Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke: The POST-TNK Randomized Clinical Trial.

Importance: The impact of adjunctive intra-arterial tenecteplase administration following near-complete to complete reperfusion by endovascular thrombectomy (EVT) for acute ischemic stroke is unknown.

Objective: To assess the efficacy and adverse events of adjunctive intra-arterial tenecteplase in patients with large vessel occlusion stroke who had achieved near-complete to complete reperfusion (defined as a score on the expanded Thrombolysis in Cerebral Infarction [eTICI] scale of 2c to 3) after EVT.

Design, Setting, And Participants: Investigator-initiated, randomized, open-label, blinded outcome assessment trial implemented at 34 hospitals in China among 540 patients with stroke due to proximal intracranial large vessel occlusion within 24 hours of the time they were last known to be well, with an eTICI score of 2c to 3 after EVT, and without prior intravenous thrombolysis.

Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke: The POST-UK Randomized Clinical Trial.

Importance: Persisting or new thrombi in the distal arteries and the microcirculation have been reported to limit the benefits of successful endovascular thrombectomy for patients with acute ischemic stroke. It remains uncertain whether intra-arterial thrombolysis by urokinase following near-complete to complete reperfusion by thrombectomy improves outcomes among patients with ischemic stroke due to large vessel occlusion.

Objective: To assess the efficacy and adverse events of intra-arterial urokinase after near-complete to complete reperfusion by thrombectomy for acute ischemic stroke due to large vessel occlusion.

Cigar, Pipe, and Smokeless Tobacco Use and Cardiovascular Outcomes From Cross Cohort Collaboration.

Importance: Cardiovascular health outcomes associated with noncigarette tobacco products (cigar, pipe, and smokeless tobacco) remain unclear, yet such data are required for evidence-based regulation.

Objective: To investigate the association of noncigarette tobacco products with cardiovascular health outcomes.

Design, Setting, And Participants: This cohort study was conducted within the Cross Cohort Collaboration Tobacco Working Group by harmonizing tobacco-related data and conducting a pooled analysis from 15 US-based prospective cohorts with data on the use of at least 1 noncigarette tobacco product ranging between 1948 and 2015.

Mental Health Utilization Among Transgender Veterans.

Importance: Compared with cisgender (CG) individuals, transgender and gender-diverse (TGD) individuals experience substantial social and economic disparities that can result in adverse mental health consequences. It is critical to understand potential barriers to care and to address the causes of the disparities in the future.

Objective: To characterize mental health care utilization among TGD veterans with depression.

The unseen animal behind medicine: exploring considerations of animal-derived medications and anaesthetics in today's landscape.

Requests for medical and anaesthetic care that is 'vegan' or free of animal-derived components are becoming increasingly common in the cultural landscape. Such requests are often rooted in religious beliefs and practices. There are currently no requirements for the disclosure of animal-derived components in medical items.

Atp1a2 and Kcnj9 Are Candidate Genes Underlying Sensitivity to Oxycodone-Induced Locomotor Activation and Withdrawal-Induced Anxiety-Like Behaviors in C57BL/6 Substrains.

Opioid use disorder is heritable, yet its genetic etiology is largely unknown. C57BL/6J and C57BL/6NJ mouse substrains exhibit phenotypic diversity in the context of limited genetic diversity which together can facilitate genetic discovery. Here, we found C57BL/6NJ mice were less sensitive to oxycodone (OXY)-induced locomotor activation versus C57BL/6J mice in a conditioned place preference paradigm.

Peripheral Vascular Emboli in Patients with Infective Endocarditis are Common.

Objective: Infective endocarditis (IE) is associated with significant morbidity and mortality and places patients at risk for subsequent peripheral vascular emboli. Our goals were to analyze the incidence of peripheral emboli and their associated complications and outcomes.

Methods: A retrospective single-center review of all patients with IE from 2013-2021 was performed.

The mysterious case of missing lymphocytes: a cautionary tale of inter-institutional variability in outcomes of lung dissociation protocols.

Rigor and reproducibility are vital to scientific advancement. It is unclear whether a protocol optimized for tissue dissociation in one institution performs well universally. Here, we share our brand-new lab's experience with inter-institutional variability that led to the discovery that a protocol optimized for murine lung dissociation at Boston University (BU) fails to reproduce similar CD4 T cell, CD8 T cell, and B cell outcomes at the University of Michigan at Ann Arbor (U-M).

Children's executive functioning and health behaviors across pediatric life stages and ecological contexts.

Executive functioning (EF) has been linked to chronic disease risk in children. Health behaviors are thought to partially explain this association. The current cross-sectional study evaluated specific domains of EF and varied health behaviors in three pediatric life stages.

Survey of Urogynecology Fellows on the Care of Patients with Differences in Sex Development/Intersex Traits.

Introduction And Hypothesis: Patients with differences in sex development or intersex traits (DSD/I) struggle to find clinically competent care in adulthood. We sought to describe the surgical exposure of Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows who had previously trained in ObGyn (URPS-Gyn) to patients with DSD/I and their interest in performing 18 relevant procedures. We hypothesized that most graduating fellows would not have had exposure to many of the surgeries.

A comprehensive analysis of serotype-specific invasive capacity, clinical presentations, and mortality trends of invasive pneumococcal disease.

Background: Pneumococcal conjugate vaccines (PCV) reduced invasive disease, but the overall prevalence of pneumococcal nasopharyngeal colonization among children has not changed significantly. Our knowledge of which serotypes, once colonized, hold a higher likelihood to cause invasive disease is limited.

Methods: Serotype-specific invasive capacity (IC) of Streptococcus pneumoniae was estimated using an enhanced population-based invasive pneumococcal disease (IPD) surveillance in children <7 years of age in Massachusetts and surveillance of nasopharyngeal (NP) colonization in selected Massachusetts communities in corresponding respiratory seasons.

Demographic Correlates of Autism: How Do Associations Compare Between Diagnosis and a Quantitative Trait Measure?

Prevalence of autism diagnosis has historically differed by demographic factors. Using data from 8224 participants drawn from the Environmental influences on Child Health Outcomes (ECHO) Program, we examined relationships between demographic factors and parent-reported autism-related traits as captured by the Social Responsiveness Scale (SRS; T score > 65) and compared these to relations with parent-reported clinician diagnosis of ASD, in generalized linear mixed effects regression analyses. Results suggested lower odds of autism diagnosis, but not of SRS T > 65, for non-Hispanic Black children (adjusted odds ratio [OR] = 0.

Development of a Japanese version of the patient perceptions of deprescribing - Short form.

Background: Deprescribing is a critical component of clinical practice, especially in geriatric medicine. Nevertheless, the attributes of patients who are prepared for, interested in, and could potentially benefit from deprescribing have not been well examined. The Patient Perceptions of Deprescribing (PPoD) evaluates patients' overall readiness for deprescribing and is complemented by an 11-item validated short form (SF-PPoD).

Barriers and facilitators to conducting human subjects research at a safety net institution from the perspective of researchers.

Introduction: The COVID-19 pandemic revealed glaring problems with clinical research enterprise. Faced with crisis, several trials opened rapidly but enrolled homogenous populations with few Black, Indigenous, and People of Color (BIPOC) individuals. Inclusive trial enrollment is important to inspire trust and confidence in BIPOC populations that have been historically excluded or harmed from research and to improve the generalizability of research findings.

Diuretics in patients with chronic kidney disease.

Diuretic drugs act on electrolyte transporters in the kidney to induce diuresis and are often used in chronic kidney disease (CKD), given that nephron loss creates a deficit in the ability to excrete dietary sodium, which promotes an increase in plasma volume. This rise in plasma volume is exacerbated by CKD-induced systemic and intra-renal activation of the renin-angiotensin-aldosterone-system, which further limits urinary sodium excretion. In the absence of a compensatory decrease in systemic vascular resistance, increases in plasma volume induced by sodium retention can manifest as a rise in systemic arterial blood pressure.

The technical expert/clinical user/patient panel (TECUPP): centering patient and family perspectives in patient-reported measure development.

Patient and caregiver perspectives are increasingly incorporated into health care research and policymaking, but their inclusion in the quality measure development process often is not robust. We describe a stakeholder panel model for incorporating patient/caregiver voices in the development of patient-reported measures, the Technical Expert/Clinical User/Patient Panel (TECUPP) model. This model is characterized by significant or equal representation of people with lived experience of the disease or condition (as patients or caregivers) to the clinicians and others with technical expertise who typically comprise technical expert panels.

Global Challenges in the Access of Endovascular Treatment for Acute Ischemic Stroke (Global MT Access).

Background: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

Aim: Our aim was to determine the key challenges for MT implementation and access worldwide.

Methods: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network, and as invited by co-authors between December 2022 and March 2023.

Maternal Gut Microbiome-Mediated Epigenetic Modifications in Cognitive Development and Impairments: A New Frontier for Therapeutic Innovation.

Cognitive impairment in various mental illnesses, particularly neuropsychiatric disorders, has adverse functional and clinical consequences. While genetic mutations and epigenetic dysregulations of several genes during embryonic and adult periods are linked to cognitive impairment in mental disorders, the composition and diversity of resident bacteria in the gastrointestinal tract-shaped by environmental factors-also influence the brain epigenome, affecting behavior and cognitive functions. Accordingly, many recent studies have provided evidence that human gut microbiota may offer a potential avenue for improving cognitive deficits.

Examining Virtual Delivery of Strength at Home for Intimate Partner Violence Perpetration.

This study examined the effectiveness of the virtual delivery of the Strength at Home (SAH) intervention program for intimate partner violence in a sample of 605 military veterans across 69 Veterans Affairs (VA) Medical Centers through a national implementation of the program. Outcome measures included physical IPV, psychological IPV, coercive control behaviors, post-traumatic stress disorder (PTSD) symptoms, and alcohol misuse. Significant pre-intervention to post-intervention reductions were found for all the outcomes, with similar effect size estimates relative to a prior investigation of in-person-delivered SAH through the same national VA implementation.

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts.

Purpose: Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

Methods:  Participants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.