Objective: To develop and retrospectively analyze an instrument that rapidly characterizes pretreatment stroke severity for use in prehospital acute stroke clinical trials.
Methods: The Los Angeles Motor Scale (LAMS) was constructed by assigning point values to Los Angeles Prehospital Stroke Screen (LAPSS) items of facial weakness, arm strength, and grip to yield a total 0-5 scale. The concurrent, discriminant, and predictive validities of the LAMS were probed using data from 90 patients enrolled in acute stroke clinical trials. Predictive performance of the LAMS was compared with that of the initial full National Institutes of Health Stroke Scale (NIHSS) and the five-item shortened NIHSS (sNIHSS) in projecting long-term outcomes on standard functional end points.
Results: LAMS score at entry averaged mean 2.6, median 2. Entry LAMS scores correlated closely with entry NIHSS scores (r=0.75). LAMS score correlations with three-month functional outcome measures were robust. Receiver operator curve analyses (c statistic) for performance in predicting three-month outcomes were: three-month modified Rankin-LAMS 0.75, sNIHSS 0.69, NIHSS 0.74; three-month Barthel Index-LAMS 0.77, sNIHSS 0.76, NIHSS 0.82; three-month NIHSS-LAMS 0.76, sNIHSS 0.62, NIHSS 0.70; and three-month GOS-LAMS 0.55, sNIHSS 0.67, NIHSS 0.76. Considering dichotomized three-month measures, entry LAMS scores were markedly lower in patients destined for excellent outcome, e.g., three-month modified Rankin score
Conclusions: A motor score derived from the LAPSS rapidly quantifies stroke severity in the field and predicts functional outcomes with accuracy comparable to that of the full NIHSS and the sNIHSS.
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http://dx.doi.org/10.1080/312703002806 | DOI Listing |
J Clin Oncol
January 2025
Children's Hospital of Philadelphia/University of Pennsylvania, Philadelphia, PA.
Larotrectinib is a highly selective tropomyosin receptor kinase (TRK) inhibitor with efficacy in children with TRK fusion tumors. We evaluated patient outcomes after elective discontinuation of larotrectinib in the absence of disease progression in a protocol-defined wait-and-see subset analysis of eligible patients where treatment resumption with larotrectinib was allowed if disease progressed. We also assessed the safety and efficacy of larotrectinib in all pediatric patients with sarcoma.
View Article and Find Full Text PDFPurpose: Outcomes for patients with advanced sarcomas are poor and there is a high unmet need to develop novel therapies. The purpose of this phase I study was to define the safety and efficacy of botensilimab (BOT), an Fc-enhanced anti-cytotoxic lymphocyte-association protein-4 antibody, plus balstilimab (BAL), an anti-PD-1 antibody, in advanced sarcomas.
Methods: BOT was administered intravenously (IV) at 1 mg/kg or 2 mg/kg once every 6 weeks in combination with BAL IV at 3 mg/kg once every 2 weeks for up to 2 years.
STAR Protoc
January 2025
Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, MA, USA. Electronic address:
Host response to environmental exposures such as pathogens and chemicals can include modifications to the epigenome and transcriptome. Improved signature discovery, including the identification of the agent and timing of exposure, has been enabled by advancements in assaying techniques to detect RNA expression, DNA base modifications, histone modifications, and chromatin accessibility. The interrogation of the epigenome and transcriptome cascade requires analyzing disparate datasets from multiple assay types, often at single-cell resolution, derived from the same biospecimen.
View Article and Find Full Text PDFAnnu Rev Med
January 2025
Division of Gastrointestinal and Liver Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA; email:
Hepatorenal syndrome-acute kidney injury (HRS-AKI) occurs in the setting of advanced chronic liver disease, portal hypertension, and ascites. HRS-AKI is found in ∼20% of patients presenting to the hospital with AKI, but it may coexist with other causes of AKI and/or with preexisting chronic kidney disease, thereby making the diagnosis challenging. Novel biomarkers such as urinary neutrophil gelatinase-associated lipocalin may be useful.
View Article and Find Full Text PDFAnnu Rev Med
January 2025
University of California, Los Angeles (UCLA) Clinical AIDS Research and Education (CARE) Center, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; email:
Despite rapid advances in the field of HIV prevention and treatment, unacceptably high global HIV incidence rates highlight the ongoing need for effective HIV prevention interventions for populations at risk for HIV acquisition. This article provides an updated review of the current data surrounding HIV prevention strategies, including treatment as prevention (TasP), preexposure prophylaxis (PrEP), and postexposure prophylaxis (PEP), as well as advances in sexually transmitted infection biomedical prevention. This review provides an overview of the multiple PrEP modalities that are available globally, such as oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring, and describes their respective clinical trials, efficacies, and regulatory approvals.
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