Prescriptions (Rx) for Prevention: Clinical Tools for Integrating Environmental Health into Pediatric Clinical Care.

The integration of environmental health (EH) into routine clinical care for children is in its early stages. The vision of pediatric EH is that all clinicians caring for children are aware of and able to help connect families to needed resources to reduce harmful environmental exposures and increase health-enhancing ones. Environmental exposures include air pollution, substandard housing, lead, mercury, pesticides, consumer products chemicals, drinking water contaminants, industrial facility emissions and, increasingly, climate change-related extreme weather and heat events.

Moral injury in treatment-seeking police officers: A qualitative study.

Objective: In their work, police officers are routinely exposed to potentially traumatic events, some of which may also be morally distressing. Moral injury refers to the multidimensional impact of exposure to such potentially morally injurious events (PMIEs). Mainly originating from a military context, there is little empirical research on moral injury in policing.

Trajectories of change in prolonged exposure for primary care: Who most likely benefits?

Objective: Prolonged Exposure for Primary Care (PE-PC) leverages an opportunity to provide evidence-based posttraumatic stress disorder (PTSD) care in the PC setting where many veterans present for services and can greatly increase treatment access. However, such acute, short-term intervention may not be effective for all PTSD patients.

Method: We analyzed data from a randomized clinical trial evaluating PE-PC to determine who may or may not benefit from PE-PC.

Prolonged grief disorder symptoms and posttraumatic growth among Chinese shidu parents: A latent transition analysis.

Objective: Chinese shidu parents (bereaved parents who have lost the only child) may experience prolonged grief disorder, as well as posttraumatic growth (PTG). This study aimed to examine their latent classes and transition patterns of prolonged grief disorder symptoms and PTG.

Method: Based on a longitudinal design, 265 shidu parents completed the Prolonged Grief Scale-Revised and Short Form of Posttraumatic Growth Inventory for Chinese Shidu Parents twice with an interval of about 5 months.

Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life.

Background: In previous efforts, health-related quality of life (HRQoL) improved for individuals at high risk of type 2 diabetes and cardiovascular disease after participation in community-based lifestyle interventions (LI) with a moderate-to-vigorous physical activity (MVPA) movement goal.

Purpose: It is unknown whether HRQoL improves with LI when the primary movement goal is to reduce sedentary behavior. HRQoL changes were examined among adults with overweight and prediabetes and/or metabolic syndrome randomized to a 12-month Diabetes Prevention Program-based Group Lifestyle Balance (DPP-GLB) community LI work with goals of weight-loss and either increasing MVPA (DPP-GLB) or reducing sedentary time (GLB-SED).

Pembrolizumab ± paricalcitol in metastatic pancreatic cancer postmaximal cytoreduction.

Lessons Learned: Intravenous paricalcitol did not improve the efficacy of pembrolizumab, likely related to the short half-life.

Background: Immunotherapy has limited benefit in the treatment of advanced pancreatic cancer with the tumor microenvironment playing a key role in immune resistance. In preclinical studies, vitamin D receptor (VDR) agonists have been shown to sensitize pancreatic tumors to PD-1 blockade.

Ovarian clear cell carcinoma: open questions on the management and treatment algorithm.

Ovarian clear cell carcinoma (OCCC) accounts for ~10% of all epithelial ovarian cancers and is considered a different entity from the more common high-grade serous ovarian carcinoma (HGSC), with distinct clinical presentations, different risk, and prognostic factors, and specific molecular features. Most OCCCs are diagnosed at an early stage and show favorable outcomes, in contrast to those diagnosed at advanced stages, which exhibit intrinsic resistance to platinum-based chemotherapy regimens and a very poor prognosis. The standard treatment of advanced OCCC is currently based on primary debulking surgery followed by platinum-based chemotherapy according to recent international guidelines.

Pooled safety analysis and management of sotorasib-related adverse events in KRAS G12C-mutated advanced non-small cell lung cancer.

Introduction: We describe the safety of sotorasib monotherapy in patients with KRAS G12C-mutated advanced non-small cell lung cancer (NSCLC) and discuss practical recommendations for managing key risks.

Methods: Incidence rates of treatment-related adverse events (TRAEs) were pooled from 4 clinical trials: CodeBreaK 100 (NCT03600883), CodeBreaK 101 (NCT04185883), CodeBreaK 105 (NCT04380753), and CodeBreaK 200 (NCT04303780) and graded according to CTCAE v5.0.

Digital therapeutics as a new weapon against diseases: focus on the current European legislation and possible therapeutic strategies.

Introduction: Digital therapeutics (DTx) are an emerging phenomenon within the scientific landscape which is attracting considerable international interest. This review aimed to provide an overview of the definition and classification of DTx, focusing on the contribution that DTx may provide in the treatment of a lot of diseases, compared with pharmacological treatments and highlighting it strengthens and weaknesses into the European regulatory landscape.

Areas Covered: They are software-generated therapeutic interventions directly to patients useful to prevent, manage or treat diseases.

Characterization of different clinical presentation of Merkel cell carcinomas and their potential prognostic implications.

Background: Recent studies analyzed the impact of Merkel cell polyomavirus (MCPyV) on the prognosis of Merkel cell carcinoma (MCC) patients. No data on specific morphological clinical differences of MCPyV+ or MCPyV- are currently available neither on the possible prognostic implication of different clinical presentation of MCC.

Objectives: 1) to describe clinicopathological characteristics of MCC patients and the prevalence of MCPyV infection in an Italian cohort of patients; 2) to define possible differences in clinicopathological and prognostic features among MCPyV+ and MCPyV- MCCs.

Prognostic utility of assessing ventricular-arterial coupling in arterial hypertension and cardiovascular diseases.

The assessment of myocardial function and its coupling with the arterial system, called ventricular-arterial coupling (VAC), is of paramount importance in many clinical fields, from arterial hypertension, which is the main cause of cardiovascular diseases and death, to heart failure. VAC has been the subject of studies for several decades both from an energetic cost and the impact it can exert on cardiovascular performance. Although more attention has been paid to the relationship between the left ventricle and the left arterial circuit in compromised hemodynamic stages, VAC has aroused interest in many other aspects of study, from its application in pathologies of the right sections of the heart to its clinical impact in prevention and cardiovascular risk factors.

Highly Sensitive Digital and Analog Immunoassay Based on Submicron Magnetic Beads and Fluorescent Microspheres.

The detection of disease-related protein biomarkers plays a crucial role in the early diagnosis, treatment, and monitoring of diseases. The concentrations of protein biomarkers can vary significantly in different diseases or stages of the same disease. However, most of the existing analytical methods cannot simultaneously meet the requirements of high sensitivity and a wide dynamic range.

Early and multiple doses of zoledronate mitigates rebound bone loss following withdrawal of RANKL inhibition.

Rebound bone loss following denosumab discontinuation is an important barrier in the effective long-term treatment of skeletal disorders. This is driven by increased osteoclastic bone resorption following the offset of RANKL inhibition, and sequential osteoclast-directed therapy has been utilised to mitigate this. However, current sequential treatment strategies intervene following the offset of RANKL inhibition and this approach fails to consistently prevent bone loss.

Comparison of the Ease-of-use and Preference Between Two Aromatherapy Delivery Methods in the Perioperative Setting.

Purpose: Nurses at the study hospitals had implemented aromatherapy as an evidence-based intervention to alleviate nausea, pain, and anxiety in patients in the perioperative setting. Initially, they were approved to administer aromatherapy using large, multidose bottles with gauze as the method of delivery; however, nurses recognized that there were many disadvantages to using this method. This led to a nurse-driven initiative to create a new delivery method for aromatherapy with the aid of the Center for Innovation at the organization.

Tendon Inversion Improves Tendon-to-Bone Healing in a Rat Bicep Tenodesis Model.

Purpose: Tendon-to-bone repair remains a surgical challenge. Although bone tunnel fixation is a common surgical technique whereby soft tissue is expected to heal against a bone tunnel interface, contemporary methods have yet to recapitulate biomechanical similarity to the native enthesis. In this study, we aimed to understand how inside-out longitudinal tendon inversion affects bone tunnel healing with the hypothesis that inversion removes the gliding epitenon surface to facilitate interface healing.

Associations of Short-Term Ozone Exposure With Hypoxia and Arterial Stiffness.

Background: Epidemiological studies reported associations between ozone (O) exposure and cardiovascular diseases, yet the biological mechanisms remain underexplored. Hypoxia is a shared pathogenesis of O-associated diseases; therefore, we hypothesized that O exposure may induce changes in hypoxia-related markers, leading to adverse cardiovascular effects.

Objectives: This study aimed to investigate associations of short-term O exposure with hypoxic biomarkers and arterial stiffness.

Severe hypophosphatemia following idecabtagene vicleucel regardless of the severity of cytokine release syndrome.

Background Aims: Hypophosphatemia has been recently recognized adverse event in chimeric antigen receptor (CAR)-T cell therapy, complicating 70-75% of patients. Severe hypophosphatemia can cause cytokine release syndrome (CRS)-like symptoms, such as respiratory and cardiovascular dysfunction. Some reports have described the association between inorganic phosphate (iP) and CRS in patients treated with tisagenlecleucel (tisa-cel), lisocabtagene maraleucel (liso-cel), axicabtagene ciloleucel (axi-cel).

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.

Results of ICE-Guided Isolation of the Superior Vena Cava With Pulsed Field Ablation.

Background: Earlier studies have documented the risk for sinoatrial node injury and phrenic nerve paralysis as complications following radiofrequency catheter ablation for electrical isolation of the superior vena cava (SVCI).

Objectives: The aim of this study was to assess the safety and feasibility of SVCI in patients with atrial fibrillation undergoing pulsed field ablation (PFA) METHODS: Six hundred sixteen consecutive patients undergoing PFA for pulmonary vein isolation plus SVCI were included in this multicenter analysis. Superior vena cava (SVC) ablation was performed under the continuous guidance of intracardiac echocardiography.

Intravascular Ultrasound-Guided vs Angiography-Guided Drug-Coated Balloon Angioplasty in Patients With Complex Femoropopliteal Artery Disease.

Background: Intravascular ultrasound (IVUS) guidance has been shown to yield favorable outcomes for endovascular treatment of femoropopliteal artery (FPA) disease with drug-coated balloon (DCB) angioplasty. However, the specific benefits of IVUS for treatment of complex FPA lesions remain uncertain.

Objectives: In this study, the authors compared the clinical impact of IVUS-guided vs angiography-guided DCB angioplasty in patients with complex or noncomplex FPA lesions.

Adverse Pregnancy Outcomes and Long-Term Risk of Heart Failure in Women: National Cohort and Co-Sibling Study.

Background: Adverse pregnancy outcomes, such as preterm delivery and hypertensive disorders of pregnancy, may be associated with higher future risks of heart failure (HF). However, the comparative effects of different adverse pregnancy outcomes on long-term risk of HF, and their potential causality, are unclear.

Objectives: The authors sought to examine 5 major adverse pregnancy outcomes in relation to long-term risk of HF in a large population-based cohort.

Elevated Neutrophil-to-Lymphocyte Ratio Predicts Prognosis in Acute Myocarditis.

Background: Neutrophil-to-lymphocyte ratio (NLR) is an easy-to-use inflammatory biomarker. Baseline NLR is independently associated with incident cardiovascular events and all-cause mortality. However, whether this applies to acute myocarditis (AM) has not been evaluated.

The Prevalence of Dermoscopy Use Among Dermatology Residents in Riyadh, Saudi Arabia: Cross-Sectional Study.

Background: Dermoscopy is a noninvasive technology used to examine the skin's invisible microstructures in dermatological practice and is gaining prominence as a crucial tool. Dermoscopy is an evidence-based practice used to enhance the early detection of skin malignancies and to help distinguish between various skin conditions, including pigmented and nonpigmented skin malignancies. Currently, the vast majority of global guidelines for skin cancer recommend dermoscopy as a critical component.