Management of Stent Underexpansion and Aorto-ostial Lesions.

Stent underexpansion (SU) and aorto-ostial lesions (AOL) are challenging conditions commonly faced during clinical practice in the setting of percutaneous coronary interventions. Compared to other interventional settings, both SU and AOL are associated with an increased risk of immediate and late events following percutaneous coronary intervention. Several specific strategies including the systematic use of intracoronary imaging and dedicated techniques for lesions' preparation and calcium debulking have been described.

Efficacy of malic and tartaric acid in mitigation of cadmium stress in Spinacia oleracea L. via modulations in physiological and biochemical attributes.

The increasing level of cadmium (Cd) contamination in soil due to anthropogenic actions is a significant problem. This problem not only harms the natural environment, but it also causes major harm to human health via the food chain. The use of chelating agent is a useful strategy to avoid heavy metal uptake and accumulation in plants.

Symptomatic Improvement in Adults and Adolescents With Eosinophilic Esophagitis Requires Higher Systemic Dupilumab Exposure Than Histologic Response.

Introduction: We assessed potential mechanisms behind the requirement for more frequent dupilumab dosing in eosinophilic esophagitis (EoE) compared with other approved indications.

Methods: Results for the phase 3 LIBERTY EoE TREET study coprimary endpoints (proportion of patients achieving a peak intraepithelial eosinophil count of ≤6 eosinophils per high-power field and absolute change from baseline in Dysphagia Symptom Questionnaire total score) were pooled in exposure-response analyses.

Results: A steep initial relationship then plateau was observed between higher dupilumab steady-state trough concentrations and decreased eosinophilic infiltration at week 24, whereas a graded exposure-response relationship was observed for symptomatic improvement at week 24.

Potential antihyperlipidemic effects of myrcenol and curzerene in high-fat fed rats.

The study evaluated the anti-hyperlipidemic effects of myrcenol and curzerene on a high fat diet induced hyperlipidemia rat model. Thirty male albino rats were fed on a high-fat diet for four months. The HFD-induced hyperperlipidemia rats were treated with rosuvastatin (10 mg/kg), curzerene (130 mg/kg) and myrcenol (100 mg/kg) for four weeks.

Feasibility of long-range telesurgical robotic radical gastrectomy in a live porcine model.

Background: Telesurgery has been made increasingly possible with the advancements in robotic surgical platforms and network connectivity. However, long-distance transnational complex robotic surgeries such as gastrectomy have yet to be attempted.

Methods: Multiple transnational network connections by Science Innovation Network (SINET), Japan Gigabit Network (JGN), and Arterial Research and Education Network in Asia-Pacific (ARENA-PAC) were established and tested by multiple surgeons in a dry box model.

Comparative Analysis of Mechanistic and Correlative Models for Global and Bhutan-Specific Suitability of Parthenium Weed and Vulnerability of Agriculture in Bhutan.

Parthenium weed ( L.) is one of the most noxious and fast-spreading invasive alien species, posing a major threat to ecosystems, agriculture, and public health worldwide. Mechanistic and correlative species distribution models are commonly employed to determine the potential habitat suitability of parthenium weed.

Comprehensive diagnosis in chronic coronary syndromes combining angiography and intracoronary testing: the AID-ANGIO study.

Background: The diagnostic yield of invasive coronary angiography (ICA) in patients with chronic coronary syndromes (CCS) in contemporary practice is uncertain.

Aims: We investigated the value of an advanced invasive diagnosis (AID) strategy combining angiography and intracoronary testing.

Methods: AID-ANGIO is an all-comers, prospective, multicentre study enrolling CCS patients referred for ICA.

A Cross-Sectional Evaluation of Opioid Dispensing Competencies in Final-Year Pharm-D Students: A Multicenter Study from Punjab, Pakistan.

Background: The opioid crisis continues to be a public health concern worldwide due to the high rates of misuse and associated mortality. Opioid dispensing competencies are critical for pharmacy graduates to promote the rational use of opioids.

Purpose: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.

Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach.

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

Cerebellopontine angle paraganglioma masquerading as vestibular schwannoma.

Paragangliomas are slow-growing, extra-adrenal neuroendocrine tumors with rare intracranial presentation. Although benign, they can be locally aggressive tumors causing bone destruction and compression related symptoms. We report the case of a 19 years old, normotensive female who presented with headache and vertigo for the past six months.

A co-design process to develop personalized mobility programming for individuals with mobility impairments.

Introduction: Individuals with neurological conditions (e.g., stroke, spinal cord injury, multiple sclerosis) may experience challenges to their mobility.

Symptomatic Improvement in Adults and Adolescents with Eosinophilic Esophagitis Requires Higher Systemic Dupilumab Exposure than Histologic Response.

Introduction: We assessed potential mechanisms behind the requirement for more frequent dupilumab dosing in eosinophilic esophagitis (EoE) compared with other approved indications.

Methods: Results for the phase 3 LIBERTY EoE TREET study co-primary endpoints (proportion of patients achieving a peak intraepithelial eosinophil count of ≤6 eosinophils per high-power field and absolute change from baseline in Dysphagia Symptom Questionnaire total score) were pooled in exposure-response analyses.

Results: A steep initial relationship then plateau was observed between higher dupilumab steady state trough concentrations (Ctrough) and decreased eosinophilic infiltration at Week 24, while a graded exposure-response relationship was observed for symptomatic improvement at Week 24.

Immunogenicity of dupilumab in adult and pediatric patients with atopic dermatitis.

Background: Development of anti-drug antibodies (ADAs) and neutralizing antibodies (NAbs) to monoclonal antibodies may adversely impact pharmacokinetics, efficacy, and/or safety.

Objective: To describe incidence, titer, and persistence of dupilumab ADAs and NAbs, and their effects on pharmacokinetics, efficacy, and safety in patients with atopic dermatitis (AD).

Methods: This analysis included seven phase 3 randomized, placebo-controlled (N=2,992) and two long-term open-label extension (N=2,287) trials of subcutaneous dupilumab in adults and pediatric patients with moderate-to-severe AD.

Association between the variations in metabolic pathways and oral cancer risk: results from a Pakistani case-control study.

Background: Oral cancer (OC) is a significant global health concern, with Pakistan ranking 5th worldwide in OC incidence. Given the poor prognosis, early detection of at-risk individuals is crucial. Genetic factors, particularly single nucleotide polymorphisms (SNPs) in metabolic genes, may influence OC susceptibility.

Safety outcomes of suspected cardiac pathology assessed in an ambulatory rapid-access cardiology clinic.

Cardiac pathology contributes to a significant proportion of emergency department (ED) attendances. Many could be managed as urgent outpatients and avoid hospital admission. We evaluated a novel rapidaccess general cardiology clinic to achieve this, implemented during the COVID-19 pandemic.

Serum lipidomic signatures in patients with varying histological severity of metabolic-dysfunction associated steatotic liver disease.

Background & Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a spectrum of pathologies ranging from simple steatosis to steatohepatitis, fibrosis and cirrhosis. Patients with metabolic associated steatohepatitis (MASH) with fibrosis are at greatest risk of liver and cardiovascular complications. To identify such at-risk MASLD patients, physicians are still reliant on invasive liver biopsies.

Feasibility and Improved Diagnostic Yield of Intracoronary Adenosine to Assess Microvascular Dysfunction With Bolus Thermodilution.

Background: Bolus thermodilution and intravenous adenosine are established methods for coronary microcirculatory assessment. Yet, its adoption remains low, partly due to procedural time and patient discomfort associated with intravenous adenosine. We investigated differences between intracoronary and intravenous adenosine using bolus thermodilution in terms of microcirculatory indices, procedural time, and side effects associated with adenosine in patients with myocardial ischemia and nonobstructive coronary arteries.

Determinants of quality of life and emotional well-being in a bariatric surgery seeking cohort of 1501 multi-ethnic Asian patients.

Objective: The relationship between ethnicity, obesity and health-related quality of life outcomes in a multi-ethnic population remains poorly understood. We aim to investigate the relationship between ethnicity, body mass index (BMI), obesity-associated diseases, as well as determinants of quality of life (QoL) in Southeast Asian patients with obesity. We aim to develop and validate a simple objective score to identify patients with obesity at high risk for major depression.

The NITRATE-OCT study-inorganic nitrate reduces in-stent restenosis in patients with stable coronary artery disease: a double-blind, randomised controlled trial.

Background: Coronary angioplasty and stent insertion is a first line treatment for patients with coronary artery disease, however it is complicated in the long-term by in-stent restenosis (ISR) in a proportion of patients with an associated morbidity. Despite this, currently there are no effective treatments available for the prevention of ISR. Repeat percutaneous revascularisation carries increased risks of major adverse cardiovascular events and a higher incidence of stent failure.