Recovery of cardiovascular testing in Asia during the COVID-19 pandemic: findings from the INCAPS COVID 2 study.

Background: Understanding pandemic-related reductions and subsequent recovery of cardiovascular testing in Asia is important for guiding regional public health efforts.

Objectives: This study sought to evaluate the recovery of cardiovascular testing in Asia 1 year into the COVID-19 pandemic.

Methods: In this subanalysis of a worldwide survey on the impact of COVID-19 on cardiovascular diagnostic care in April 2020 and April 2021, recovery of testing volume in Asia was compared among subregions, World Bank income groups and imaging modalities.

Beyond Student Evaluations of Teaching and Educator Portfolios: A Multisource, Longitudinal System for Evaluating Teaching.

Traditional student evaluations of teaching and educator portfolios do not adequately assess the breadth and depth of medical educators' efforts. Current processes use limited perspectives, focus on a small portion of educators' work, and emphasize subjective opinions, which introduce bias. Use of these data for high-stakes decisions such as academic promotion contributes to inequitable career advancement.

Changes in the distribution of the tear film lipid layer after intensive pulsed light combined with meibomian gland expression in patients with meibomian gland dysfunction.

Purpose: This study aimed to investigate changes in dry eye disease (DED) parameters and tear film lipid layer distribution after intensive pulse light (IPL) combined with meibomian gland expression (MGX) in patients with meibomian gland dysfunction (MGD).

Methods: This retrospective study included 218 patients diagnosed with MGD who underwent IPL combined with MGX. Various DED parameters, including tear film lipid layer thickness (LLT), were measured using a Placido disc tear film analyzer and slit lamp.

Non-Invasive Diagnostic Strategies for Membranous Nephropathy in the NEPTUNE Study.

Background: Clinical practice guidelines recommend that a kidney biopsy is no longer required to confirm a diagnosis of membranous nephropathy (MN) in patients with nephrotic syndrome and a positive test for anti-phospholipase A2 receptor antibodies (PLA2R-Ab). However, the optimal diagnostic strategy for using the PLA2R-Ab enzyme-linked immunosorbent assay (ELISA), PLA2R-Ab indirect immunofluorescence (IIF) test, and genetic risk score for diagnosing MN, including the tests' optimal thresholds for positivity among incident patients with proteinuria, is still unknown.

Methods: We used serum samples at or before the first clinically indicated kidney biopsy from participants in the Nephrotic Syndrome Study Network (NEPTUNE) to analyze test performance characteristics using different combinations and cut-offs of the PLA2R-Ab ELISA, IIF, and genetic risk score for diagnosing MN.

An evidence-based treatment algorithm for congenital diaphragmatic hernia.

Background: Congenital diaphragmatic hernia (CDH) affects more than 1100 newborns in the United States each year. Severity of clinical presentation is highly variable. Standardized care improves outcomes by promoting consistency in decision-making and clarifying goals of treatment, but CDH management has not yet been standardized.

Neighborhood deprivation and association with 18-month neurodevelopmental impairment of preterm infants born in a dense urban setting.

Background: Neighborhood adversity's impact on 18-month neurodevelopmental impairment (NDI) is not well-described. The aim of our study was to determine whether area deprivation index (ADI), a measure of neighborhood socioeconomic disadvantage, at birth is associated with 18-month NDI of preterm infants born in dense urban setting.

Methods: A retrospective case-cohort study was performed in infants born at 23-32 weeks gestational age (GA) with birth weight (BW) ≤1250 g between 2013 and 2017 and evaluated for NDI at 18-month corrected age (CA).

Irradiation-responsive PRDM10-DT modulates the angiogenic response in human NSCLC cells in an SP1-dependent manner via the miR-663a/TGF-β1 axis.

Background: Photon radiation has been shown to stimulate the secretion of radioresistant factors from tumor cells, ultimately promoting tumor angiogenesis and metastasis. On the other hand, heavy-ion radiotherapy has been demonstrated to control tumor angiogenesis and metastasis levels. The molecular mechanisms responsible for the different angiogenic responses to photon and heavy-ion irradiation are not fully understood.

Single-cell and spatial genomic landscape of non-small cell lung cancer brain metastases.

Brain metastases frequently develop in patients with non-small cell lung cancer (NSCLC) and are a common cause of cancer-related deaths, yet our understanding of the underlying human biology is limited. Here we performed multimodal single-nucleus RNA and T cell receptor, single-cell spatial and whole-genome sequencing of brain metastases and primary tumors of patients with treatment-naive NSCLC. Chromosomal instability (CIN) is a distinguishing genomic feature of brain metastases compared with primary tumors, which we validated through integrated analysis of molecular profiling and clinical data in 4,869 independent patients, and a new cohort of 12,275 patients with NSCLC.

Preoperative breast MRI reduces reoperations for unilateral invasive lobular carcinoma: a patient-matched analysis from the MIPA study.

Objectives: To investigate the surgical impact of preoperative breast MRI in patients diagnosed with invasive lobular breast cancer (ILC) in a prospective observational study.

Methods: The prospective MIPA observational study database was queried for patients aged 18-80 with newly diagnosed unilateral ILC at needle biopsy referred for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) with those who did not (noMRI group) according to nine confounding covariates.

Insights from the largest diverse ancestry sex-specific disease map for genetically predicted height.

We performed ancestry and sex specific Phenome Wide Association Studies (PheWAS) to explore disease related outcomes associated with genetically predicted height. This is the largest PheWAS on genetically predicted height involving up to 840,000 individuals of diverse ancestry. We explored European, African, East Asian ancestries and Hispanic population groups.

Patient Navigators Improve In-Office Eye Exam Adherence After Community Eye Screenings in a Randomized Clinical Trial: NYC-SIGHT Study.

Purpose: To assess the effectiveness and cost of patient navigators in improving adherence to an initial in-office eye exam following community-based eye health screening and referral to ophthalmology among underserved populations.

Design: 5-year prospective, cluster-randomized clinical trial.

Participants: Eligible individuals aged 40 years and older were recruited from affordable housing developments and senior centers in Upper Manhattan.

Risk Factors, Trends, and Outcomes Associated with Rural Delivery Hospitalizations Complicated by Hypertensive Disorders of Pregnancy.

Objective: Hypertensive disorders of pregnancy (HDP) may account for a considerable and growing clinical burden at rural hospitals which have been providing fewer obstetric services over the past two decades. The objectives of this analysis were to evaluate trends, risk factors, and outcomes associated with hypertensive disorders of pregnancy (HDP) during delivery hospitalizations at rural hospitals in the United States.

Study Design: The 2000-2020 National Inpatient Sample was used for this repeated-cross sectional analysis.

Infant feeding experiences of women with systemic lupus erythematosus: A qualitative study.

Background/objective: Although breastfeeding is safe in women with systemic lupus erythematosus (SLE) who take breastfeeding-compatible medications, rates of breastfeeding are inconsistent, and little is known about the lived experiences surrounding infant feeding among women with SLE. In this qualitative study, we identified factors that influence infant feeding practices of these women.

Methods: Using a phenomenological approach, we conducted and thematically analyzed semi-structured interviews on infant feeding practices with adult women with SLE evaluated at a single tertiary care musculoskeletal center who had given birth within the last 6 years.

Central Nervous System-Targeted Gene Therapy for the Treatment of Neurocognitive Deficits in Mucopolysaccharidosis Type II Mice.

Mucopolysaccharidosis type II (MPS II) is an X-linked lysosomal storage disorder caused by pathogenic variants in the gene encoding iduronate-2-sulfatase (IDS), which hydrolyzes sulfate groups in dermatan sulfate and heparan sulfate. The current treatment for MPS II includes enzyme replacement therapy and hematopoietic stem cell transplantation (HSCT). Both therapies have shown limited penetration through the blood-brain barrier.

Development and Implementation of Rapid Discharge Plan in a Municipal Healthcare System.

When patient demand exceeds hospital capacity in certain scenarios, such as natural disasters, terrorist attacks, or staffing shortages, the rapid discharge of patients identified through reverse triage methodologies can create surge capacity. The evaluation of this concept has been documented in numerous resources and studies, but current tools tend to be extensive and siloed, which may make them difficult to use during emergencies. To prepare the largest municipal healthcare system in the United States for situations requiring rapid patient discharge, NYC Health + Hospitals/Central Office Emergency Management sought to develop a short, synthesized, and user-friendly plan.

Reduced cerebellar rhythm by climbing fiber denervation is linked to motor rhythm deficits in mice and ataxia severity in patients.

Cerebellar ataxia results from various genetic and nongenetic disorders and is characterized by involuntary movements that impair precision and motor rhythm. Here, we report that climbing fiber (CF) denervation is a common pathophysiology underlying motor rhythm loss in cerebellar ataxia. By examining cerebellar pathology in patients with spinocerebellar ataxia (SCA) types 1, 2, and 6 and multiple system atrophy, we identified CF degeneration with synaptic loss as a shared pathophysiology.

An endogenous GLP-1 circuit engages VTA GABA neurons to regulate mesolimbic dopamine neurons and attenuate cocaine seeking.

Recent studies show that systemic administration of a glucagon-like peptide-1 receptor (GLP-1R) agonist is sufficient to attenuate cocaine seeking. However, the neural mechanisms mediating these effects and the role of endogenous central GLP-1 signaling in cocaine seeking remain unknown. Here, we show that voluntary cocaine taking decreased plasma GLP-1 levels in rats and that chemogenetic activation of GLP-1-producing neurons in the nucleus tractus solitarius that project to the ventral tegmental area (VTA) decreased cocaine seeking.

Microneedle-mediated intracochlear injection safely achieves higher perilymphatic dexamethasone concentration than intratympanic delivery in guinea pig.

Intracochlear injection through the round window membrane (RWM) has been proposed to overcome imprecise drug delivery into the inner ear. Using a novel ultrasharp microneedle, we compared the perilymphatic dexamethasone (DEX) concentration achieved after intratympanic vs. intracochlear injection at two different time points and assessed its safety in guinea pigs.

Education and midlife cognitive functioning: Evidence from the High School and Beyond cohort.

Introduction: Educational attainment is associated with midlife cognitive functioning. However, degree attainment is the culmination of complex and unequal processes involving students' backgrounds, the opportunities that schools provide them, and their performance within those schools─all of which may also shape midlife cognition. What do educational gradients in midlife cognition look like using a richer conceptualization and measures of "education?"

Methods: We use data from High School and Beyond (HS&B:80)─a large, nationally representative sample of Americans followed from high school through age ∼60─to assess the role of education in stratifying midlife cognition.

Genome-Wide Association Study for Resting Electrocardiogram in the Qatari Population Identifies 6 Novel Genes and Validates Novel Polygenic Risk Scores.

Background: Electrocardiography is one of the most valuable noninvasive diagnostic tools in determining the presence of many cardiovascular diseases. Genetic factors are important in determining ECG abnormalities and their link to cardiovascular diseases. Genome-wide association studies and polygenic risk scores (PRSs) have been conducted for various ECG traits such as QT interval and QRS duration.

Hypertension Prevention and Healthy Life Expectancy in Black Adults: The Jackson Heart Study.

Background: The impact of preventing hypertension and maintaining normal blood pressure (BP) on life expectancy and healthy life expectancy (HLE) among Black adults, who are disproportionately affected by hypertension, has not been quantified.

Methods: We used a discrete event simulation to estimate life expectancy and HLE among a cohort of Black adults from the Jackson Heart Study (n=4933) from age 20 to 100 years or until death. We modeled preventing hypertension as having BP <130/80 mm Hg and maintaining normal BP as having BP <120/80 mm Hg across the lifespan.

Late-Onset Progressive Osseous Heteroplasia: 2 Unrelated Cases and Use of Positron Emission Tomography for Diagnosis.

Progressive osseous heteroplasia (POH) is a rare autosomal-dominant hereditary bone disorder caused by inactivating pathogenic variants in . POH is characterized by progressive cutaneous ossification and heterotopic ossification in skeletal muscles and subdermal connective tissues. Understanding of the natural history and phenotypic heterogeneity of the illness is incomplete.

Advancements in Melanoma Treatment: A Review of PD-1 Inhibitors, T-VEC, mRNA Vaccines, and Tumor-Infiltrating Lymphocyte Therapy in an Evolving Landscape of Immunotherapy.

Melanoma, an aggressive skin cancer, presents significant therapeutic challenges. Consequently, innovative treatment strategies beyond conventional chemotherapy, radiation, and surgery are actively explored. This review discusses the evolution of immunotherapy in advanced melanoma, highlighting PD-1/PD-L1 inhibitors, mRNA vaccines, Talimogene Laherparepvec (T-VEC), and tumor-infiltrating lymphocyte (TIL) therapies.