study of 100 patients with atrial fibrillation found that 33% experienced recurrence within 1 year after radiofrequency catheter ablation. Patients with recurrence had poorer left atrial and left atrial appendage function, with lower strain and strain-rate measures. LA appendage strain and strain rate emerged as potential predictors of recurrence.

A review finds no strong link between chronic rhinosinusitis and metabolic dysfunction despite frequent metabolic comorbidities.

Chronic Rhinosinusitis and Metabolic Dysfunction: New Evidence

A systematic review of 53 studies involving more than 1.1 million patients with chronic rhinosinusitis found frequent metabolic comorbidities, including overweight/obesity (45.1%), hypertension (25.3%), dyslipidemia (22.0%), and diabetes (11.7%). However, CRS was not strongly associated with diabetes, hypertension, or elevated cholesterol compared with non-CRS populations.

Five-year survival of bone-anchored craniofacial implants was 46% after head and neck cancer surgery, with diabetes increasing loss risk.

Bone-Anchored Implant Survival After Head and Neck Cancer

A 20-year UK study of 184 bone-anchored craniofacial implants in 51 patients found survival fell from 94% at 1 year to 46% at 5 years, about half the rate reported in mixed populations. Diabetes significantly increased implant loss risk, while radiation showed a trend toward loss, supporting additional implants and lifelong follow-up.

ENDO-DIABETOLOGY

Review finds GLP-1 treatments linked to substantial fat-free mass loss, highlighting the need to assess strength and performance.

GLP-1 Drugs and Fat-Free Mass Loss: New Review

An updated review of 40 DXA-based reports found that people using GLP-1 receptor agonist-based obesity treatments lost an average 29.1% of their weight as fat-free mass. This remained at the upper end of losses seen with nonsurgical weight-loss approaches, highlighting the need to assess strength, physical performance, and body composition, especially in high-risk populations.

Medicare data suggest GLP-1 RAs may increase kidney and endometrial cancer risk, but further studies are needed.

GLP-1 RAs Linked to Higher Risk of Certain Cancers

A real-world Medicare study of patients with type 2 diabetes found no significant difference in overall cancer risk with GLP-1 receptor agonists versus SGLT2 or DPP-4 inhibitors. However, GLP-1 RA use was associated with higher risks of kidney cancer versus SGLT2 inhibitors and endometrial cancer versus DPP-4 inhibitors, warranting further validation.

Persistent Median Artery ...

Persistent Median Artery Used as Pedicle in RFFF Case