Potential to reduce margins and Shrink targets in patients with intact cervical cancer treated on An MRI guided radiation therapy (MRgRT) system.

Introduction: Consensus contouring guidelines for intensity-modulated-radiation-therapy (IMRT) of patients with locally advanced cervix cancer (LACC) advise including the whole uterus in the target volume and adding generous planning-target-volumes (PTVs) to account for motion uncertainties of the gross-tumor-volume (GTV). The primary objective of this analysis was to assess the interfractional GTV motions using a magnetic-resonance-image (MRI) guided-Radiation-Therapy (MRgRT) system to investigate the margins required for MRgRT treatments.

Methods: 125 daily set-up MRIs from five patients with LACC who received MRgRT were analyzed.

Consensus Guidelines for Delineation of Clinical Target Volumes for Intensity Modulated Radiation Therapy for Intact Cervical Cancer: An Update.

Purpose: Accurate target delineation is essential when using intensity modulated radiation therapy for intact cervical cancer. In 2011, the Radiation Therapy Oncology Group published a consensus guideline using magnetic resonance imaging (MRI). The current project expands on the previous atlas by including computed tomography (CT)-based contours, contours with MRI and positron emission tomography (PET) registrations, the addition of common and complex scenarios, and incorporating information on simulation and treatment planning techniques.

Representation of women and racial minorities in SGLT2 inhibitors and heart failure clinical trials.

Background: Inadequate representation of women and racial minorities in heart failure (HF) clinical trials continues to limit the generalizability of the results. This could create a disparity in treatment for future heart failure therapies and devices. The study aims to assess the representation of women and racial minorities in recent heart failure studies involving sodium-glucose cotransporter-2 (SGLT-2) inhibitors.

Comparison of waitlist and post-transplant outcomes in patients supported with total artificial heart versus continuous biventricular assist devices.

Background: Durable biventricular support may be necessary to bridge patients with end-stage biventricular failure to heart transplantation. This study compares waitlist and post-transplant outcomes between patients supported with continuous flow, durable biventricular assist devices (BiVAD), and total artificial heart (TAH).

Methods: Using the UNOS registry, we analyzed adult (≥18 years old), first-time transplant candidates with TAH or BiVAD at the time of listing or transplantation from 10/1/2010-10/31/2020, with follow-up through 3/31/2022.

Iota-carrageenan as a regenerating system for Eu recovery: adsorption/desorption cycles.

Renewable and biodegradable polysaccharides attract attention as environmentally friendly adsorbents for the removal of heavy metals from wastewater. One such group, is carrageenan, of which were recently successfully employed to adsorb representative lanthanide and actinide ions. Herein, iota-carrageenan-based hydrogels were used to adsorb europium ions (Eu) from water solutions, followed by desorption of the ions from the hydrogel beads and recycling of the beads three times.

Analgesia and Anesthesia Practice Patterns for Gynecologic Brachytherapy Procedures and Potential Impact on Women's Procedural Experience: A National Survey.

Purpose: The purpose of this study was to determine the current U.S. practice patterns of analgesia (AG) and anesthesia (AS) for gynecologic brachytherapy (BT) procedures.

Instructional approach, sleep, and perceived academic well-being in adolescents during COVID-19: Evidence from the NESTED study.

Objectives: At the peak of COVID-19, adolescent life was disrupted as schools adapted their instructional approaches such as online, in-person, or hybrid instruction. We and others have previously commented on how these shifts facilitated longer, later and (more developmentally appropriate) sleep. Here, we report how sleep contributed to associations between remote instruction and broader academic well-being (e.

A descriptive study of sleep patterns and knowledge among department of juvenile services staff.

Study Objectives: Little is known about sleep health among staff in the US juvenile justice system. Poor sleep health is associated with negative mental and physical health, which may impact daily interactions and treatment of detained youth. The current study explored sleep-wake patterns and sleep health knowledge of Department of Juvenile Services (DJS) staff in Maryland (MD).

Accuracy and correlation of bed and standing scale weights in monitoring volume status in heart failure patients.

Accurate volume status monitoring is crucial for effective diuretic therapy in patients with acute decompensated heart failure (ADHF). While guidelines recommend daily standing body weight measurement as an indicator of volume status, bed scales are commonly used in healthcare facilities. A method-comparison design was used to compare bed and standing scale weights among adults hospitalized with ADHF at Los Angeles County-University of Southern California Medical Center between March and April 2023.

Drug Allergy Mimics.

When approaching a case of apparent drug allergy, the consulting clinician should consider a broad differential diagnosis. This article presents a series of cases that could be commonly referred to an allergist for assessment as "drug allergy," however, a real diagnosis exists that mandates a different diagnostic and treatment strategy, including a case of inducible laryngeal obstruction, multiple drug intolerance syndrome, viral rash, seizure due to metastatic malignancy, and hemophagocytic lymphohistiocytosis initially diagnosed as drug reaction and eosinophilia with systemic symptoms. The initial misdiagnoses of these patients delayed or interfered with their medical care, emphasizing the importance of accurate diagnoses for the benefit of our patients.

Successful Pregnancy After Left Ventricular Assist Device Explantation for Myocardial Recovery.

A 36 year old woman with history of heart failure and left ventricular assist device (LVAD) implantation, with subsequent explantation after myocardial recovery, presented for management of preconception counseling and subsequent pregnancy. To our knowledge, this case represents the first documented successful pregnancy after LVAD explantation. Management details are provided, and relevant literature is reviewed.

Sleep Health among Children Adopted from Foster Care: The Moderating Effect of Parent-Child Sleep Interactions.

Objectives: Sleep disruption is prevalent among children placed in foster care, elevating risk for a range of deleterious outcomes. Theoretically, achieving permanency via adoption may have a positive influence on children's sleep via the presence of various factors, but little is known about the sleep health of children adopted from foster care, including predictors and moderators of sleep health.

Method: The current study included 226 parents who adopted a child from foster care in the U.

The associations between instructional approach, sleep characteristics and adolescent mental health: Lessons from the COVID-19 pandemic.

Objectives: To test whether adolescents' mental health during the COVID-19 pandemic is associated with the combination of their instructional approach(es) and their sleep patterns.

Design: Cross-sectional.

Setting: Adolescents were recruited through social media outlets in October and November 2020 to complete an online survey.

Predicting Penicillin Allergy: A United States Multicenter Retrospective Study.

Background: Using the reaction history in logistic regression and machine learning (ML) models to predict penicillin allergy has been reported based on non-US data.

Objective: We developed ML positive penicillin allergy testing prediction models from multisite US data.

Methods: Retrospective data from 4 US-based hospitals were grouped into 4 datasets: enriched training (1:3 case-control matched cohort), enriched testing, nonenriched internal testing, and nonenriched external testing.

Biosorption of uranyl ions from aqueous solutions by soluble renewable polysaccharides.

Polysaccharides derived from natural sources have been offered as environment friendly sorbents for the adsorption of heavy metals. We present a simple technique to remove uranyl ions from aqueous solutions by using representative polysaccharides. The adsorption efficiency of UO decreased in the following order: xanthan gum > kappa > iota/guar gum, for instance, the efficiencies after sorption of 30 min with 500 mg per L uranyl acetate and 0.

Selective Sorption of Heavy Metals by Renewable Polysaccharides.

Renewable and biodegradable polysaccharides have attracted interest for their wide applicability, among them their use as sorbents for heavy metal ions. Their high sorption capacity is due mainly to the acidic groups that populate the polysaccharide backbone, for example, carboxylic groups in alginate and sulfate ester groups in the iota and lambda carrageenans. In this study, these three polysaccharides were employed, alone or in different mixtures, to recover different heavy metal ions from aqueous solutions.

A Pilot Randomized Control Trial Demonstrating the Efficacy of the SIESTA Sleep Hygiene Intervention.

Shorter sleep duration can negatively impact children's daytime functioning and health. Latino children living near urban areas in the Mainland U.S.

Drug Allergy in Women.

Across all settings, women self-report more drug allergies than do men. Although there is epidemiologic evidence of increased drug allergy labeling in postpubertal females, the evidence base for female sex as a risk factor for true immune-mediated drug hypersensitivity reactions (DHRs), particularly in fatal drug-induced anaphylaxis, is low. A focus on the known immunologic mechanisms described in immediate and delayed DHR, layered on known hormonal and genetic sex differences that drive other immune-mediated diseases, could be the key to understanding biological sex variations in DHR.

Sleep and circadian health in juvenile justice systems: A descriptive analysis.

Objective: Few studies have explored sleep health and environmental influences on sleep and circadian health within juvenile justice facilities. The current study aims to describe sleep and circadian health of adolescents living in detention and treatment facilities.

Methods: Youth (N = 62) were recruited from 11 Department of Juvenile Services facilities.

Assessment of Aortic Characteristic Impedance and Arterial Compliance from Non-invasive Carotid Pressure Waveform in The Framingham Heart Study.

The primary goal of this study was to test the hypothesis that a hybrid intrinsic frequency-machine learning (IF-ML) approach can accurately evaluate total arterial compliance (TAC) and aortic characteristic impedance (Zao) from a single noninvasive carotid pressure waveform in both women and men with heart failure (HF). TAC and Zao are cardiovascular biomarkers with established clinical significance. TAC is lower and Zao is higher in women than in men, so women are more susceptible to the consequent deleterious effects of them.

Social Determinants of Health and COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected disadvantaged populations. Many of the factors related to the disproportionate impact on underserved communities are related to social determinants of health, defined by the World Health Organization as the nonmedical factors that influence health outcomes. They include the wider set of forces and systems shaping the conditions of daily life.

New UNOS allocation system associated with no added benefit in waitlist outcomes and worse post-transplant survival in heart-kidney patients.

Background: The 2018 United Network for Organ Sharing (UNOS) heart transplant policy change (PC) sought to improve waitlist risk stratification to decrease waitlist mortality and promote geographically broader sharing for high-acuity patients awaiting heart transplantation. Our analysis sought to determine the effect of the UNOS PC on outcomes in patients waiting for, or who have received, a heart-kidney transplantation.

Methods: We analyzed adult (≥18 years old), first-time, heart-only and heart-kidney transplant candidates and recipients from the UNOS Registry.

Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations.