Active Monitoring With or Without Endocrine Therapy for Low-Risk Ductal Carcinoma In Situ: The COMET Randomized Clinical Trial.

Importance: Active monitoring for low-risk ductal carcinoma in situ (DCIS) of the breast has been proposed as an alternative to guideline-concordant care, but the safety of this approach is unknown.

Objective: To compare rates of invasive cancer in patients with low-risk DCIS receiving active monitoring vs guideline-concordant care.

Design, Setting, And Participants: Prospective, randomized noninferiority trial enrolling 995 women aged 40 years or older with a new diagnosis of hormone receptor-positive grade 1 or grade 2 DCIS without invasive cancer at 100 US Alliance Cancer Cooperative Group clinical trial sites from 2017 to 2023.

Sex Differences in Cardiovascular-Kidney-Metabolic Syndrome: 30-Year US Trends and Mortality Risks-Brief Report.

Background: The American Heart Association recently published guidelines on how to clinically identify and categorize individuals with cardiovascular-kidney-metabolic (CKM) syndrome. The extent to which CKM syndrome prevalence and prognosis differ by sex remains unknown. This study aimed to examine the impact of sex on trends in prevalence over 30 years and the long-term prognosis of CKM syndrome in the United States.

Cost-effectiveness of radiofrequency echographic multi-spectrometry for the diagnosis of osteoporosis in the United States.

Radiofrequency echographic multi-spectrometry (REMS) is an innovative, non-ionizing diagnostic technique that has shown high accuracy and precision, making it a promising alternative to DXA for osteoporosis diagnosis in clinical settings. With economic considerations playing an increasingly crucial role in healthcare decisions, this study aims to evaluate the cost-effectiveness and economic impact of improved osteoporosis diagnosis using REMS followed by treatment in the United States. A microsimulation-based Markov model was constructed to estimate the cost per quality-adjusted life year (QALY) gained (in US$2022) for REMS followed by treatment vs no diagnosis and treatment in US women aged 50 yr and older with osteoporosis.

Management of acute decompensated valvular heart disease.

Worldwide, valvular heart disease (VHD) is a common cause of hospitalization for acute heart failure. In acute heart failure caused by VHD, symptoms result from rapid haemodynamic changes and subsequent decline in cardiac function, and if left untreated, leads to acute decompensation and cardiogenic shock. Current evidence remains scarce and recommendations regarding the management of acute heart failure caused by VHD are lacking in most recent international guidelines.

π-HuB: the proteomic navigator of the human body.

The human body contains trillions of cells, classified into specific cell types, with diverse morphologies and functions. In addition, cells of the same type can assume different states within an individual's body during their lifetime. Understanding the complexities of the proteome in the context of a human organism and its many potential states is a necessary requirement to understanding human biology, but these complexities can neither be predicted from the genome, nor have they been systematically measurable with available technologies.

A case report of verapamil toxicity leading to haemodynamic compromise in obstructive hypertrophic cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) is an inherited condition characterized by left ventricular (LV) hypertrophy unexplained by increased afterload, often with concomitant outflow tract obstruction. Verapamil is commonly used to treat symptomatic patients. However, its potential for adverse effects should be recognized.

Current and emerging strategies for the prevention of hepatocellular carcinoma.

Liver cancer is the third leading cause of cancer-related deaths globally, with incident cases expected to rise from 905,700 in 2020 to 1.4 million by 2040. Hepatocellular carcinoma (HCC) accounts for about 80% of all primary liver cancers.

Physician Reasons for or Against Treatment Intensification in Patients With Metastatic Prostate Cancer.

Importance: Clarifying the underutilization of treatment intensification (TI) for metastatic castration-sensitive prostate cancer (mCSPC) may improve implementation of evidence-based medicine and survival outcomes.

Objective: To investigate physicians' beliefs about TI in mCSPC to understand the gap between evidence-based guidelines and clinical practice.

Design, Setting, And Participants: This survey study analyzed data from the Adelphi Real World retrospective survey, which comprised physician surveys that were linked to medical record reviews of US adult patients treated for mCSPC between July 2018 and January 2022.

Automated Evaluation for Pericardial Effusion and Cardiac Tamponade with Echocardiographic Artificial Intelligence.

Background: Timely and accurate detection of pericardial effusion and assessment cardiac tamponade remain challenging and highly operator dependent.

Objectives: Artificial intelligence has advanced many echocardiographic assessments, and we aimed to develop and validate a deep learning model to automate the assessment of pericardial effusion severity and cardiac tamponade from echocardiogram videos.

Methods: We developed a deep learning model (EchoNet-Pericardium) using temporal-spatial convolutional neural networks to automate pericardial effusion severity grading and tamponade detection from echocardiography videos.

Implementing Precision Medicine for Dilated Cardiomyopathy: Insights from The DCM Consortium.

Background: Clinical genetic evaluation of dilated cardiomyopathy (DCM) is implemented variably or not at all. Identifying needs and barriers to genetic evaluations will enable strategies to enhance precision medicine care.

Methods: An online survey was conducted in June 2024 among cardiologist investigators of the DCM Consortium from US advanced heart failure/transplant (HF/TX) programs to collect demographics, training, program characteristics, genetic evaluation practices for DCM, and implementation needs.

Genome-wide association study reveals shared and distinct genetic architecture of fatty acids and oxylipins in the Hispanic Community Health Study/Study of Latinos.

Bioactive fatty acid-derived oxylipin molecules play key roles mediating inflammation and oxidative stress. Circulating levels of fatty acids and oxylipins are influenced by environmental and genetic factors; characterizing the genetic architecture of bioactive lipids could yield new insights into underlying biology. We performed a genome-wide association study (GWAS) of 81 fatty acids and oxylipins in 11,584 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants with genetic and lipidomic data measured at study baseline (58.

The impact of COVID-19 mitigation measures on neonatal health outcomes in sub-Saharan Africa: A systematic review and meta-analysis.

Objectives: To assess the relationship between COVID-19 mitigation measures and stillbirth, low birth weight (LBW), and preterm birth (PTB) in sub-Saharan Africa.

Study Design: Systematic review/meta-analysis.

Methods: We searched six databases for literature indexed from January 2020 to December 2022 for studies examining COVID-19 policies and neonatal outcomes in sub-Saharan Africa.

Association between dietary inflammatory index score and incident dementia.

Introduction: We evaluated whether higher Dietary Inflammatory Index (DII) scores were associated with increased incidence of all-cause dementia and Alzheimer's disease (AD) dementia over 22.3 years of follow-up in the community-based Framingham Heart Study Offspring cohort.

Methods: One thousand four hundred eighty-seven participants (mean ± standard deviation, age in years 69 ± 6) completed food frequency questionnaires (FFQs) and had incident all-cause dementia and AD surveillance data available.

Burden of illness of non-hematopoietic stem cell transplant-related hepatic sinusoidal obstruction syndrome: A systematic review.

Background: Sinusoidal obstruction syndrome (SOS)/veno-occlusive disease (VOD) is generally associated with hematopoietic cell transplant (HCT), but little is known about this condition outside the HCT setting. This systematic review examines the burden of illness and current management approaches in non-HCT SOS/VOD.

Methods: We searched Embase, Medline, and grey literature sources for non-HCT SOS/VOD studies published 2002-2023.

Complete revascularization versus culprit-only revascularization in older adults with ST-elevation myocardial infarction: Systematic review and meta-analysis of randomized controlled trials.

Background: Randomized controlled trials (RCTs) of complete revascularization (CR) versus culprit-only revascularization (COR) in patients with ST-elevation myocardial infarction (STEMI) have shifted the recommendation for CR from class III to class I in the AHA/ACC/SCAI guidelines, but it remains unclear if the benefit of CR over COR extends to older adults, who have greater bleeding risk, comorbidity burden, and complexity of lesions. We performed a meta-analysis to place the results of the previous RCTs in the context of the recently published FIRE trial and the subgroup analysis of the COMPLETE trial in adults ≥75 years old.

Methods: We searched the literature from inception to October 21, 2023.

Gaps in Workplace Injury Reporting Among Physicians to the United States Bureau of Labor Statistics.

Objective: To identify gaps in nonfatal injury and illness (NII) reporting between physicians and other occupations.

Methods: Bureau of Labor Statistics data (2011-2019) were analyzed, comparing annualized NII incidence rates using incidence rate ratios (IRR), with physicians as the reference.

Results: Between 2011-2019, physicians reported significantly lower NII rates compared to high-hazard non-medical occupations (IRR 17.