Impella versus Non-Impella for Non-emergent High-Risk Percutaneous Coronary Intervention: Impella vs. Non-Impella for HR-PCI.

Background: The benefit of mechanical circulatory support (MCS) with Impella (Abiomed, Inc, Danvers, MA) for patients undergoing non-emergent, high-risk percutaneous coronary intervention (HR-PCI) is unclear and currently the subject of a large randomized clinical trial (RCT), PROTECT IV. While contemporary registry data from PROTECT III demonstrated improvement of outcomes with Impella when compared with historical data (PROTECT II), there is lack of direct comparison to the HR-PCI cohort that did not receive Impella support.

Methods: We retrospectively identified patients from our institution meeting PROTECT III inclusion criteria (left ventricular ejection fraction [LVEF] <35% with unprotected left main or last remaining vessel or LVEF <30% undergoing multivessel PCI), and compared this group (NonIMP) to the published outcomes data from the PROTECT III registry (IMP).

Imaging of Peripheral Intraneural Tumors: A Comprehensive Review for Radiologists.

Background/objectives: Intraneural tumors (INTs) pose a diagnostic challenge, owing to their varied origins within nerve fascicles and their wide spectrum, which includes both benign and malignant forms. Accurate diagnosis and management of these tumors depends upon the skills of the radiologist in identifying key imaging features and correlating them with the patient's clinical symptoms and examination findings.

Methods: This comprehensive review systematically analyzes the various imaging features in the diagnosis of intraneural tumors, ranging from basic MR to advanced MR imaging techniques such as MR neurography (MRN), diffusion tensor imaging (DTI), and dynamic contrast-enhanced (DCE) MRI.

What Are the Implications of Choosing a TAVR-First Strategy in the Lifetime Management of Aortic Stenosis?: A Critical Review of TAVR-Explant- and Redo-TAVR.

Some patients with aortic stenosis may require multiple valve interventions in their lifetime, and choosing transcatheter aortic valve replacement (TAVR) as the initial intervention may be appealing to many. If their transcatheter heart valve degenerates later in life, most will hope to undergo redo-TAVR. However, if redo-TAVR is not feasible, some may have to undergo surgical explantation of their transcatheter heart valve (TAVR-explant).

Cytomegalovirus Colitis Masquerading as a Recurrent Colonic Polyp in a Patient With Neurofibromatosis Type 1.

Cytomegalovirus colitis most commonly affects immunocompromised patients, although it is a rare cause of gastrointestinal bleeding in immunocompetent patients. Older age, chronic disease, and critical illness are also important risk factors and may lead providers to consider the diagnosis in otherwise immunocompetent patients. Endoscopic presentation is variable and does not significantly influence outcomes.

A retrospective study of reported adverse events associated with cardiac stents in Indian population.

Background: Cardiac stents are utilized to treat coronary artery diseases, a leading cause of death worldwide including in India. We investigated frequency and nature of adverse events (AEs) associated with cardiac stents in the Indian population.

Methods: The source data was systematically collected by National Coordination Centre-Materiovigilance programme of India (NCC-MvPI), anonymized from 2020 to 2022.

Percutaneous Removal of Cardiac Papillary Fibroelastomas.

Papillary fibroelastomas (PFEs) are primary cardiac tumors associated with significant embolic risk. Surgical excision or medical therapy with antiplatelets and/or anticoagulants have been the treatment options for symptomatic patients. This paper reports our early experiences of percutaneous removal of PFE using mechanical aspiration techniques.

Health Disparities in Rheumatology in the United States.

Objective: Underserved populations are often at risk of experiencing systematic healthcare disparities. Existing disparities in care access, quality of care received, and treatment outcomes among patients with rheumatic disease are not well understood.

Methods: We conducted a targeted literature review to understand disparities in health outcomes, treatment patterns, and healthcare management faced by rheumatology patients in the United States, with a focus on rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

Transcriptomic analysis reveals suppression of steroidogenic acute regulatory protein in gender-specific differences in Alzheimer's disease.

Alzheimer's disease (AD)-related dementia preferentially impacts two-thirds of women and one-third of men. The steroidogenic acute regulatory (StAR) protein mediates the biosynthesis of neurosteroids that sustain diverse neuronal activities. Aging, involving neurosteroidal imbalance, is the predominant risk factor for AD causing dementia.

VISTA-induced tumor suppression by a four amino acid intracellular motif.

VISTA is a key immune checkpoint receptor under investigation for cancer immunotherapy; however, its signaling mechanisms remain unclear. Here we identify a conserved four amino acid (NPGF) intracellular motif in VISTA that suppresses cell proliferation by constraining cell-intrinsic growth receptor signaling. The NPGF motif binds to the adapter protein NUMB and recruits Rab11 endosomal recycling machinery.

Disparities in Surgical Intervention in Pediatric Patients With Submucous Cleft Palate and Velopharyngeal Dysfunction.

Objective: To evaluate factors impacting access to and timing of surgery in patients with submucous cleft palate (SMCP) and velopharyngeal dysfunction (VPD).

Study Design: Retrospective cohort study.

Setting: Single academic medical center.

Towards assembling functional cyanobacterial β-carboxysomes in Oryza sativa chloroplasts.

The major limiting factor of photosynthesis in C3 plants is the enzyme, rubisco which inadequately distinguishes between carbon dioxide and oxygen. To overcome catalytic deficiencies of Rubisco, cyanobacteria utilize advanced protein microcompartments, called the carboxysomes which envelopes the enzymes, Rubisco and Carbonic Anhydrase (CA). These microcompartments facilitate the diffusion of bicarbonate ions which are converted to CO by CA, following in an increase in carbon flux near Rubisco boosting CO fixation process.

Structural analysis of genetic variants of the human tumor suppressor Palb2 coiled-coil domain.

The tumor suppressor PALB2 is a key player in the Homologous Recombination (HR) pathway, functionally connecting BRCA proteins at the DNA damage site. PALB2 forms homodimers via its coiled-coil domain, and during HR, it forms a heterodimeric complex with BRCA1 using the same domain. However, the structural details of the human PALB2 coiled-coil domain are unknown.

Disparities in Medication Prescriptions and Post-Tracheostomy Outcomes in Pediatric Patients.

Background: Granulation tissue formation and tracheitis are common pediatric tracheostomy complications. Ciprofloxacin/dexamethasone is frequently prescribed, but the influence of social determinants on this topic is unexplored.

Methods: This study extends a prior cohort study of pediatric tracheostomy patients at a single academic institution from 2016 to 2020.

The impact of sleep and exercise on brain atrophy in mild cognitive impairment.

Chronic sleep deprivation and lack of physical exercise may have detrimental effects on overall health, particularly in terms of brain health, with significant implications for cognitive function and well-being. This review explores the impact of chronic sleep deprivation and physical exercise on brain atrophy in mild cognitive impairment (MCI) and Alzheimer's disease (AD). Drawing insights from 40 selected studies, the review synthesizes evidence on these lifestyle factors' correlations with neurodegenerative changes.

ICT-based fluorescent nanoparticles for selective cyanide ion detection and quantification in apple seeds.

In this report, we successfully engineered a novel probe based on an acceptor-donor-acceptor (A-D-A) architecture featuring dicyanovinyl-substituted thieno[3,2-]thiophene, termed DCVTT. The designed probe self-assembles into luminous nanoparticles (DCVTT NPs) upon introducing mixed aqueous solutions. These fluorescent nanostructures served as a ratiometric probe for detecting cyanide (CN) ions in aqueous-based environments, owing to the robust Intramolecular Charge Transfer (ICT) characteristics of DCVTT.

Comparing immunogenicity and safety following transition from reference rituximab to biosimilar rituximab (DRL_RI) in patients with rheumatoid arthritis: a randomized, double-blind, phase 3 study.

Objectives: To assess immunogenicity and safety in patients with active rheumatoid arthritis (RA) transitioning from rituximab [US-licensed rituximab: Reference Product (RP); EU-approved rituximab: Reference Medicinal Product (RMP)] to DRL_RI (proposed rituximab biosimilar), in comparison to those continuing on RP/RMP.

Methods: This double-blind, randomized, Phase 3 study included 140 RA patients having prior exposure to RP/RMP; transitioned to DRL_RI (n = 70) or continued with RP/RMP (n = 70) for two 1000 mg infusions on Days 1 and 15. Assessments included Time-matched Rituximab Concentration (TMRC), anti-drug antibodies (ADAs), neutralizing antibodies (NAbs) and ADA titre over 12 weeks, and safety follow-up till 26 weeks.

Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-versus-host Disease.

The oral microbiota, second in abundance to the gut, is implicated in chronic systemic diseases, but its specific role in GVHD pathogenesis has been unclear. Our study finds that mucositis-induced oral dysbiosis in patients post-hematopoietic cell transplantation associated with increased chronic GVHD (cGVHD) even in patients receiving post-transplant cyclophosphamide. In murine HCT models, oral dysbiosis caused by bilateral molar ligatures exacerbated cGVHD and increased bacterial load in the oral cavity and gut with Enterococcaceae significantly increasing in both organs.

Nonmotor Manifestations of Idiopathic Parkinson's Disease and Its Correlation with the Severity and Duration of the Disease: A Cross-sectional Study.

Overview: Parkinson's disease (PD) is a neurodegenerative disorder that is common in individuals over the age of 50 years, affecting about 1% of the population. Nonmotor symptoms (NMS) are a common occurrence in PD, but they are often ignored by motor symptoms. Studies have shown that NMS in PD show a significant impact on quality of life.

Generating Real-World Evidence From the Excellence Network in Rheumatology.

Purpose: The Excellence Network in RheumatoloGY (ENRGY) was founded in 2021 and encompasses data from more than 700 private practice rheumatology providers throughout the United States, forming a practice-based research network (PBRN).

Methods: Electronic health record (EHR) data from participating practices are aggregated, including structured data (e.g.

A large, multi-site lipidomic investigation of parity and aging in dairy cows.

Efforts to optimize the longevity of dairy cows are hindered by the increased risk of adverse health events, culling or dying on farm with increased parity. Lipidomics provides a platform to help identify important biomarkers and biological pathways associated with increased parity and associated aging. A large, multi-site (15 pasture-based, 15 TMR farms) cross-sectional study collected plasma samples from nonlactating, late pregnant, 'dry' cow (696 cows, ~27 d prepartum) and peak-milk cows (796 cows, ~58 DIM) in a disproportionate stratified (parity: 0, 1, 2, > 2 for dry cows; 1, 2, 3, > 3 for peak-milk cows) random sampling frame.

Robotic repair of a right paraduodenal hernia: a clinical presentation and management.

Paraduodenal hernias are rare internal hernias in which the small intestine becomes trapped behind the mesentery of the colon. These hernias can lead to bowel obstruction and ischaemia, making early diagnosis and intervention crucial. Patients often exhibit non-specific symptoms, highlighting the importance of using CT imaging for diagnosis.