Evaluating the Management of Intermittent Claudication before and after Publication of the Society of Vascular Surgery's Appropriate Use Criteria.

Objectives: In April 2022, the Society for Vascular Surgery (SVS) published the Appropriate Use Criteria (AUC) for the management of intermittent claudication (IC). Our goal was to compare practice patterns before and after publication of the AUC to identify changes.

Methods: The Vascular Quality Initiative (VQI) peripheral vascular intervention (PVI), and suprainguinal, and infrainguinal bypass registries were analyzed for interventions for IC.

Delirium Among Liver Transplant Recipients: A National Analysis Using MarketScan.

Introduction: Delirium is a common issue following liver transplantation (LT), but research has mainly focused on single-center cohorts.

Methods: We studied delirium in a national cohort of adult LT recipients transplanted October, 2015-December, 2020 using the MarketScan database. Claims data were used to identify LT recipients with delirium.

Illuminating the multidimensional contributions of small-scale fisheries.

Sustainable development aspires to "leave no one behind". Even so, limited attention has been paid to small-scale fisheries (SSF) and their importance in eradicating poverty, hunger and malnutrition. Through a collaborative and multidimensional data-driven approach, we have estimated that SSF provide at least 40% (37.

Challenges and potential solutions to enrollment in a clinical trial of arteriovenous fistula vs arteriovenous graft vascular access strategy.

This article presents the rationale, challenges, and adaptive strategies employed during the initiation and execution of the arteriovenous (AV) access trial-a multicenter randomized controlled trial (RCT) comparing AV fistulas and AV grafts for hemodialysis in older adults with major comorbidities. Motivated by shifts in epidemiologic landscapes and evolving guidelines moving away from a fistula-first approach and to more patient-centric approaches, the objective of this randomized controlled trial was to fill critical knowledge gaps in determining the optimal vascular access for this complex patient population. We outline the challenges encountered in patient recruitment along with measures employed to overcome these obstacles in recruitment.

Using supervised machine learning and ICD10 to identify non-accidental trauma in pediatric trauma patients in the Maryland Health Services Cost Review Commission dataset.

Background: Identifying non-accidental trauma (NAT) in pediatric trauma patients is challenging. We developed a machine learning model that uses demographic characteristics and ICD10 codes to detect the first diagnosis of NAT.

Methods: We analyzed data from the Maryland Health Services Cost Review Commission (2015-2020) for patients aged 0-19 years.

Phasic dopamine release in two different rat models of attention-deficit/hyperactivity disorder: Spontaneously hypertensive rats (SHR) versus Lphn3 knockout rats.

We examined DA activity in the medial prefrontal cortex (mPFC) and nucleus accumbens core (NAcc) in two Different Rat Models of Attention-Deficit/Hyperactivity Disorder: Spontaneously Hypertensive Rats (SHR) Versus Lphn3 Knockout Rats. We examined baseline stimulation-evoked phasic DA release, half-life, and DA autoreceptor (DAR) functioning in the mPFC and NAcc, as well as the response to nomifensine (10 mg/kg, IP), a DA transporter (DAT) blocker, on these measures in the NAcc. Both rat models were hypodopaminergic, with notable regional and mechanistic differences.

Systematic Review of Pain Assessment Measures Used in Pediatric Acute Lymphoblastic Leukemia.

Background: Pain is a prevalent, frequent, and often persistent symptom among children with acute lymphoblastic leukemia (ALL). Despite its high prevalence, pain has remained understudied, and no evidence-based recommendations exist for how best to assess and treat pain in this population. Without proper assessment, clinical efforts to improve pain management in pediatric ALL will be ineffective.

ALK-positive anaplastic large cell lymphoma initially diagnosed as neurosarcoidosis in a 12-year-old girl.

We present a rare case of optic neuropathy due to anaplastic lymphoma kinase-positive (ALK+) anaplastic large cell lymphoma (ALCL) with optic nerve infiltration in a 12-year-old girl who presented with acute unilateral vision loss, diplopia, and headache after two prior hospitalizations at an outside facility for disk edema. She had a presumptive diagnosis of neurosarcoidosis and empiric treatment had been initiated with high-dose corticosteroids. Ongoing worsening of vision prompted presentation at our facility.

Identification and Confirmation of Virulence Factor Production from , a Causal Agent of Root Rot in Pulses.

is an aggressive pathogen of pulse crops and a causal agent in root rot disease that negatively impacts Canadian agriculture. This study reports the results of a targeted metabolomics-based profiling of secondary metabolism in an 18-strain panel of cultured axenically in multiple media conditions, in addition to an in planta infection assay involving four strains inoculated on two pea cultivars. Multiple secondary metabolites with known roles as virulence factors were detected which have not been previously associated with , including fungal decalin-containing diterpenoid pyrones (FDDPs), fusaoctaxins, sambutoxin and fusahexin, in addition to confirmation of previously reported secondary metabolites including enniatins, fusarins, chlamydosporols, JM-47 and others.

Fenestrated and Branched Endovascular Aortic Repair and Mortality at Hospitals Without Investigational Device Trials.

Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).

Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.

CoREST Complex Inhibition Alters RNA Splicing to Promote Neoantigen Expression and Enhance Tumor Immunity.

Unlabelled: Epigenetic complexes tightly regulate gene expression and colocalize with RNA splicing machinery; however, the consequences of these interactions are uncertain. Here, we identify unique interactions of the CoREST repressor complex with RNA splicing factors and their functional consequences in tumorigenesis. Using mass spectrometry, in vivo binding assays, and cryo-EM we find that CoREST complex-splicing factor interactions are direct and perturbed by the CoREST complex inhibitor, corin, leading to extensive changes in RNA splicing in melanoma and other malignancies.

Effectiveness of dolutegravir-based regimens compared to raltegravir-, elvitegravir-, bictegravir, and darunavir-based regimens among older adults with HIV in the Veterans Aging Cohort Study (VACS).

Background: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.

Methods: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights.

Race/ethnicity, sex, and age differences in pediatric SCAT-5 concussion symptoms.

Objective: To examine sociodemographic differences in concussion symptom reporting, among young children by race/ethnicity, sex, and age at initial presentation to guide potential interventions for children from different backgrounds.

Method: Participants were elementary-age children (ages 5 to 12 years;  = 392) who sustained a concussion within 30 days of specialty concussion clinic visit. Independent variables were self-defined race/ethnic group, participants' sex, and age.

Virtual reality obstacle avoidance training can be enhanced by physical feedback via perturbations: A proof-of-concept study.

Background: Fall injuries resulting from trips are a major health concern. Virtual reality (VR) offers an effective way of training obstacle avoidance while walking due to its ability to provide safe and meaningful real-time feedback during rehabilitation. This proof-of-concept study examined the benefit of providing physical feedback during obstacle avoidance gait training using VR.

The Critical Role of Host and Bacterial Extracellular Vesicles in Endometriosis.

Endometriosis is a chronic, inflammatory, oestrogen-dependent disorder that is defined by the presence of endometrium-like tissue in the extra-uterine environment. It is estimated to affect approximately 10% of women of reproductive age, and the cause is still largely unknown. The heterogenous nature and complex pathophysiology of the disease results in diagnostic and therapeutic challenges.

A standardized carotid endarterectomy care pathway is associated with lower ICU admission rates and a significant reduction in hospital charges.

Background: This study investigated the outcomes before and after initiation of a postoperative care pathway for carotid endarterectomy (CEA) patients.

Methods: A CEA pathway was developed with stakeholders. We compared in-hospital outcomes and charges (USD) for patients undergoing CEA 18 months before (11/2019-04/2021) vs.

Rapid viral suppression using integrase inhibitors during acute HIV-1 infection.

Background: Antiretroviral therapy (ART) is recommended for all individuals with HIV infection, including those with acute HIV-1 infection (AHI). While recommendations are similar to those for chronic infection, efficacy data regarding treatment of acute HIV is limited.

Methods: This was a single arm, 96-week study of a once-daily integrase inhibitor (INSTI)-based regimen using elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) in AHI.

Statewide Outbreak of Neisseria meningitidis Serogroup Y, Sequence Type 1466 - Virginia, 2022-2024.

Invasive meningococcal disease (IMD) is a severe illness that can have devastating effects; outbreaks are uncommon in the United States. Vaccination is the preferred control measure for IMD outbreaks when a defined population at risk (e.g.

The Dexcom Community Glucose Monitoring Project: 6-Month Results Using Continuous Glucose Monitoring in Type 2 Diabetes.

The Dexcom Community Glucose Monitoring Project is a collaborative, ongoing, primary care-driven public health initiative designed to provide continuous glucose monitoring (CGM) systems to adults with type 2 diabetes who lack health insurance coverage for CGM. After 6 months of program participation, mean A1C decreased by 2.4 ± 1.

Association between Regional Market Competition and Early Femoropopliteal Interventions for Claudication.

Background: Regional market competition is known to impact practice patterns in surgical care. We aimed to investigate the association of regional market competition with the utilization of early peripheral vascular interventions (PVIs) for the treatment of claudication, and the subsequent impact on clinical outcomes.

Methods: We conducted a retrospective analysis of 100% Medicare fee-for-service claims data from January 2019 to December 2021 to identify patients with a new diagnosis of claudication.

An International, Expert-Based Delphi Consensus Document on Controversial Issues about TransCarotid Artery Revascularization (TCAR).

Background: Transcarotid artery revascularization (TCAR) has emerged as an alternative therapeutic modality to carotid endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS) for the management of patients with carotid artery stenosis. However, certain issues regarding the indications and contraindications of TCAR remain unanswered or unresolved. The aim of this international, expert-based Delphi consensus document was to attempt to provide some guidance on these topics.

Location-biased β-arrestin conformations direct GPCR signaling.

β-arrestins are multifunctional intracellular proteins that regulate the desensitization, internalization and signaling of over 800 different G protein-coupled receptors (GPCRs) and interact with a diverse array of cellular partners. Beyond the plasma membrane, GPCRs can initiate unique signaling cascades from various subcellular locations, a phenomenon known as "location bias". Here, we investigate how β-arrestins direct location-biased signaling of the angiotensin II type I receptor (AT1R).

Racial Differences in Adoption and Outcomes of Transcarotid Artery Revascularization among High-Risk Adults with Carotid Artery Stenosis.

Background: Differential access to new technologies may contribute to racial disparities in surgical outcomes but has not been well-studied in the treatment of carotid artery stenosis. We examined race-based differences in adoption and outcomes of transcarotid artery revascularization (TCAR) among high-risk non-Hispanic (NH) Black and NH white adults undergoing carotid revascularization.

Methods: We conducted a retrospective analysis of TCAR, transfemoral carotid artery stenting (TF-CAS), and carotid endarterectomy (CEA) procedures performed for carotid artery stenosis from January 2015 to July 2023 in the Vascular Quality Initiative.