The analysis of cell-free tumor DNA (ctDNA) and proteins in the blood of patients with cancer potentiates a new generation of non-invasive diagnostic approaches. However, confident detection of tumor-originating markers is challenging, especially in the context of brain tumors, where these analytes in plasma are extremely scarce. Here, we apply a sensitive single-molecule technology to profile multiple histone modifications on individual nucleosomes from the plasma of patients with diffuse midline glioma (DMG).
View Article and Find Full Text PDFRadiotherapy is an integral component in the treatment of many types of cancer, with approximately half of cancer patients receiving radiotherapy. Systemic therapy applies pressure that can select for resistant tumor subpopulations, underscoring the importance of understanding how radiation impacts tumor evolution to improve treatment outcomes. We integrated temporal genomic profiling of 120 spatially distinct tumor regions from 20 patients with undifferentiated pleomorphic sarcomas (UPS), longitudinal circulating tumor DNA (ctDNA) analysis, and evolutionary biology computational pipelines to study UPS evolution during tumorigenesis and in response to radiotherapy.
View Article and Find Full Text PDFEcological momentary assessment (EMA) collects real-time data in daily life, enhancing ecological validity and reducing recall bias. An EMA questionnaire that measures symptoms and transdiagnostic factors was recently developed with network modeling purposes. This study examines this EMA protocol's (a) subjective experience (e.
View Article and Find Full Text PDFPulmonary function tests (PFT) are recommended for hematopoietic cell transplantation (HCT) evaluation. However, their prognostic value in chimeric antigen receptor T-cell (CAR-T) therapy remains unclear. We assessed the predictive significance of PFTs and pulmonary comorbidity classifications, per the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), in B-cell lymphoma patients undergoing autologous CD19-CAR-T therapy.
View Article and Find Full Text PDFProblemThe U.S. physician scholar workforce, currently comprising less than 1.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
December 2024
Ambulatory antimicrobial stewardship can be challenging due to disparities in resource allocation across the care continuum, competing priorities for ambulatory prescribers, ineffective communication strategies, and lack of incentive to prioritize antimicrobial stewardship program (ASP) initiatives. Efforts to monitor and compare outpatient antibiotic usage metrics have been implemented through quality measures (QM). Healthcare Effectiveness Data and Information Set (HEDIS®) represent standardized measures that examine the quality of antibiotic prescribing by region and across insurance health plans.
View Article and Find Full Text PDFBackground: Cardiac allograft vasculopathy (CAV) results in impaired blood flow in both epicardial vessels and the microvasculature and is a leading cause of poor outcomes in heart transplant (HT) recipients. Most patients have mild (International Society for Heart and Lung Transplantation [ISHLT] CAV 1) disease. This study examined outcomes among those with ISHLT CAV 1 and investigated the value of physiologic assessment via cardiac positron emission tomography/computed tomography (PET/CT) for added risk stratification.
View Article and Find Full Text PDFObjectives: There is a burgeoning discrepancy between the procedural competency of graduating diagnostic radiology residents and the needs of our patient population. The causes of this mismatch and opportunities for improvement are explored by the APDR Procedural Competency of Graduating DR Residents Task Force.
Materials And Methods: The APDR convened a task force consisting of diverse broad stakeholder viewpoints, drawing from organized radiology, academic and private practices.
Objective: The objective of this study was to examine weight reduction and adverse events associated with use of antiobesity medications (AOMs) in older adults ages ≥65 years.
Methods: Seven databases were searched for studies evaluating weight reduction of Food and Drug Administration (FDA)-approved AOMs. Studies had to include adults ages ≥65 years with obesity (BMI ≥ 30 kg/m or ≥27 kg/m with one weight-related condition), with independent analysis of weight reduction for adults ages ≥65 years.
Introduction: No clear guidelines exist for unfractionated heparin (UFH) monitoring in adult patients on veno-arterial extracorporeal life support (VA-ECLS) for refractory cardiogenic shock. In this study, we sought to compare outcomes between anti-factor Xa (FXa) and activated partial thromboplastin time (aPTT) strategies for UFH monitoring during VA-ECLS.
Methods: This is a single-center, retrospective review of VA-ECLS patients who received UFH in the cardiothoracic intensive care unit between July 2019 and November 2023.
The network theory of psychopathology posits that mental disorders are systems of mutually reinforcing symptoms. This framework has proven highly generative but does not specify precisely how any specific mental disorder operates as such a system. Cognitive behavioral theories of mental disorders provide considerable insight into how these systems may operate.
View Article and Find Full Text PDFInterictal epileptiform discharges (IEDs) such as spikes and sharp waves represent pathological electrophysiological activities occurring in epilepsy patients between seizures. IEDs occur preferentially during non-rapid eye movement (NREM) sleep and are associated with impaired memory and cognition. Despite growing interest, most studies involving IED detections rely on visual annotations or employ simple amplitude threshold approaches.
View Article and Find Full Text PDFImmunoglobulin G (IgG) is traditionally recognized as a plasma protein that neutralizes antigens for immune defense. However, our research demonstrates that IgG predominantly accumulates in adipose tissue during obesity development, triggering insulin resistance and macrophage infiltration. This accumulation is governed by neonatal Fc receptor (FcRn)-dependent recycling, orchestrated in adipose progenitor cells and macrophages during the early and late stages of diet-induced obesity (DIO), respectively.
View Article and Find Full Text PDFGlobal obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
December 2024
Inspired by the way that digital artists zoom out of the canvas to assess the visual impact of their works, we introduce a conceptually simple yet effective metric for quantifying the clarity of digital images. This metric contrasts original images with progressively "melted" counterparts, produced by randomly flipping adjacent pixel pairs. It measures the presence of stable structures, assigning the value zero to completely uniform or random images and finite values for those with discernible patterns.
View Article and Find Full Text PDFCirc Heart Fail
December 2024
Background: Cardiac allograft vasculopathy (CAV) leads to impaired myocardial blood flow (MBF), increasing the risk of cardiovascular death or retransplant among heart transplantation (HT) recipients. Data on elevation in donor-derived cell-free DNA (dd-cfDNA) and CAV in the absence of rejection are mixed. We sought to test the hypothesis that CAV with reduced MBF (RMBF) is associated with elevated dd-cfDNA.
View Article and Find Full Text PDFWe previously demonstrated that sphingosine-1-phosphate receptor 3 (S1PR3) in the medial prefrontal cortex (mPFC) prevents reductions in sociability normally caused by stress. S1PR3 is a ubiquitously expressed G-protein coupled receptor that regulates immune system function, although its regulation of other biological processes is not well understood. Pharmacological activators of S1PR3 might provide important insights for understanding the neural substrates underlying sociability.
View Article and Find Full Text PDFBackground And Aims: Primary biliary cholangitis (PBC) is a rare, progressive liver disease. Obeticholic acid (OCA) received accelerated approval for treating patients with PBC in whom ursodeoxycholic acid (UDCA) failed, based on a surrogate endpoint of reduction in alkaline phosphatase. Analysis of the long-term safety extension with 2 external control groups demonstrated a significant increase in event-free survival in OCA-treated patients.
View Article and Find Full Text PDFAccording to psycholinguistic theories, during language processing, spoken and written words are first encoded along independent phonological and orthographic dimensions, then enter into modality-independent syntactic and semantic codes. Non-invasive brain imaging has isolated several cortical regions putatively associated with those processing stages, but lacks the resolution to identify the corresponding neural codes. Here, we describe the firing responses of over 1000 neurons, and mesoscale field potentials from over 1400 microwires and 1500 iEEG contacts in 21 awake neurosurgical patients with implanted electrodes during written and spoken sentence comprehension.
View Article and Find Full Text PDFNetwork approaches to psychopathology have become increasingly common in mental health research, with many theoretical and methodological developments quickly gaining traction. This article illustrates contemporary practices in applying network analytical tools, bridging the gap between network concepts and their empirical applications. We explain how we can use graphs to construct networks representing complex associations among observable psychological variables.
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