High Modified 5 Factor Frailty Index is Associated With Worse PROMs and Decreased Return to Activities After 1 or 2 Level MI-TLIF.

Study Design: Retrospective cohort study.

Objective: Frailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality.

Advanced Automated Model for Robust Bone Marrow Segmentation in Whole-body MRI.

Rationale And Objectives: To establish an advanced automated bone marrow (BM) segmentation model on whole-body (WB-)MRI in monoclonal plasma cell disorders (MPCD), and to demonstrate its robust performance on multicenter datasets with severe myeloma-related pathologies.

Materials And Methods: The study cohort comprised multi-vendor, multi-protocol imaging data acquired with varying field strength across 8 different centers. In total, 210 WB-MRIs of 207 MPCD patients were included.

Annular Closure Device Reduces Symptomatic Reherniation Rates: Results of a Meta-analysis.

The scope of existing annular closure device (ACD) studies examining long-term follow-up data is limited. There is a paucity of studies that report and analyze recent outcomes data following ACD use. We sought to summarize the available long-term follow-up data on postoperative outcomes of the Barricaid (Intrinsic Therapeutics) ACD.

Impact of pedicle screw accuracy on clinical outcomes after 1- or 2-level minimally invasive transforaminal lumbar interbody fusion.

Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.

Challenges encountered to creating a renal biopsy program at a tertiary care academic institution in the United States.

Biopsy is the gold standard for diagnosing renal pathology and the procedure is required to be learned per ACGME guidelines for Nephrology Fellowship graduation. We describe the process for the planning and development of a new Nephrologist directed native renal biopsy program to increase the opportunity to train Nephrology fellows in this procedure. The article outlines the barriers, complications and lessons learned to developing the program, highlighting the key challenges and progress that has been made within a single American tertiary academic medical center.

Salvage Autologous Transplant in Relapsed Multiple Myeloma: Long-Term Follow-Up of the Phase 3 GMMG ReLApsE Trial.

The multicenter, phase III GMMG ReLApsE trial (EudraCT-No:2009-013856-61) randomized relapsed and/or refractory multiple myeloma (RRMM) patients equally to lenalidomide/dexamethasone (LEN/DEX, 25mg days 1-21/40mg weekly, 4-week cycles) re-induction, salvage high dose chemotherapy (sHDCT, melphalan 200mg/m2), autologous stem cell transplantation (ASCT) and LEN maintenance (10mg/day; transplant arm, n=139) versus continuous LEN/DEX (control arm, n=138). Ninety-four percent of patients had received frontline HDCT/ASCT. We report an updated analysis of survival endpoints with a median follow-up of 99 months.

Temporal Changes in PROMs Improvement and Recovery Kinetics Following Transforaminal Endoscopic Lumbar Discectomy.

Study Design: Retrospective cohort study.

Objective: to analyze trends in PROMs improvement and recovery kinetics following transforaminal endoscopic lumbar discectomy and foraminotomy (TELD).

Summary Of Background Data: As TELDs become an increasingly common alternative to fusions for lateral disc herniations, it is important to understand patients' postoperative recovery timelines to manage patient expectations.

Influence of coronal lumbar Cobb angle and surgical level on short-segment lumbar surgery outcomes in degenerative scoliosis.

Purpose: This study investigates the relationship between surgical levels and coronal deformity to identify risk factors for failing to achieve a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI) following short-segment isolated decompression or fusion surgery in patients with degenerative scoliosis (DS) and concurrent lumbar canal stenosis (LCS), without severe sagittal deformity malalignment.

Methods: Patients with degenerative scoliosis who underwent 1- or 2-level lumbar isolated decompression or fusion surgery were included. Surgical level was labeled as "Cobb-related" when decompression or surgical levels spanned or were between end vertebrae, and "outside" when the operative levels did not include the end vertebrae.

Does Approach Matter? Comparison of Early Postoperative Life-threatening Complications in Elderly Patients With Multilevel Cervical Stenosis.

Study Design: Retrospective cohort study.

Summary Of Background Data: The optimal surgical approach for multilevel cervical stenosis in elderly patients is controversial because of the risk of life-threatening complication.

Objective: To compare life-threatening early complication rates between ≥3 levels anterior and posterior cervical surgery in elderly patients.

Isatuximab, Lenalidomide, Bortezomib, and Dexamethasone Induction Therapy for Transplant-Eligible Newly Diagnosed Multiple Myeloma: Final Part 1 Analysis of the GMMG-HD7 Trial.

Previously, addition of isatuximab (Isa) to standard-of-care lenalidomide-bortezomib-dexamethasone (RVd) in transplant-eligible patients with newly diagnosed multiple myeloma in the GMMG-HD7 trial (ClinicalTrials.gov identifier: NCT03617731) resulted in a significant increase of minimal residual disease negativity (MRD-) rates after induction therapy. A total of 662 patients were randomly assigned to receive induction therapy with Isa-RVd (n = 331) or RVd (n = 329), followed by single or tandem autologous stem-cell transplant and second random assignment to maintenance with lenalidomide alone or Isa-lenalidomide.

Temperature Dependence of Coherent versus Spontaneous Raman Scattering.

Because of their sub picosecond temporal resolution, coherent Raman spectroscopies have been proposed as a viable extension of spontaneous Raman thermometry, to determine dynamics of mode specific vibrational energy content during out of equilibrium molecular processes. Here we show that the presence of multiple laser fields stimulating the vibrational coherences introduces additional quantum pathways, resulting in destructive interference. This ultimately reduces the thermal sensitivity of single spectral lines, nullifying it for harmonic vibrations and temperature independent polarizability.

Mutagenic impact and evolutionary influence of radiotherapy in hematologic malignancies.

Ionizing radiotherapy (RT) is a widely used palliative and curative treatment strategy for malignancies. In solid tumors, RT-induced double strand breaks lead to the accumulation of indels, and their repair by non-homologous end-joining has been linked to the ID8 mutational signature in resistant cells. However, the extent of RT-induced DNA damage in hematologic malignancies and its impact on their evolution and interplay with commonly used chemotherapies has not yet been explored.

Role and mechanism of the outer membrane porin LamB in T-2 mycotoxin-mediated extensive drug resistance in Escherichia coli.

The influence of mycotoxins in ecological niches shared with antibiotic-resistant bacteria (ARB) remains underexplored. This study examined the impact of T-2 mycotoxin on the evolution of antibiotic resistance in Escherichia coli, highlighting the role of specific porins. Our findings revealed that exposure to 10 ng/mL of T-2 toxin induced multi-drug resistant (MDR) phenotypes in three E.

Short-segment fusion versus isolated decompression in lumbar spinal canal stenosis patients with Cobb angles over 20 degrees.

Background Context: Lumbar decompression and short-segment lumbar fusion are standard procedures for short-segment lumbar canal stenosis, even in patients with moderate Cobb angles. Adult degenerative scoliosis is diagnosed at a threshold of 10 degrees, and patients with coronal Cobb angles over 30 degrees are recommended for long fusion due to global spinal deformity. However, there is a lack of research on clinical outcomes in patients with moderate coronal deformity, such as Cobb angles between 20 and 30 degrees.

Early NRS Leg and Back Thresholds Predict Clinical Recovery after MIS Transforaminal Lumbar Interbody Fusion for Degenerative Spine Disease.

Study Design: This retrospective study included patients who underwent primary one-level minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spine conditions.

Objective: To identify early predictors of failing to achieve the Oswestry Disability Index (ODI) minimum clinically important difference (MCID) one-year post-surgery.

Summary Of Background Data: Early identification of patients at risk of failing to achieve ODI-MCID is crucial for early intervention and improved postoperative counseling.

EASIX-guided risk stratification for complications and outcome after CAR T-cell therapy with ide-cel in relapsed/refractory multiple myeloma.

Background: Chimeric antigen receptor (CAR) T-cell therapy has demonstrated significant benefits in the treatment of relapsed/refractory multiple myeloma (RRMM). However, these outcomes can be compromised by severe complications, including cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome (ICANS) and immune effector cell-associated hematotoxicity (ICAHT), predisposing for life-threatening infections.

Methods: This retrospective observational study examined a total of 129 patients with RRMM who had received idecabtagene vicleucel (ide-cel) at two major myeloma centers in Germany and one center in the USA to assess the Endothelial Activation and Stress Index (EASIX) as a risk marker for an unfavorable clinical course and outcome after CAR T-cell therapy.

Temporal Genomic Dynamics Shape Clinical Trajectory in Multiple Myeloma.

To comprehensively unravel the temporal relationship between initiating and driver events and its impact on clinical outcomes, we analyzed 421 whole-genome sequencing profiles from 382 patients. Using clock-like mutational signatures, we estimated a time lag of 2-4 decades between initiating events and diagnosis. In patients with hyperdiploidy, we demonstrate that trisomies of odd-numbered chromosomes can be acquired simultaneously with other chromosomal gains, such as 1q gain.

Longitudinal assessment of established risk stratification models in patients with monoclonal gammopathy of undetermined significance.

Risk of progression of monoclonal gammopathy of undetermined significance (MGUS) into multiple myeloma and related plasma cell disorders can be determined by three major risk stratification models, namely Mayo2005, Sweden2014, and NCI2019. This retrospective study of 427 patients with MGUS diagnosed according to the 2014 International Myeloma Working Group criteria aimed to describe and analyze the longitudinal applicability of these risk models. In all three models, the majority of patients remained at their baseline risk group, whereas small numbers of patients migrated to a different risk group.

Discrepancy between global- and disease-specific outcome measures following lumbar spine surgery.

Objective: The aim of this study was to assess the correlation between patient-perceived changes in health and commonly utilized patient-reported outcome measures (PROMs) in lumbar spine surgery.

Methods: This was a retrospective review of prospectively collected data on consecutive patients who underwent lumbar microdiscectomy, lumbar decompression, or lumbar fusion at a single academic institution from 2017 to 2023. Correlation between the global rating of change (GRC) questionnaire, a 5-item Likert scale (much better, slightly better, about the same, slightly worse, and much worse), and PROMs (Oswestry Disability Index, visual analog scale for back and leg pain, 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary, and PROMIS physical function) was assessed using Spearman's rank correlation coefficients.