The impact of complication-sensitive risk models on hospital benchmarking for failure to rescue.

Background: Failure to rescue has been increasingly used as a surgical quality metric, although implementation with complication-agnostic risk models may disproportionately penalize centers that care for high-risk patients. We used a nationally representative database to assess the impact of complication-sensitive risk models on hospital benchmarking for failure to rescue.

Methods: All adults undergoing elective coronary artery bypass grafting, aortic/mitral valve replacement, or esophageal/pancreatic/large bowel resection were identified within the 2019 Nationwide Readmissions Database.

Lipid Nanoparticles and PEG: Time Frame of Immune Checkpoint Blockade Can Be Controlled by Adjusting the Rate of Cellular Uptake of Nanoparticles.

The engineerability of lipid nanoparticles (LNPs) and their ability to deliver nucleic acids make LNPs attractive tools for cancer immunotherapy. LNP-based gene delivery can be employed for various approaches in cancer immunotherapy, including encoding tumor-associated antigens and silencing of negative immune checkpoint proteins. For example, LNPs carrying small interfering RNAs can offer several advantages, including sustained and durable inhibition of an immune checkpoint protein.

Computational Analysis of Intravascular OCT Images for Future Clinical Support: A Comprehensive Review.

Over the past two decades, intravascular optical coherence tomography (IVOCT) has emerged as a promising tool for planning percutaneous coronary interventions (PCI), studying coronary artery disease, and assessing treatments. With its nearhistological resolution and optical contrast, IVOCT uniquely evaluates coronary plaque characteristics, enhancing the guidance of interventional procedures. Artificial intelligence (AI) techniques have been widely applied to IVOCT imaging, providing fast and accurate automated interpretation.

Development of Bioorthogonally Degradable Tough Hydrogels Using Enamine N-Oxide Based Crosslinkers.

Inducibly degradable polymers present new opportunities to integrate tough hydrogels into a wide range of biomaterials. Rapid and inducible degradation enables fast transition in material properties without sacrificing material integrity prior to removal. In pursuit of bioorthogonal chemical modalities that will enable inducible polymer degradation in biologically relevant environments, enamine N-oxide crosslinkers are developed for double network acrylamide-based polymer/alginate hydrogels.

Improving coronary artery segmentation with self-supervised learning and automated pericoronary adipose tissue segmentation: a multi-institutional study on coronary computed tomography angiography images.

Purpose: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, with coronary computed tomography angiography (CCTA) playing a crucial role in its diagnosis. The mean Hounsfield unit (HU) of pericoronary adipose tissue (PCAT) is linked to cardiovascular risk. We utilized a self-supervised learning framework (SSL) to improve the accuracy and generalizability of coronary artery segmentation on CCTA volumes while addressing the limitations of small-annotated datasets.

Chlorhexidine vs Routine Foot Washing to Prevent Diabetic Foot Ulcers: A Randomized Clinical Trial.

Importance: Foot ulcers are a common and feared complication for people with diabetes because 20% of foot ulcers become infected and lead to a lower extremity amputation.

Objective: To evaluate the effect of daily foot care using chlorhexidine wipes vs soap-and-water wipes for 1 year on the risk of developing new foot complications in veterans with diabetes.

Design, Setting, And Participants: This double-blind, placebo-controlled, phase 2b randomized clinical trial was conducted at the Baltimore Veterans Affairs (VA) Medical Center between January 2019 to January 2023.

Prediction of obstructive coronary artery disease using coronary calcification and epicardial adipose tissue assessments from CT calcium scoring scans.

Background: Low-cost/no-cost non-contrast CT calcium scoring (CTCS) exams can provide direct evidence of coronary atherosclerosis. In this study, using features from CTCS images, we developed a novel machine learning model to predict obstructive coronary artery disease (CAD), as defined by the coronary artery disease-reporting and data system (CAD-RADS).

Methods: This study analyzed 1324 patients from the SCOT-HEART trial who underwent both CTCS and CT angiography.

Special Considerations Related to Race, Sex, Gender, and Socioeconomic Status in the Preoperative Evaluation: Part 1: Race, History of Incarceration, and Health Literacy.

Patients anticipating surgery and anesthesia benefit from preoperative care to lower risks and facilitate services on the day of surgery. Preparing patients often requires extensive evaluation and coordination of care. Vulnerable, marginalized, and disenfranchised populations have special concerns, limitations, and needs.

Pericoronary adipose tissue feature analysis in computed tomography calcium score images in comparison to coronary computed tomography angiography.

Purpose: We investigated the feasibility and advantages of using non-contrast CT calcium score (CTCS) images to assess pericoronary adipose tissue (PCAT) and its association with major adverse cardiovascular events (MACE). PCAT features from coronary computed tomography angiography (CCTA) have been shown to be associated with cardiovascular risk but are potentially confounded by iodine. If PCAT in CTCS images can be similarly analyzed, it would avoid this issue and enable its inclusion in formal risk assessment from readily available, low-cost CTCS images.

Blood Culture Use in Medical and Surgical Intensive Care Units and Wards.

Importance: Blood culture (BC) use benchmarks in US hospitals have not been defined.

Objective: To characterize BC use in adult intensive care units (ICUs) and wards in US hospitals.

Design, Setting, And Participants: A retrospective cross-sectional study of BC use in adult medical ICUs, medical-surgical ICUs, medical wards, and medical-surgical wards from acute care hospitals from the 4 US geographic regions was conducted.

Celiac trunk angiography with balloon occlusion of splenic artery for diagnosis and treatment of splenic steal syndrome.

Splenic steal syndrome (SSS) post liver transplant is a potential cause of graft dysfunction in the setting of peripheral hepatic arterial bed resistance and redirection of blood flow to a dominant splenic artery resulting in reduction of hepatic arterial inflow. We report utilization of balloon occlusion of the proximal splenic artery as an objective measure to confirm the diagnosis of SSS in a patient with orthotopic liver transplant followed by successful treatment with proximal splenic artery embolization using Gelfoam and Amplatzer vascular plug. Written informed consent for the publication of this case report was obtained from the patient.

Inhibition of glutaminase elicits senolysis in therapy-induced senescent melanoma cells.

The cyclin D1-Cyclin-Dependent Kinases 4 and 6 (CDK4/6) complex is crucial for the development of melanoma. We previously demonstrated that targeting CDK4/6 using small molecule inhibitors (CDK4/6i) suppresses Braf melanoma growth in vitro and in vivo through induction of cellular senescence. However, clinical trials investigating CDK4/6i in melanoma have not yielded successful outcomes, underscoring the necessity to enhance the therapeutic efficacy of CDK4/6i.

Predictors of postpandemic preparedness for special pathogens.

In this survey of 31 hospitals, large metropolitan facilities had a 9.5-fold odds of reporting preparedness for special pathogens; hospitals with special pathogens teams had a 14.3-fold odds of reporting preparedness for special pathogens.

Perovskite nanocomposites: synthesis, properties, and applications from renewable energy to optoelectronics.

The oxide and halide perovskite materials with a ABX structure exhibit a number of excellent properties, including a high dielectric constant, electrochemical properties, a wide band gap, and a large absorption coefficient. These properties have led to a range of applications, including renewable energy and optoelectronics, where high-performance catalysts are needed. However, it is difficult for a single structure of perovskite alone to simultaneously fulfill the diverse needs of multiple applications, such as high performance and good stability at the same time.

Plaque Characteristics Derived from Intravascular Optical Coherence Tomography That Predict Cardiovascular Death.

This study aimed to investigate whether plaque characteristics derived from intravascular optical coherence tomography (IVOCT) could predict a long-term cardiovascular (CV) death. This study was a single-center, retrospective study on 104 patients who had undergone IVOCT-guided percutaneous coronary intervention. Plaque characterization was performed using Optical Coherence TOmography PlaqUe and Stent (OCTOPUS) software developed by our group.

Four intestinal ultrasound scores and bowel wall thickness alone correlated well with pediatric ulcerative colitis disease activity.

Objectives: Intestinal ultrasound (IUS) is a noninvasive tool in ulcerative colitis (UC), but scoring systems have mostly been developed for adults, Crohn's disease, and flaring UC. Our aim was to evaluate the performance of bowel wall thickness (BWT) and four IUS scores in pediatric patients with newly diagnosed UC.

Methods: Patients <18 years old with suspected UC were prospectively enrolled.

Azithromycin-resistant mph(A)-positive Salmonella enterica serovar Typhi in the United States.

Objectives: The United States Centers for Disease Control and Prevention (CDC) conducts active surveillance for typhoid fever cases caused by Salmonella enterica serovar Typhi (Typhi). Here we describe the characteristics of the first two cases of mph(A)-positive azithromycin-resistant Typhi identified through US surveillance.

Methods: Isolates were submitted to public health laboratories, sequenced, and screened for antimicrobial resistance determinants and plasmids, as part of CDC PulseNet's routine genomic surveillance.

RePair: Increasing the Scalability of RePair by Decreasing Memory Usage.

The RePair compression algorithm produces a context-free grammar by iteratively substituting the most frequently occurring pair of consecutive symbols with a new symbol until all consecutive pairs of symbols appear only once in the compressed text. It is widely used in the settings of bioinformatics, machine learning, and information retrieval where random access to the original input text is needed. For example, in pangenomics, RePair is used for random access to a population of genomes.

Mobile genetic elements define the non-random structure of the serovar Typhi pangenome.

Bacterial relatedness measured using select chromosomal loci forms the basis of public health genomic surveillance. While approximating vertical evolution through this approach has proven exceptionally valuable for understanding pathogen dynamics, it excludes a fundamental dimension of bacterial evolution-horizontal gene transfer. Incorporating the accessory genome is the logical remediation and has recently shown promise in expanding epidemiological resolution for enteric pathogens.

Midline Catheters as an Alternative for Central Venous Catheters in Venous Oxygen Saturation Monitoring: A Single Center Experience.

Background: Central venous oxygen saturation (ScvO2) obtained from a central venous catheter (CVC) is often used to approximate oxygen delivery in critically ill patients. Despite their importance in administering medications and monitoring oxygen delivery, the use of CVCs can be associated with significant complications. Midline catheters are inserted via a peripheral vein above the antecubital fossa and provide a safe alternative to CVCs.

Heroes and villains: opposing narrative roles engage neural synchronization in the inferior frontal gyrus.

Neuroscientific studies have highlighted the role of the default mode network (DMN) in processing narrative information. Here, we examined whether the neural synchronization of the DMN tracked the appearances of protagonists and antagonists when viewing highly engaging, socially rich audiovisual narratives. Using inter-subject correlation analysis on two independent, publicly available movie-watching fMRI datasets, we computed whole-brain neural synchronization during the appearance of the protagonists and antagonists.