High-affinity chimeric antigen receptor signaling induces an inflammatory program in human regulatory T cells.

Regulatory T cells (Tregs) are promising cellular therapies to induce immune tolerance in organ transplantation and autoimmune disease. The success of chimeric antigen receptor (CAR) T cell therapy for cancer has sparked interest in using CARs to generate antigen-specific Tregs. Here, we compared CAR with endogenous T cell receptor (TCR)/CD28 activation in human Tregs.

Global health in axial spondyloarthritis: thresholds for the Assessment of SpondyloArthritis international Society Health Index and the EuroQol score: analysis of the ASAS-PerSpA study.

Objectives: In axial spondyloarthritis (axSpA), patient-perceived quality of life/global functioning and health (GH) can be assessed using disease-specific [Assessment of SpondyloArthrit is international Society Health Index (ASAS-HI)] or generic [(3-level EuroQol 5 Dimensions (EQ-5D-3L)] scores. Our objectives were to explore the link between these scores and to define thresholds for good and poor GH.

Method: We conducted a post-hoc analysis of the cross-sectional ASAS-PerSpA study for patients fulfilling ASAS criteria for axSpA.

Guideline-Directed Medical Therapy After Hospitalization for Acute Heart Failure: Insights From the CONNECT-HF.

Background: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

Methods And Results: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction.

A Systematic Review of the Diagnostic Accuracy of Deep Learning Models for the Automatic Detection, Localization, and Characterization of Clinically Significant Prostate Cancer on Magnetic Resonance Imaging.

Background And Objective: Magnetic resonance imaging (MRI) plays a critical role in prostate cancer diagnosis, but is limited by variability in interpretation and diagnostic accuracy. This systematic review evaluates the current state of deep learning (DL) models in enhancing the automatic detection, localization, and characterization of clinically significant prostate cancer (csPCa) on MRI.

Methods: A systematic search was conducted across Medline/PubMed, Embase, Web of Science, and ScienceDirect for studies published between January 2020 and September 2023.

Iatrogenic emboli during mechanical thrombectomy for acute ischemic stroke: comparison between stent retriever technique and contact aspiration-a retrospective case-control study.

Background: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke from large vessel occlusion (LVO). While embolization to a new territory (ENT) after MT is well-documented, data on embolization in the same distal territory (EDT) are limited. Achieving modified Treatment In Cerebral Infarction (mTICI) 3 reperfusion presents significant clinical benefits over mTICI 2b/2c, necessitating strategies to reduce both ENT and EDT.

Psychometric Scales of the Strong Black Woman Construct Evaluating Stress-Related Health Disparities among African American Women: A Scoping Review.

This scoping review delves into psychometric measures assessing the strong Black woman and superwoman constructs among African American women. It evaluates various scales, emphasizing their clinical relevance and implications for women's health. By recognizing and addressing unique stressors faced by Black women, health care interventions can be tailored to promote holistic well-being and mitigate adverse health outcomes.

scToppR: a coding-friendly R interface to ToppGene.

Motivation: The scToppR package provides a ToppGene interface from R programs/scripts to fully access/control the database for functional enrichment without the need for active interaction on its Web site (https://toppgene.cchmc.org/).

Virtual Reality Strategies for Promoting Mobility in the Intensive Care Unit: A Case Report.

Prolonged bed rest is a known contributor to muscle atrophy, weakness, and deconditioning. Early active mobilization protocols aim to combat acquired weakness and loss of function in patients in the intensive care unit. Despite these benefits, mobilization of patients in the intensive care unit remains a challenge, most notably for patients with limited ability to get out of bed because of invasive devices and prolonged hospitalization.

A tight anterosuperior intercondylar notch may increase the risk of cyclops syndrome after anterior cruciate ligament reconstruction using a quadruple semi-tendinosus short autograft.

Background: Cyclops syndrome is loss of terminal knee extension caused by a fibrous nodule developed in the anterior intercondylar notch. The many known risk factors include preoperative motion-range limitation, tibial tunnel malposition, and tight hamstrings. The primary objective of this study was to assess whether intercondylar notch size was associated with the risk of cyclops syndrome or graft tear after anterior cruciate ligament (ACL) reconstruction using a quadruple semi-tendinosis autograft.

Single-nucleus and spatial landscape of the sub-ventricular zone in human glioblastoma.

The sub-ventricular zone (SVZ) is the most well-characterized neurogenic area in the mammalian brain. We previously showed that in 65% of patients with glioblastoma (GBM), the SVZ is a reservoir of cancer stem-like cells that contribute to treatment resistance and emergence of recurrence. Here, we built a single-nucleus RNA-sequencing-based microenvironment landscape of the tumor mass (T_Mass) and the SVZ (T_SVZ) of 15 GBM patients and 2 histologically normal SVZ (N_SVZ) samples as controls.

Remote Follow-up in a Heart Failure Pragmatic Trial: Insights From the CONNECT-HF.

Background: Randomized controlled trials typically require study-specific visits, which can burden participants and sites. Remote follow-up, such as centralized call centers for participant-reported or site-reported, holds promise for reducing costs and enhancing the pragmatism of trials. In this secondary analysis of the CONNECT-HF (Care Optimization Through Patient and Hospital Engagement For HF) trial, we aimed to evaluate the completeness and validity of the remote follow-up process.

Disease activity and widespread pain are main contributors to patient-reported global health in axial spondyloarthritis: an analysis of 6064 patients.

Global health (GH) and health-related quality of life are patient priorities in axial spondyloarthritis (axSpA). Our objective was to assess the relative importance of disease-related factors including disease activity, and patient-related factors including comorbidities, to explain GH in axSpA. Post hoc cross-sectional analyses of 4 sets (COMOSPA, PERSPA, COMEDSPA, and DESIR) of patients fulfilling ASAS criteria for axSpA.

A randomized controlled trial evaluating a theory driven, complex intervention centered on task sharing and mobile health to improve selfcare and outcomes in heart failure - The PANACEA-HF RCT: Design and rationale.

Background: We developed a three-pronged complex intervention to improve selfcare and deliver whole person care for patients with heart failure, underpinned by the 'extant cycle' theory - a theory based on our formative work.

Methods: This is a 3 centre, 2-arm, 1:1, open, adaptive stratified, randomized controlled trial. We included patients aged ≥ 18 years with heart failure, taking any of the key guideline directed medical treatments, with a history of or currently on a high ceiling diuretic.

Short peripheral blood leukocyte telomere length in rheumatoid arthritis-interstitial lung disease.

Shortened telomere lengths (TLs) can be caused by single nucleotide polymorphisms and loss-of-function mutations in telomere-related genes (TRG), as well as ageing and lifestyle factors such as smoking. Our objective was to determine if shortened TL is associated with interstitial lung disease (ILD) in individuals with rheumatoid arthritis (RA). This is the largest study to demonstrate and replicate that shortened peripheral blood leukocytes-TL is associated with ILD in patients with RA compared with RA without ILD in a multinational cohort, and short PBL-TL was associated with baseline disease severity in RA-ILD as measured by forced vital capacity percent predicted.

Impact and Sustainability of a Palliative Care Education Module in Patients With Heart Failure.

Background: Approximately 6.7 million American adults are living with heart failure (HF). Current therapies are geared toward preventing progression and managing symptoms, as there is no cure.

Applying the RE-AIM framework to evaluate an educational model to "close the gap" and improve health equity in uncontrolled hypertension.

Objectives: To use the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to evaluate an educational model addressing self-management of uncontrolled hypertension.

Methods: We used a pre-post single cohort design to identify minoritized patients with uncontrolled hypertension (systolic > 160 mmHg and/or diastolic > 100 mmHg). Trained Ambassadors provided telephone outreach, skill-based blood pressure (BP) monitoring, and goal-setting for 4 months.

Evaluation of lay health workers on quality of care in the inpatient setting.

Aims: To evaluate the impact of a lay health worker support role in the inpatient setting.

Background: Healthcare systems are facing critical nursing and nurse assistant staffing shortages. These disciplines can be challenging to recruit and retain, leading healthcare leaders to identify innovative staffing models.

Novel scores relevant to antimicrobial resistance and hospital-acquired infections developed with data from a multi-hospital consortium in the Parisian region of France.

Purpose: Indicators for comparing and understanding differences in antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) for benchmarking are essential to identify priorities for hospitals.

Methods: This study measured the incidence of hospital-acquired or resistant Gram-negative bacilli bloodstream infections (GNB-BSIs) in a large public healthcare consortium in the Parisian region of France.

Results: Within each hospital, there was a strong positive correlation between the incidence of GNB-BSIs due to resistant GNB and the incidence of hospital-acquired GNB-BSIs.