Worldwide epidemiology of paediatric multiple sclerosis: data from the Multiple Sclerosis International Federation Atlas of MS, third edition.

Background: Limited data are available on the global rates of paediatric multiple sclerosis. Here, we report on the estimated worldwide prevalence of paediatric MS.

Methods: We included paediatric prevalence data in 2020-2022 (Multiple Sclerosis International Federation Atlas of MS) and the prevalence of child neurologists (International Child Neurology Association).

Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study.

Purpose: Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs).

Methods: This multicenter retrospective study included 214 OH patients with CS across 22 ICUs (2010-2021).

Development of a drug allergy alert tiering algorithm for penicillins and cephalosporins.

Introduction: Limited research is available regarding recommendations about which drug allergy alerts (DAAs) in clinical decision support (CDS) systems should interrupt provider workflow. The objective was to evaluate the frequency of penicillin and cephalosporin DAA overrides at two institutions. A secondary objective was to redesign DAAs using a new tiered alerting system based on patient factors.

Long-term posttransplant-related bone volumetric changes in eight face transplant recipients - A single-center retrospective case series.

Background: The long-term stability of allograft or native bone in facial vascularized composite allograft (fVCA) recipients is unclear. This study quantified long-term bone volume changes in facial transplants.

Methods: Computed tomography scans of eight fVCA recipients (2011-2023) were analyzed with Materialise Mimics.

Association between DNA damage repair alterations and outcomes to Lu-PSMA-617 in advanced prostate cancer.

Background: Lu-prostate-specific membrane antigen (PSMA)-617 (LuPSMA) is a radionuclide therapy approved for patients with PSMA-avid metastatic castrate-resistant prostate cancer (mCRPC). We evaluated whether alterations in the DNA damage repair (DDR) pathway were associated with outcomes to LuPSMA.

Patients And Methods: We identified an institutional cohort of men (n = 134) treated with ≥2 cycles of LuPSMA who had panel-based germline and/or tumor genomic sequencing.

Lysosomal dysfunction and inflammatory sterol metabolism in pulmonary arterial hypertension.

Vascular inflammation regulates endothelial pathophenotypes, particularly in pulmonary arterial hypertension (PAH). Dysregulated lysosomal activity and cholesterol metabolism activate pathogenic inflammation, but their relevance to PAH is unclear. Nuclear receptor coactivator 7 () deficiency in endothelium produced an oxysterol and bile acid signature through lysosomal dysregulation, promoting endothelial pathophenotypes.

Outpatient Palliative Care and End-of-Life Care Intensity: Linking Massachusetts Cancer Registry with All-Payer Claims.

Background: Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks.

Methods: We linked Massachusetts Cancer Registry and the All-Payer Claims Database for individuals with commercial insurance, Medicaid or Medicare Advantage diagnosed with colorectal, lung, prostate, and breast cancers from 2010 through 2013 who died by December 31, 2014.

Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence.

Background: Obesity, classified by body mass index (BMI), is associated with higher postmenopausal breast cancer (BCa) risk. Yet, the associations between abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) with BCa are unclear.

Methods: We assessed BCa associations with abdominal VAT and SAT in a prospective cohort of postmenopausal women without a history of cancer and with 27 years follow-up (N = 9950), during which all new cancers were adjudicated.

Epstein-Barr virus BALF0/1 subverts the Caveolin and ERAD pathways to target B cell receptor complexes for degradation.

Epstein-Barr virus (EBV) establishes persistent infection, causes infectious mononucleosis, is a major trigger for multiple sclerosis and contributes to multiple cancers. Yet, knowledge remains incomplete about how the virus remodels host B cells to support lytic replication. We previously identified that EBV lytic replication results in selective depletion of plasma membrane (PM) B cell receptor (BCR) complexes, composed of immunoglobulin and the CD79A and CD79B signaling chains.

Worsening of Heart Failure in Outpatients With Transthyretin Amyloidosis and Cardiomyopathy in the APOLLO-B Trial.

Background: Outpatient worsening heart failure (HF), defined by initiation or intensification of diuretics, is adversely prognostic for patients with either reduced or preserved ejection fraction.

Objectives: This study sought to investigate the prognostic value of outpatient worsening HF in transthyretin amyloidosis with cardiomyopathy and the effect of patisiran treatment.

Methods: Post hoc analyses of the APOLLO-B trial (NCT03997383) evaluated the associations between outpatient worsening HF (defined by oral diuretic initiation or intensification), measures of disease progression, and a composite endpoint of all-cause mortality and cardiovascular (CV) events.

Outcomes of chronic limb-threatening ischemia revascularization in patients with chronic kidney disease in the BEST-CLI trial.

Background: Chronic limb-threatening ischemia (CLTI) in patients with chronic kidney disease (CKD) has a high risk of poor outcomes. We aimed to compare the outcomes of lower extremity revascularization in patients with CLTI stratified by CKD severity in patients enrolled in the prospective, randomized Best Endovascular vs Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.

Methods: The BEST-CLI trial dataset was queried to categorize patients into three groups according to CKD stage.

Intrapericardial Corticosteroids and Colchicine Prevent Pericarditis and Atrial Fibrillation After Epicardial Ablation of Ventricular Arrhythmias.

Background: Postprocedural pericarditis (PP) can occur in up to 29.4% of patients undergoing epicardial catheter ablation of ventricular tachycardia (VT). Despite several proposed strategies to mitigate this adverse outcome, rates of PP and pericarditic pain remain high.

Effects of Age and Sex on Systemic Inflammation and Cardiometabolic Function in Individuals With Type 2 Diabetes.

Background: Systemic inflammation, aging, and type 2 diabetes (T2D) lead to varying degrees of cardiovascular dysfunction and impaired aerobic exercise capacity. This study evaluates the impact of inflammation and sex differences on coronary and peripheral vascular function and exercise capacity in older individuals with and without T2D.

Methods: Older individuals (aged≥65 years) underwent biochemical and tissue inflammatory phenotyping, cardiopulmonary exercise testing, cardiovascular magnetic resonance imaging, and vascular reactivity testing.

Comprehensive Assessment of the Risk of Symptomatic Embolism in Patients With Infective Endocarditis.

Background: Echocardiographic evaluation of vegetations is crucial in infective endocarditis (IE). Although several studies have noted a link between larger vegetations and an increased risk of embolization, a more comprehensive evaluation of vegetation characteristics in a contemporary cohort has not been conducted. Our study aimed to define the short-term risk of symptomatic embolization in patients with IE.

Endothelial FOXM1 and Dab2 promote diabetic wound healing.

Diabetes mellitus can cause impaired and delayed wound healing, leading to lower extremity amputations; however, the mechanisms underlying the regulation of vascular endothelial growth factor-dependent (VEGF-dependent) angiogenesis remain unclear. In our study, the molecular underpinnings of endothelial dysfunction in diabetes are investigated, focusing on the roles of disabled-2 (Dab2) and Forkhead box M1 (FOXM1) in VEGF receptor 2 (VEGFR2) signaling and endothelial cell function. Bulk RNA-sequencing analysis identified significant downregulation of Dab2 in high-glucose-treated primary mouse skin endothelial cells.

Leveraging human centered design to enhance clinician communication during pregnancy care: Overcoming language barriers with Spanish-speaking patients.

Background: Engaging patients in quality improvement and innovation projects is increasingly important, yet challenges persist with involving patients who speak languages other than English. This article presents design activities our team used to engage Spanish-speaking patients and cultural brokers.

Objective: To develop a clinician communication tool to enhance patient trust in pregnancy care clinicians, especially among minoritized populations who face language and cultural barriers, using human-centered design (HCD).

Brain mapping during resection of high-grade brain arteriovenous malformation.

Eloquent brain creates a challenge when resecting brain arteriovenous malformations (bAVMs). Here the authors present their technique of using subcortical motor mapping as an adjunct to increase safety during resection of a high-grade bAVM involving somatosensory cortex as well as cortical spinal tracts and visual tracts. After a bilateral craniotomy, they use direct cortical stimulation of the left motor cortex and subcortical stimulation using a suction stimulator to dynamically map motor tracts during the resection.

Motor mapping-guided resection of a brainstem recurrent pilocytic astrocytoma.

Brainstem tumors are bounded by a compact topography of eloquent tracts, cranial nerves, and nuclei. Reliable intraoperative neuromonitoring aids microneurosurgical technique to optimize safe resection. The authors present a case of motor mapping-guided resection of a recurrent brainstem pilocytic astrocytoma.

Utility of loop diuretics as a marker of risk in clinical trials of heart failure with preserved ejection fraction: Analysis from the Swedish Heart Failure Registry.

Aims: It is common in heart failure (HF) trials, especially in HF with preserved (HFpEF) and mildly reduced ejection fraction (HFmrEF), to select for increased risk of outcomes ('enrichment'). We investigated the association between loop diuretic use and common trial outcomes.

Methods And Results: Patients in the Swedish HF Registry with HFmrEF and HFpEF were divided into three groups: no loop diuretic use, 1-40 mg furosemide equivalent, and >40 mg.

Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials.

Aims: The sodium-glucose cotransporter 2 inhibitor canagliflozin reduces the risk of heart failure (HF) hospitalization or cardiovascular death and chronic kidney disease (CKD) progression among patients with type 2 diabetes at high cardiovascular risk or with CKD. Patients with type 2 diabetes commonly have coexisting HF or CKD that require treatment with loop diuretics; however, the prognostic implications of oral loop diuretic intensification are not well characterized.

Methods And Results: In this participant-level pooled analysis of the CREDENCE and CANVAS trials (not including CANVAS-R), 1454/8731 (16.