Blood immunophenotyping of multiple sclerosis patients at diagnosis identifies a classical monocyte subset associated to disease evolution.

Introduction: Myeloid cells trafficking from the periphery to the central nervous system are key players in multiple sclerosis (MS) through antigen presentation, cytokine secretion and repair processes.

Methods: Combination of mass cytometry on blood cells from 60 MS patients at diagnosis and 29 healthy controls, along with single cell RNA sequencing on paired blood and cerebrospinal fluid (CSF) samples from 5 MS patients were used for myeloid cells detailing.

Results: Myeloid compartment study demonstrated an enrichment of a peculiar classical monocyte population in 22% of MS patients at the time of diagnosis.

The Melody Valve in Small Children Undergoing First Mitral Valve Replacement: Better Than Mechanical?

Background: In small children with left atrioventricular valve dysfunction, valve repair is preferred but some will require valve replacement. No prosthetic valve has growth potential, bioprostheses have poor durability, and mechanical prostheses have high rates of thromboembolic and hemorrhagic complications. We reviewed our experience with a modified bovine jugular vein valve designed for use in the right ventricular outflow tract (Melody valve, Medtronic) and compared this with contemporary mechanical valve replacement.

Comparative in vitro toxicity of compositionally distinct thermal spray particulates in human bronchial cells.

Unlabelled: Thermal spray, in general, is a process that involves forcing a melted substance, such as metal or ceramic in the form of wire or powder, onto the surface of a targeted object to enhance its desired surface properties. In this paper, the melted substance is metal wire generated by an electric arc and forcibly coated on a rotary iron substrate using compressed air. This thermal process is referred to as double-wire arc thermal spray.

Labor and delivery unit practices and racial and ethnic disparities in severe maternal and neonatal morbidity among nulliparous individuals with low-risk pregnancies.

Persistent racial and ethnic disparities exist in severe maternal and neonatal morbidity, which may be due in part to differences in labor and delivery unit practices across hospitals. We used data collected from 184 hospitals in California (2015-2018) to assess whether nulliparous individuals with low-risk pregnancies differ by race and ethnicity in giving birth at hospitals that tend to use lower-interventional labor and delivery unit practices, and whether such differences contribute to disparities in severe maternal and neonatal morbidity. We classified labor and delivery units as higher- or lower-interventional based on a latent class analysis of survey responses about the frequency of using lower-interventional practices.

Carotid endarterectomy in the setting of persistent hypoglossal artery.

Persistent hypoglossal artery (PHA) is a rare, anatomical variant in which the posterior cerebral circulation is primarily supplied by a branch of the carotid artery, rather than the vertebral arteries. This case report discusses carotid endarterectomy performed on a man, 67 years of age, with high-grade, asymptomatic carotid artery stenosis and ipsilateral PHA. Preoperative computed tomography angiography identified the PHA arising from the internal carotid artery, compensating for atretic bilateral vertebral arteries and providing primary perfusion to anterior spinal artery.

Risk of Surgical Overtreatment in cN1 Breast Cancer Patients who Become ypN0 After Neoadjuvant Chemotherapy: SLNB Versus TAD.

Background: Two surgical approaches have emerged for axillary staging in cN1 breast cancer patients after neoadjuvant chemotherapy (NAC): sentinel lymph node biopsy (SLNB) and targeted axillary dissection (TAD). Direct comparisons of technical and oncological outcomes with SLNB versus TAD are lacking.

Methods: We routinely performed SLNB from 2017 to 2018 for cN1 breast cancer patients who converted to cN0 after NAC, then adopted TAD from 2019 to 2022.

10 practical priorities to prevent and manage serious allergic reactions: GALEN ANACare and EFA Anaphylaxis Manifesto.

This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient-centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals.

Efficacy of a Mobile App-Based Behavioral Intervention (DRIVEN) to Help Individuals With Unemployment-Related Emotional Distress Return to Work: Protocol for a Randomized Controlled Trial.

Background: Employment plays an important role in the maintenance of mental and physical health. Losing a job creates emotional distress, which can, in turn, interfere with effective job seeking. Thus, a program for job seekers that provides support for both the logistics of job seeking as well as emotional distress may help people find employment and improve emotional well-being.

Viral sequence determines HLA-E-restricted T cell recognition of hepatitis B surface antigen.

The non-polymorphic HLA-E molecule offers opportunities for new universal immunotherapeutic approaches to chronic infectious diseases. Chronic Hepatitis B virus (HBV) infection is driven in part by T cell dysfunction due to elevated levels of the HBV envelope (Env) protein hepatitis B surface antigen (HBsAg). Here we report the characterization of three genotypic variants of an HLA-E-binding HBsAg peptide, Env identified through bioinformatic predictions and verified by biochemical and cellular assays.

Thriving Through Adaptation: Adaptive Sports after Spinal Cord Injury.

This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment considerations, and recommendations on how to determine sport appropriateness for a person with spinal cord injury will be provided. The authors emphasize through appropriate medical management and consideration of level of disability, functional performance, psychological readiness, and individual preference, a health care provider can play a valuable role in connecting individuals with spinal cord injury to adaptive sports and recreation.

Supporting diversity in clinical trials: the equitable breakthroughs in medicine site maturity model.

Background: Among the most powerful barriers to broader inclusion of diverse participants in clinical trials are social determinants of health, trustworthiness of health care providers and research institutions, and competing pressures on potential participants. Nevertheless, current tools to assess organizational capabilities for clinical trial diversity focus primarily on trial infrastructure, rely solely on quantitative self-reported data, and lack meaningful assessment of capabilities related to community engagement.

Methods: The Equitable Breakthroughs in Medicine (EQBMED) initiative developed a holistic, collaborative, site-driven formative model and accompanying assessment to catalog sites' current capabilities and identify opportunities for growth in both conducting industry-sponsored clinical trials and enriching diversity of those trials.

A framework for N-of-1 trials of individualized gene-targeted therapies for genetic diseases.

Individualized genetic therapies-medicines that precisely target a genetic variant that may only be found in a small number of individuals, as few as only one-offer promise for addressing unmet needs in genetic disease, but present unique challenges for trial design. By nature these new individualized medicines require testing in individualized N-of-1 trials. Here, we provide a framework for maintaining scientific rigor in N-of-1 trials.

Inpatient Falls: Epidemiology, Risk Assessment, and Prevention Measures. A Narrative Review.

Background Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay.

Nexus of Soil Microbiomes, Genes, Classes of Carbon Substrates, and Biotransformation of Fluorotelomer-Based Precursors.

The unpredictable biodegradation of fluorotelomer (FT)-based per- and polyfluoroalkyl substances (PFAS) causes complicated risk management of PFAS-impacted sites. Here, we have successfully used redundancy analysis to link FT-based precursor biodegradation to key microbes and genes of soil microbiomes shaped by different classes of carbon sources: alcohols (C2-C4), alkanes (C6 and C8), an aromatic compound (phenol), or a hydrocarbon surfactant (cocamidopropyl betaine [CPB]). All the enrichments defluorinated fluorotelomer alcohols (:2 FtOH; = 4, 6, 8) effectively and grew on 6:2 fluorotelomer sulfonate (6:2 FtS) as a sulfur source.

Hypertensive Disorders in Pregnancy: Differences by Hispanic Ethnicity and Black Race.

Objective: Black individuals carry the greatest burden of maternal mortality, with hypertensive disorders during pregnancy being a significant driving force to this disparity. However, research on maternal health disparities predominantly groups Hispanic Black individuals with all other individuals of Hispanic ethnicity. We hypothesized that this aggregation might obscure the risk patterns of hypertensive disorders in pregnancy for Hispanic-Black and non-Hispanic Black individuals.