Lecanemab for mild Alzheimer disease - is there a way forward?

This Editorial reviews data on the efficacy and adverse effects of lecanemab amongst individuals with mild Alzheimer disease. Additionally, the recent controversy regarding the rejection by the EMA of a marketing authorization request for lecanemab, followed by its subsequent approval, is also discussed. The need for thoughtful discussions regarding the risks and benefits of this medication as well as the importance of developing Appropriate Use Recommendations and/or national guidelines for the use of lecanemab are also highlighted.

Carriers of a single cystic fibrosis transmembrane conductance regulator pathogenic variant and COVID-19 in pregnancy: A retrospective cohort study.

COVID-19 outcomes are worse in non-pregnant patients that are cystic fibrosis carriers; however, no studies have examined COVID-19 outcomes in pregnant patients that are cystic fibrosis carriers. We evaluated the cystic fibrosis carrier status of pregnant patients with COVID-19 in three geographical regions in the United States and compared outcomes between non-carriers and carriers. Out of 2430 pregnant patients with COVID-19, 229 had a cystic fibrosis screen.

Mixed methods evaluation of a digital resource to build students' skills in ASsessing cardiovascular risk, MOtivating change, and SUStaining a healthier lifestyle in themselves and others- ASMOSUS: a study protocol.

Background: Cardiovascular disease (CVD) is a prevalent cause of morbidity and mortality globally. Nurses and nursing students are in an optimum role to assess, manage and promote lifestyle changes associated with CVD risk. Patients and service users are more likely to adopt these changes if the person delivering the information embodies this lifestyle themselves.

The Need for Postoperative Chest X-Ray After Placement of Hypoglossal Nerve Stimulator.

Objective: Hypoglossal nerve stimulation (HGNS) is a surgical treatment for obstructive sleep apnea (OSA) in patients intolerant to CPAP. Current practice often involves chest x-ray (CXR) in the postanesthesia care unit (PACU), though the incidence of pulmonary complications is low. This study evaluates the necessity of immediate postoperative CXR after HGNS placement.

Serum microRNA-24-based nomogram predicts prognosis for patients with resected pancreatic cancer.

Pancreatic cancer (PCa) is one of the malignant tumors with an extremely poor prognosis. Rare biomarkers exist for predicting the outcomes of PCa patients. This study aimed to develop a nomogram model based on serum microRNA-24 (miR-24) and clinicopathological factors to predict overall survival (OS) and treatment response to conventional adjuvant chemotherapy (ACT) in patients with PCa.

Brain and intracranial volumes are both enlarged and serve as potential risk factors in normal pressure hydrocephalus.

Normal pressure hydrocephalus (NPH) is a poorly understood neurodegenerative condition leading to gait impairment and ultimately dementia. Prior work has shown larger intracranial volume (ICV) among those with NPH which has been taken to establish a link to Benign external hydrocephalus of infancy (BEH) as a predisposing factor. These studies have not evaluated brain volume which we hypothesize will also be elevated in NPH and account for the increase in ICV.

BubR1 Controls Heart Development by Promoting Expression of Cardiogenesis Regulators.

Background: Congenital heart defects are structural anomalies present at birth that can affect the function of the heart. Aneuploidy is a significant risk factor for congenital heart defects. Mosaic variegated aneuploidy syndrome, caused by mutations in (encoding BubR1, a mitotic checkpoint protein), leads to congenital heart defects such as septal defects.

Integration of large-scale community-developed causal loop diagrams: a Natural Language Processing approach to merging factors based on semantic similarity.

Background: Complex public health problems have been addressed in communities through systems thinking and participatory methods like Group Model Building (GMB) and Causal Loop Diagrams (CLDs) albeit with some challenges. This study aimed to explore the feasibility of Natural Language Processing (NLP) in simplifying and enhancing CLD merging processes, avoiding manual merging of factors, utilizing different semantic textual similarity models.

Methods: The factors of thirteen CLDs from different communities in Victoria, Australia regarding the health and wellbeing of children and young people were merged using NLP with the following process: (1) extracting and preprocessing of unique factor names; (2) assessing factor similarity using various language models; (3) determining optimal merging threshold maximising the F1-score; (4) merging the factors of the 13 CLDs based on the selected threshold.

Changes in Hypoxemia Metrics After Upper Airway Surgery for Obstructive Sleep Apnea.

Objective: The apnea-hypopnea index (AHI) quantifies obstructive sleep apnea (OSA) severity but has limited correlation with subjective symptoms and cardiovascular risk. Sleep parameters related to oxygenation status and hypoxic burden may offer utility as additional predictors of cardiovascular risk and the physiologic consequences of OSA. This study aims to assess the change in measures of oxygenation status following sleep surgery for OSA.

Distinct age-related alterations in alpha-beta neural oscillatory activity during verbal working memory encoding in children and adolescents.

Emerging imaging studies of working memory (WM) have identified significant WM-related oscillatory events that are unique to each phase of working memory (e.g. encoding, maintenance).

Improving the Physician Inbox Management in Electronic Health Record by a Multifaceted Bundled Intervention.

Timely closure of patient encounters and addressing tasks in the Electronic Health Record (EHR) inbox are essential for quality care and efficiency. Delinquent items in the EHR inbox impact patient care, cost of care, and overall patient and provider experience. This project aimed to improve the management of these items using a quality improvement initiative with a bundled intervention.

Identifying Patient, Care Partner, and Clinician Needs for Functional Recovery Following Hospitalization When Dementia is Present.

Objectives: Persons with dementia are frequently hospitalized, which threatens their ability to return to and live at home. Current post-acute paradigms tend to default to short-term rehabilitation in a nursing home. Still, alternative post-acute care models are crucial for veterans with dementia to recover at home.

Continuous Ranibizumab via Port Delivery System vs Monthly Ranibizumab for Treatment of Diabetic Macular Edema: The Pagoda Randomized Clinical Trial.

Importance: Frequent visits and intravitreal anti-vascular endothelial growth factor (VEGF) injections are often required to manage diabetic macular edema (DME), burdening patients and their health care networks. The Port Delivery System (PDS) with ranibizumab is the first continuous anti-VEGF therapy that has the potential to reduce visit and treatment burden without sacrificing vision outcomes for patients with DME.

Objective: To evaluate the efficacy and safety through 64 weeks of ranibizumab, 100 mg/mL, via PDS with refill exchanges every 24 weeks (PDS Q24W) in patients with DME vs intravitreal injections of ranibizumab, 0.

A one-week reduced-carbohydrate diet to mitigate iatrogenic peripheral hyperinsulinemia does not improve insulin sensitivity or endothelial function in a randomized, crossover trial in patients with type 1 diabetes.

Background: Iatrogenic peripheral hyperinsulinemia, resulting from peripheral insulin administration in type 1 diabetes, may increase insulin resistance and impair endothelial function. We hypothesized that lowering iatrogenic peripheral hyperinsulinemia via a one-week, reduced-carbohydrate diet (RCD) would improve insulin sensitivity and endothelial function compared with an isocaloric standard carbohydrate diet (SCD).

Methods: In this randomized, single-blinded, crossover trial, we studied 12 adults with type 1 diabetes.

EV DNA from pancreatic cancer patient-derived cells harbors molecular, coding, non-coding signatures and mutational hotspots.

DNA packaged into cancer cell-derived EV is not well appreciated. Here, we uncovered signatures of EV DNA secreted by pancreatic cancer cells. The cancer cells and non-cancer counterparts exhibit distinct low vs.

Altered Functional Connectivity Dynamics Serving Cognitive Flexibility in Regular Cannabis Users.

Despite its widespread use and popularity, cannabis is known to impact higher order cognitive processes such as attention and executive function. However, far less is known about the impact of chronic cannabis use on cognitive flexibility, a component of executive function, and this is especially true for the underlying functional connectivity dynamics. To address this, we enrolled 25 chronic cannabis users and 30 demographically matched non-users who completed an interview probing current and past substance use, a urinalysis to confirm self-reported substance use and a task-switch cognitive paradigm during magnetoencephalography (MEG).

Healthy aging is associated with altered visual gamma band onset and offset responses.

Gamma oscillations have been shown to be critical for basic sensory processing, as well as visual attention and several other higher-order cognitive functions. Aberrant gamma oscillations have also been shown in neuropsychiatric and neurodegenerative diseases. Despite the possible clinical implications of altered gamma activity and emerging stimulation-based interventions targeting gamma, research into age-related changes in gamma oscillatory activity in healthy adults remains sparse.

Investigating the Impact of Preoperative Kinesiophobia and Pain on Postoperative Gait Biomechanics Following Anterior Cruciate Ligament Injury.

Background: Aberrant gait biomechanics-ie, lower knee abduction moment (KAM) impulse- are linked to the development of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). There is a clinical need to identify modifiable factors, such as kinesiophobia and pain, that may contribute to aberrant gait development after ACLR to advance multimodal rehabilitation strategies.

Purpose/hypothesis: This study aimed to determine associations between preoperative kinesiophobia and pain and gait biomechanics linked to posttraumatic osteoarthritis development at 2 and 4 months after ACLR.

An Ultra-Long-Acting Dimeric Bictegravir Prodrug Defined by a Short Pharmacokinetic Tail.

Ultra-long-acting (ULA) antiretroviral parenteral formulations, with low injection volumes, high resistance barriers, and short pharmacokinetic (PK) tails, can transform HIV-1 therapeutics. Here, we converted bictegravir (BIC), a potent daily oral antiretroviral drug, into monomeric and homodimeric ester prodrugs. The homodimeric prodrug nanosuspension, NMXBIC, shows sustained plasma BIC levels >16 times the protein-adjusted 95% inhibitory concentration (PA-IC) for six months after a single injection in Sprague Dawley rats.

Prion Safety Laboratory Swipe Test.

Transmission of iatrogenic prion disease has occurred from contaminated neurosurgical tools, transplant materials, and occupational exposure to prion-contaminated laboratory tools. Prions cause disease by the templated misfolding of the normal cellular form of the prion protein, PrP, into the misfolded and pathogenic form PrP and are invariably fatal. Reducing iatrogenic and occupational prion transmission is challenging.

Trends and Economic Implications of Operative Management for Pediatric Forearm Fractures: A Retrospective Study.

Introduction: Pediatric forearm fractures are traditionally managed conservatively with satisfactory results. However, operative management is trending upward without definitive evidence of superior outcomes. This investigation aims to evaluate trends in the operative management of acute pediatric forearm fractures globally and to estimate the cost of treatment to ascertain management preferences and guidance.