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Pseudomonas Aeruginosa Epidemiology And Antibiotic Resistance: A Five Years Retrospective Study In Iraq., Huda Ghassan Hameed

Al-Esraa University College Journal for Medical Sciences

One of the leading causes of diseases and deaths across the world are bacterial infections, and the situation is only going to grow worse as antibiotic resistance spreads. Antimicrobial resistance must be closely monitored so as to control the spread of multi-antibiotic-resistant microorganisms. As a result, the goal for the study was to estimate the prevalence of Pseudomonas aeruginosa infection on top of that to look into the antibacterial pattern over the last five years. This retrospective investigation was carried out in various hospitals in Iraq like Central Children's Teaching Hospital for Children, Al Kindi Teaching Hospital, Al-Numan Hospital, Yarmouk …

Cariesthe Effect Of Sweet Taste Perception On Dental Caries Experience In Relation To Age And Gender In Primary School Children, Mohammed H. Abdulaziz, Suha T. Abd

Al-Esraa University College Journal for Medical Sciences

This study aims to investigate the impact of sweet taste perception (sweet taste threshold and preference) on dental caries experience in relation to age and gender among a sample of schoolchildren. The research follows a cross-sectional observational design and includes 181 schoolchildren of both genders aged between 6 and 12 years from the Al-Risafa district of Baghdad city. The participants were divided into two age groups (6-8 and 9-12). Dental caries were assessed using the decayed, missing, and filled indices for primary and permanent teeth (dmfs, dmft, DMFS, and DMFT). Additionally, the sweet taste threshold and sweet taste preference were …

Determination The Effect Of Glucose On Btp, Lfabp Levels In The Patients With Diabetic Nephropathy, Zahraa Khalid Mahmood, Suhayr Aesa Al-Qaysi, Alaa Jafear Mahrath

Al-Esraa University College Journal for Medical Sciences

Everywhere in the globe, kidney illness is becoming more common, and there is no medication that can stop the progression of chronic kidney disease to end-stage renal disease, which is extremely expensive. Diabetes, kidney stones, accidents, and bleeding are the main contributors to kidney disease. The study was designed as a case control study. The study was involved (80) participants, only (36) were involved in this study and divided into two groups patients with nephropathy (23) and diabetic nephropathy (13) with age (20-65years) and BMI (19 -29 kg/m2). All these patients were diagnosed by nephrologist conducted in nephrology Clinic at …

Genetic Polymorphisms Of Aqp1 Rs10244884 Associated With Iron Deficiency Anemia In Baghdad City, Sawsan Hashim Hoshe, Moead E. Al Gazally, Hussein Naji Al-Shammari

Al-Esraa University College Journal for Medical Sciences

Most people throughout the world suffer from iron deficiency anemia (IDA). The morbidity rate is relatively high for such a complicated illness. Importantly, it has been identified that the aquaporin-1 polymorphism rs10244884 plays a critical role in iron homeostasis in the human body. The rs10244884 (T > C) polymorphism is significantly associated with iron levels and a variety of blood factors, leading to iron deficiency anemia (IDA). Venous blood samples were collected from (100) people in this analytical (case and control) investigation, including (50) patients with iron deficiency anemia and (50) healthy volunteers as a control group. The following parameters were …

Using Artificial Intelligence To Diagnose Demented In The Elderly, Ohood Fadil Alwan

Al-Esraa University College Journal for Engineering Sciences

In addition to possible other symptoms, memory loss and impairment are the hallmarks of Demented or Alzheimer’s disease (AD). Despite the fact that dementia is incurable and has a significant negative impact on patients' lives, an early diagnosis can help start the right treatment and prevent additional brain damage. Over the years, machine learning techniques have been used to classify AD; nevertheless, the efficacy of the results depends on the use of multi-step classifiers and manually created features. Thanks to recent advances in deep learning, patterns may now be classified using neural networks' final stage. In order to diagnose dementia …

Risk Detection Of Gestational Diabetes In Early Pregnancy Depend On Artificial Neural Network, Sanaa Hammad Dhahi

Al-Esraa University College Journal for Engineering Sciences

Early prediction of gestational diabetes mellitus (GDM) risk is particularly important because it may enable more effective interventions and reduce cumulative maternal and fetal injury. The aim of this study is to develop machine learning (ML) models for early prediction of GDM using widely available variables, facilitating early intervention, and enabling the application of prediction models in settings where more complex tests are not accessible. In this paper, an artificial neural network (ANN) was used to detect the risk of gestational diabetes. A global dataset was used to collect clinical and experimental data from pregnant women and people with diabetes …

The Neutrosophic Regular And Most Important Properties That Bind Neutrosophic Ring Elements, Murhaf Riad Alabdullah

Neutrosophic Sets and Systems

No abstract provided.

An Enhanced Generalized Neutrosophic Number And Its Role In Multi-Criteria Decision-Making Challenges, Sumathi I. R, Augus Kurian, Parvathy K

Neutrosophic Sets and Systems

No abstract provided.

Neutrosophic Sets And Systems, Vol. 61,2023, Florentin Smarandache, Mohamed Abdel-Basset, Said Broumi

Neutrosophic Sets and Systems

No abstract provided.

The Concise Guide To Pharmacology 2023/24: Catalytic Receptors, Stephen P.H. Alexander, Doriano Fabbro, Eamonn Kelly, Alistair A. Mathie, John A. Peters, Emma L. Veale, Jane F. Armstrong, Elena Faccenda, Simon D. Harding, Jamie A. Davies, Annie Beuve, Peter Brouckaert, Clare Bryant, John C. Burnett, Richard W. Farndale, Andreas Friebe, John Garthwaite, Adrian J. Hobbs, Gavin E. Jarvis, Doris Koesling, Michaela Kuhn, David Macewan, Tom P. Monie, Lincoln R. Potter, Michael Russwurm, Harald H.H.W. Schmidt, Johannes-Peter Stasch, Scott A. Waldman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

The Concise Guide to PHARMACOLOGY 2023/24 is the sixth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of approximately 1800 drug targets, and nearly 6000 interactions with about 3900 ligands. There is an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (https://www.guidetopharmacology.org/), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes almost 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It …

Evaluation Of A Targeted Covid-19 Community Outreach Intervention: Case Report For Precision Public Health, Isela De La Cerda, Cici X Bauer, Kehe Zhang, Miryoung Lee, Michelle Jones, Arturo Rodriguez, Joseph B Mccormick, Susan P Fisher-Hoch

Faculty, Staff and Student Publications

BACKGROUND: Cameron County, a low-income south Texas-Mexico border county marked by severe health disparities, was consistently among the top counties with the highest COVID-19 mortality in Texas at the onset of the pandemic. The disparity in COVID-19 burden within Texas counties revealed the need for effective interventions to address the specific needs of local health departments and their communities. Publicly available COVID-19 surveillance data were not sufficiently timely or granular to deliver such targeted interventions. An agency-academic collaboration in Cameron used novel geographic information science methods to produce granular COVID-19 surveillance data. These data were used to strategically target an …

The Potential For Development Of Clinically Relevant Microbial Resistance To Rifaximin-Α: A Narrative Review, Herbert L Dupont

Faculty, Staff and Student Publications

Rifaximin-α is a gut-targeted antibiotic indicated for numerous gastrointestinal and liver diseases. Its multifaceted mechanism of action goes beyond direct antimicrobial effects, including alterations in bacterial virulence, cytoprotective effects on host epithelial cells, improvement of impaired intestinal permeability, and reduction of proinflammatory cytokine expression via activation of the pregnane X receptor. Rifaximin-α is virtually non-absorbed, with low systemic drug levels contributing to its excellent safety profile. While there are high concentrations of drug in the colon, low water solubility leads to low colonic drug bioavailability, protecting the gut microbiome. Rifaximin-α appears to be more active in the bile-rich small bowel. …

Prt543, A Protein Arginine Methyltransferase 5 Inhibitor, In Patients With Advanced Adenoid Cystic Carcinoma: An Open-Label, Phase I Dose-Expansion Study, Renata Ferrarotto, Paul Swiecicki, Dan Zandberg, Robert Baiocchi, Robert Wesolowski, Cristina Rodriguez, Meredith Mckean, Hyunseok Kang, Varun Monga, Rajneesh Nath, Neil Palmisiano, Naveen Babbar, William Sun, Glenn Hanna

Department of Medical Oncology Faculty Papers

OBJECTIVES: Currently, no systemic treatments are approved for patients with recurrent and/or metastatic (R/M) adenoid cystic carcinoma (ACC). PRT543, a protein arginine methyltransferase 5 inhibitor that downregulates NOTCH1 and MYB signalling in tumours, is a potential candidate for R/M ACC treatment. We report the safety, tolerability and preliminary efficacy of PRT543 in a dose-expansion cohort of patients with R/M ACC.

MATERIALS AND METHODS: This phase I multicentre, open-label, sequential-cohort, dose-escalation and dose-expansion study (NCT03886831) enrolled patients with advanced solid tumours and select haematologic malignancies. Dose-escalation study design and results were reported previously. In the dose expansion, patients with R/M ACC …

Challenges And Countermeasures For Treatment And Remediation Of Contaminated Mega-Sites In China, Xiaoyong Liao, Yixuan Hou, You Li, Tianyi Wang

Bulletin of Chinese Academy of Sciences (Chinese Version)

The treatment and remediation of pollution at contaminated mega-sites poses a significant challenge in the environmental science both domestically and internationally. Contaminated mega-sites are characterized by their widespread impact, multiple types of pollutants, and significant ecological and environmental threats. The environmental behavior cognition and efficient remediation at contaminated mega-sites face enormous challenges, among which key technological issues such as the formation mechanism of soil and groundwater pollution, accurate identification of pollution sources, and intelligent decision-making optimization urgently need to be solved. In China, contaminated mega-sites are concentrated in economically developed regions such as Beijing-Tianjin-Hebei, the Yangtze River Economic Belt, and …

Scenario Simulation Of “35 Goals” And “50 Vision” For Beautiful China Initiative, Huiyi Zhu, Linsheng Yang, Wei Qi, Erqi Xu, Jiewei Chen, Quansheng Ge

Bulletin of Chinese Academy of Sciences (Chinese Version)

Realizing the Beautiful China Initiative is the general goal of China’s ecological civilization construction in the next 30 years. The overall goal includes two phased goals: “35 goals” and “50 vision”. This study first expounds the understanding of the goal from the aspects of ecosystem elements, structure, process, and function, and then constructs an index system to describe the goal and simulates the “35 goals” and “50 vision” under the trend of climate change, population decline and economic growth. The results show that, by 2035, China will have a population of 1.44 billion (including Hong Kong, Macao, and Taiwan) and …

Ten Problems And Solutions For Restoration Of Karst Ecosystem In Southwest China, Xiaoyong Bai, Sirui Zhang, Chen Ran, Luhua Wu, Chaochao Du, Lei Dai, Xingyi Yang, Zilin Li, Yingying Xue, Mingkang Long, Minghui Li, Shu Yang, Qing Luo, Xiaoyun Zhang, Xiaoqian Shen, Fei Chen, Qin Li, Yuanhong Deng, Zeyin Hu, Chaojun Li

Bulletin of Chinese Academy of Sciences (Chinese Version)

The karst areas in southwest China are one of the key but difficult areas targeted in the “Beautiful China” construction initiative, which focuses on soil erosion, proportion of farmland, water pollution, karst drought, ecological restoration, carbon sink, ecological effects of urbanization, rocky desertification management indicators, and biodiversity and sustainability assessment. The study synthesizes the knowledge accumulated during ecological restoration practice in karst areas into 10 problems and solutions that are strong, universal and empirically supported. These problems and solutions help to explain the challenges of achieving sustainability in karst ecology restoration and thus point to solutions. They constitute a core …

Evolution Of Urbanized Area’S Entities And Flow Space Towards High-Quality Development Path In China, Mingxing Chen, Liangkan Chen, Yue Xian, Jiafan Cheng, Longwu Liang, Jing Ma

Bulletin of Chinese Academy of Sciences (Chinese Version)

The eco-environmental conservation and Beautiful China have entered the critical phase. Urbanized areas serve as important spatial carriers in the Beautiful China initiative scenarios, but the most prominent challenges in human-environment relationship and difficult points in building Beautiful China. This study focuses on the physical urban area, and utilizing big data technology to reexamine the spatiotemporal distribution and grouped evolution characteristics of impervious surface in cities, as well as the structural features of urban flow networks from space of flows. Moreover, preliminary thoughts and policy recommendations are provided for promoting high-quality development in urbanized areas of the new era. More …

Five Issues And Countermeasures Of China Cropland Resource Use, Sijing Ye, Changqing Song, Changxiu Cheng, Peichao Gao, Shi Shen, Wangshu Mu

Bulletin of Chinese Academy of Sciences (Chinese Version)

Understand the cropland use situation, analyze management countermeasures, and explore the regional suitable cropland use mode are important prerequisites for the implementation of the strictest protection of cultivated land strategy with Chinese characteristics. At present, the cropland resource utilization in China is facing the five issues of non-agricultural, non-grain, fragmentation, marginalization, and ecological degradation. This study estimates the spatial-temporal changes of these cropland use issues in China, analyzes the challenges of cropland use governance from the aspects of complex driving factors, phase characteristics, cognitive differences of responsible subjects, and dynamic changes of external factors. On this basis, the countermeasures of …

Stereotactic Mr-Guided On-Table Adaptive Radiation Therapy (Smart) For Borderline Resectable And Locally Advanced Pancreatic Cancer: A Multi-Center, Open-Label Phase 2 Study, Michael Chuong, Percy Lee, Daniel Low, Joshua Kim, Kathryn Mittauer, Michael Bassetti, Carri Glide-Hurst, Ann Raldow, Yingli Yang, Lorraine Portelance, Kyle Padgett, Bassem Zaki, Rongxiao Zhang, Hyun Kim, Lauren Henke, Alex Price, Joseph Mancias, Christopher Williams, John Ng, Ryan Pennell, M Raphael Pfeffer, Daphne Levin, Adam Mueller, Karen Mooney, Patrick Kelly, Amish Shah, Luca Boldrini, Lorenzo Placidi, Martin Fuss, Parag Jitendra Parikh

Department of Radiation Oncology Faculty Papers

BACKGROUND AND PURPOSE: Radiation dose escalation may improve local control (LC) and overall survival (OS) in select pancreatic ductal adenocarcinoma (PDAC) patients. We prospectively evaluated the safety and efficacy of ablative stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) for borderline resectable (BRPC) and locally advanced pancreas cancer (LAPC). The primary endpoint of acute grade ≥ 3 gastrointestinal (GI) toxicity definitely related to SMART was previously published with median follow-up (FU) 8.8 months from SMART. We now present more mature outcomes including OS and late toxicity.

MATERIALS AND METHODS: This prospective, multi-center, single-arm open-label phase 2 trial (NCT03621644) enrolled 136 …

Research Priorities For Children’S Cancer: A James Lind Alliance Priority Setting Partnership In The Uk, Susie Aldiss, Rachel Hollis, Bob Phillips, Ashley Ball-Gamble, Alex Brownsdon, Julia Chisholm, Scott Crowther, Rachel Dommett, Jonathan Gower, Nigel J Hall, Helen Hartley, Jenni Hatton, Louise Henry, Loveday Langton, Kirsty Maddock, Sonia Malik, Keeley Mcevoy, Jessica Elizabeth Morgan, Helen Morris, Simon Parke, Sue Picton, Rosa Reed-Berendt, Dan Saunders, Andy Stewart, Wendy Tarplee-Morris, Amy Walsh, Anna Watkins, David Weller, Faith Gibson

Faculty, Staff and Student Publications

OBJECTIVES: To engage children who have experienced cancer, childhood cancer survivors, their families and professionals to systematically identify and prioritise research questions about childhood cancer to inform the future research agenda.

DESIGN: James Lind Alliance Priority Setting Partnership.

SETTING: UK health service and community.

METHODS: A steering group oversaw the initiative. Potential research questions were collected in an online survey, then checked to ensure they were unanswered. Shortlisting via a second online survey identified the highest priority questions. A parallel process with children was undertaken. A final consensus workshop was held to determine the Top 10 priorities.

PARTICIPANTS: Children and …

Bacterial Outer Membrane Vesicles Provide An Alternative Pathway For Trafficking Of Escherichia Coli O157 Type Iii Secreted Effectors To Epithelial Cells, Natalie Sirisaengtaksin, Eloise J O'Donoghue, Sara Jabbari, Andrew J Roe, Anne Marie Krachler

Faculty, Staff and Student Publications

Outer membrane vesicles (OMVs) are proteoliposomes shed by Gram-negative bacteria. Their secretion is enhanced by the transition into the intra-host milieu, and OMVs play critical roles during pathogenesis. Enterohemorrhagic Escherichia coli O157 (EHEC) can cause diarrheal disease in humans, and soluble toxins including Shiga-like toxins that contribute to disease severity and clinical complications like hemolytic uremic syndrome have been shown to be OMV associated. In addition to Shiga-like toxins, EHEC produces a type III secretion system (T3SS), and T3SS effectors are associated with colonization and disease severity in vivo. Here, we show that type III secreted substrates including translocators …

Colonization Of Larval Zebrafish (Danio Rerio) With Adherent-Invasive Escherichia Coli Prevents Recovery Of The Intestinal Mucosa From Drug-Induced Enterocolitis, Erika Flores, Soumita Dutta, Rachel Bosserman, Ambro Van Hoof, Anne-Marie Krachler

Faculty, Staff and Student Publications

Although inflammatory bowel diseases are on the rise, what factors influence IBD risk and severity, and the underlying mechanisms remain to be fully understood. Although host genetics, microbiome, and environmental factors have all been shown to correlate with the development of IBD, cause and effect are difficult to disentangle in this context. For example, AIEC is a known pathobiont found in IBD patients, but it remains unclear if gut inflammation during IBD facilitates colonization with AIEC, or if AIEC colonization makes the host more susceptible to pro-inflammatory stimuli. It is critical to understand the mechanisms that contribute to AIEC infections …

Colonization Of Larval Zebrafish (Danio Rerio) With Adherent-Invasive Escherichia Coli Prevents Recovery Of The Intestinal Mucosa From Drug-Induced Enterocolitis, Erika Flores, Soumita Dutta, Rachel Bosserman, Ambro Van Hoof, Anne-Marie Krachler

Faculty, Staff and Student Publications

Although inflammatory bowel diseases are on the rise, what factors influence IBD risk and severity, and the underlying mechanisms remain to be fully understood. Although host genetics, microbiome, and environmental factors have all been shown to correlate with the development of IBD, cause and effect are difficult to disentangle in this context. For example, AIEC is a known pathobiont found in IBD patients, but it remains unclear if gut inflammation during IBD facilitates colonization with AIEC, or if AIEC colonization makes the host more susceptible to pro-inflammatory stimuli. It is critical to understand the mechanisms that contribute to AIEC infections …

Effects Of Episodic Food Insecurity On Psychological And Physiological Responses In African American Women With Obesity (Responses): Protocol For A Longitudinal Observational Cohort Study, Candice A. Myers, Robbie A. Beyl, Daniel S. Hsia, Melissa N. Harris, Isabella J. Reed, Danielle D. Eliser, Lauren Bagneris, John W. Apolzan

School of Public Health Faculty Publications

Background; Food insecurity is a risk factor for multiple chronic diseases, including obesity. Importantly, both food insecurity and obesity are more prevalent in African American women than in other groups. Furthermore, food insecurity is considered a cyclic phenomenon, with episodes of food adequacy (ie, enough food to eat) and food shortage (ie, not enough food to eat). More research is needed to better understand why food insecurity is linked to obesity, including acknowledging the episodic nature of food insecurity as a stressor and identifying underlying mechanisms. Objective; The objective of this study is to investigate the episodic nature of food …

No Family For The Holidays In Sacramento: California's Capital Lags Far Behind Most Every Other Major California County In Placing Foster Children With Family Members, Children's Advocacy Institute, University Of San Diego School Of Law

CAI Special Reports

No abstract provided.

Rapidiron Trial Follow-Up Study - The Rapidiron-Kids Study: Protocol Of A Prospective Observational Follow-Up Study, Richard Derman, Roopa Bellad, Mrutyunjaya Bellad, Jesse Bradford-Rogers, Michael Georgieff, Zubair Aghai, Simal Thind, Michael Auerbach, Rupsa Boelig, Benjamin Leiby, Vanessa Short, S. Yogeshkumar, Umesh Charantimath, Manjunath Somannavar, Ashalata Mallapur, Ramesh Pol, Umesh Ramadurg, Radha Sangavi, Basavaraj Peerapur, Nasima Banu, Praveen Patil, Amaresh Patil, Subarna Roy, Phaniraj Vastrad, Dennis Wallace, Hemang Shah, Shivaprasad Goudar

Global Health Articles

BACKGROUND: Anemia is a worldwide problem with iron deficiency being the most common cause. When anemia occurs in pregnancy, it increases the risk of adverse maternal, fetal, and postnatal outcomes. It induces preterm births and low birth weight (LBW) deliveries, long-term neurodevelopmental sequelae, and an increased risk of earlier onset of postnatal iron deficiency. Anemia rates are among the highest in South Asia, and India's National Family Health Survey (NFHS-5) for 2019-2021 indicated that over half of pregnant women, and more than 65% of children, in the country are classified as anemic (Sciences IIfP, National Family Health Survey-5, 2019-21, India …

Practice Profile Of Practicing Plastic Surgeons: A 20-Year Review Of Plastic Surgery Statistics, Kristof S. Gutowski, Emily S. Chwa, Joshua P. Weissman, Stuti P. Garg, Christopher J. Simmons, Keith E. Brandt, Arun K. Gosain

Student Publications

Background: Evaluation of practice patterns by American Board of Plastic Surgery (ABPS) diplomates allows for a greater understanding as to how the field is progressing. Understanding evolving procedural trends can give insight into plastic surgeons' subspecialty focus and influence resident training to prepare them for future practice.

Methods: American Society of Plastic Surgeons member only projections for aesthetic and reconstructive procedures were reviewed from 1999 to 2018 in 5-year increments to identify shifts in frequency between the beginning (1999-2003) and end (2014-2018) of the timeframe. Tracer utilization for all four ABPS modules were also examined between 2014 and 2018. Descriptive …

Characterization Of 3d Printed Lattice Structures Used In The Design Of Modified Compression Release Stabilized Transhumeral Prosthetic Sockets, Jade Myers

Theses

Abstract A prosthetic socket is the critical interface between a person and their prosthetic device. Pressure, shear, and friction experienced by the residual limb from wearing a socket can damage soft tissue. While Compression Release Stabilized (CRS) style sockets are beneficial for enhancing prosthesis stability, range of motion, and control, the abrupt differences in compression throughout the socket present risks for tissue damage to the residual limb. A socket design that enables clinicians to control a progressive decrease in firmness in the transition areas between compression and release could mitigate such undesirable effects. Density-graded lattice structures designed and produced with …

Abnormal Patterns Of Sleep And Waking Behaviors Are Accompanied By Neocortical Oscillation Disturbances In An Ank3 Mouse Model Of Epilepsy-Bipolar Disorder Comorbidity, Juan E Villacres, Nicholas Riveira, Sohmee Kim, Laura L Colgin, Jeffrey L Noebels, Angel Y Lopez

Faculty, Staff and Students Publications

ANK3 is a leading bipolar disorder (BD) candidate gene in humans and provides a unique opportunity for studying epilepsy-BD comorbidity. Previous studies showed that deletion of Ank3-1b, a BD-associated variant of Ank3 in mice leads to increased firing threshold and diminished action potential dynamic range of parvalbumin (PV) interneurons and absence epilepsy, thus providing a biological mechanism linking epilepsy and BD. To explore the behavioral overlap of these disorders, we characterized behavioral patterns of Ank3-1b KO mice during overnight home-cage activity and examined network activity during these behaviors using paired video and EEG recordings. Since PV interneurons contribute to the …

Pediatric Endocrinology Milestones 20-Guide To Their Implementation, Cara V Tillotson, Imen Becetti, Katherine Hwu, Laura Page, Sowmya Krishnan, Dianne Stafford, Takara Stanley, Patricia Vuguin, Jennifer M Barker

Faculty, Staff and Students Publications

The Milestones were initiated by the Accreditation Council for Graduate Medical Education (ACGME) to provide a framework for monitoring a trainee's progression throughout residency/fellowship. The Milestones describe stepwise skill progression through six core domains of clinical competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-based Learning and Improvement, Professionalism, and Systems-based Practice. Since their introduction in 2013, several barriers to implementation have emerged. Thus, the ACGME launched the Milestones 2.0 project to develop updated specialty-specific milestones. The Pediatric Endocrinology Milestones 2.0 project aimed to improve upon Milestones 1.0 by addressing common limitations, providing resources for faculty to easily incorporate …