Characterization of lamotrigine disposition changes during and after pregnancy in women with epilepsy.

Background: Lamotrigine clearance can change drastically in pregnant women with epilepsy (PWWE) making it difficult to assess the need for dosing adjustments. Our objective was to characterize lamotrigine pharmacokinetics in PWWE during pregnancy and postpartum along with a control group of nonpregnant women with epilepsy (NPWWE).

Methods: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study was a prospective, observational, 20 site, cohort study conducted in the United States (December 2012 and February 2016).

Effect of digital health applications with or without gamification on physical activity and cardiometabolic risk factors: a systematic review and meta-analysis of randomized controlled trials.

Background: Use of health applications (apps) to support healthy lifestyles has intensified. Different app features may support effectiveness, including gamification defined as the use of game elements in a non-game situation. Whether health apps with gamification can impact behaviour change and cardiometabolic risk factors remains unknown.

Effect of psilocybin versus escitalopram on depression symptom severity in patients with moderate-to-severe major depressive disorder: observational 6-month follow-up of a phase 2, double-blind, randomised, controlled trial.

Background: Psilocybin therapy (PT) produces rapid and persistent antidepressant effects in major depressive disorder (MDD). However, the long-term effects of PT have never been compared with gold-standard treatments for MDD such as pharmacotherapy or psychotherapy alone or in combination.

Methods: This is a 6-month follow-up study of a phase 2, double-blind, randomised, controlled trial involving patients with moderate-to-severe MDD.

Detection of neurologic changes in critically ill infants using deep learning on video data: a retrospective single center cohort study.

Background: Infant alertness and neurologic changes can reflect life-threatening pathology but are assessed by physical exam, which can be intermittent and subjective. Reliable, continuous methods are needed. We hypothesized that our computer vision method to track movement, pose artificial intelligence (AI), could predict neurologic changes in the neonatal intensive care unit (NICU).

A noninvasive urinary microRNA-based assay for the detection of pancreatic cancer from early to late stages: a case control study.

Background: Pancreatic cancer is highly aggressive and has a low survival rate primarily due to late-stage diagnosis and the lack of effective early detection methods. We introduce here a novel, noninvasive urinary extracellular vesicle miRNA-based assay for the detection of pancreatic cancer from early to late stages.

Methods: From September 2019 to July 2023, Urine samples were collected from patients with pancreatic cancer (n = 153) from five distinct sites (Hokuto Hospital, Kawasaki Medical School Hospital, National Cancer Center Hospital, Kagoshima University Hospital, and Kumagaya General Hospital) and non-cancer participants (n = 309) from two separate sites (Hokuto Hospital and Omiya City Clinic).

α-Cyclodextrin supplementation improves endurance exercise performance and reduces post-exercise fatigue in human males: a randomized, double-blind, placebo-controlled, parallel-group study.

α-Cyclodextrin (αCD), a cyclic hexasaccharide composed of six glucose units, is not digested in the small intestine but is completely fermented by gut microbes. Recently, we have reported that αCD supplementation for nonathlete men improved their 10 km biking times. However, the beneficial effects of αCD on exercise are not yet fully understood.

The association of workforce configurations with length of stay and charges in hospitalized patients with congestive heart failure.

Introduction: Clinicians are the conduits of high-quality care delivery. Clinicians have driven advancements in pharmacotherapeutics, devices, and related interventions and improved morbidity and mortality in patients with congestive heart failure over the past decade. Yet, the management of congestive heart failure has become extraordinarily complex and has fueled recommendations from the American Heart Association and the American College of Cardiology to optimize the composition of the care team to reduce the health, economic, and the health system burden of high lengths of stay and hospital charges.

Patient With Post-operative Recurrent Pancreatic Cancer Treated With Cone Beam Computed Tomography-Guided Stereotactic Adaptive Radiotherapy: A Case Report.

CT-guided adaptive radiotherapy (ART) for the treatment of pancreatic adenocarcinoma is rapidly increasing and has been shown to provide advanced treatment tools comparable to magnetic resonance imaging (MRI)-guided adaptive therapy. Here, we provide the first case report of a local pancreatic recurrence treatment after definitive resection using cone beam computed tomography (CBCT)-guided ART (CT-guided ART) enabled by HyperSight imaging (Varian Medical Systems, Inc., Palo Alto, CA, USA) for daily delineation of organs-at-risk (OARs) and target to improve the quality of online ART.

Physiological effects of combined breathing and physical training in middle-aged and older adults.

[Purpose] The safety and physiological effects of combined training with breathing resistance and sustained physical exertion in middle-aged and older adults remain unclear. This pilot study investigated the safety and physiological benefits of this training method in older adults. [Participants and Methods] Participants aged 55-75 without respiratory, circulatory, or metabolic diseases were randomly divided into two groups: a combined breathing and physical training group and a control group.

The role of multimodality imaging in diabetic cardiomyopathy: a brief review.

Diabetic cardiomyopathy (DMCM), defined as left ventricular dysfunction in the setting of diabetes mellitus without hypertension, coronary artery disease or valvular heart disease, is a well-recognized entity whose prevalence is certainly predicted to increase alongside the rising incidence and prevalence of diabetes mellitus. The pathophysiology of DMCM stems from hyperglycemia and insulin resistance, resulting in oxidative stress, inflammation, cardiomyocyte death, and fibrosis. These perturbations lead to left ventricular hypertrophy with associated impaired relaxation early in the course of the disease, and eventually culminating in combined systolic and diastolic heart failure.

Visual and Refractive Outcomes After Bilateral Implantation of a New Toric Intraocular Lens.

Purpose: To evaluate the clinical outcomes of a new FDA approved toric aspheric hydrophobic acrylic intraocular lens.

Patients And Methods: This is a single surgeon, single-arm, on-label, non-randomized, prospective observational study. Thirty patients underwent bilateral cataract surgery (60 eyes) with placement of a Clareon™ Toric IOL in each eye.

Examining a brief web and longitudinal app-based intervention [Wysa] for mental health support in Singapore during the COVID-19 pandemic: mixed-methods retrospective observational study.

The COVID-19 pandemic in Singapore led to limited access to mental health services, resulting in increased distress among the population. This study explores the potential benefits of offering a digital mental health intervention (DMHI), Wysa, as a brief and longitudinal intervention as part of the mindline.sg initiative launched by the MOH Office for Healthcare Transformation in Singapore.

The inter-trial and inter-session reliability of Theia3D-derived markerless gait analysis in tight versus loose clothing.

Background: Gait analysis is traditionally conducted using marker-based methods yet markerless motion capture is emerging as an alternative. Initial studies have begun to evaluate the reliability of markerless motion capture yet the evaluation of different clothing conditions across sessions and complete evaluation of the lower limb and pelvis reliability have yet to be considered. The aim of this study was to evaluate the inter-trial, inter-session and inter-session-clothing variation and root mean square differences between tight- or loose-fitting clothing during walking.

Tacrolimus to belatacept conversion in proteinuric kidney transplant recipients.

Background: Proteinuria is associated with worse allograft outcomes in kidney transplant recipients (KTRs) and treatment strategies are limited. We examined the outcomes of calcineurin inhibitor (CNI) to belatacept conversion in proteinuric KTRs.

Methods: In a pilot phase II single-arm multicenter prospective trial, we recruited adult KTRs >6 months post-kidney transplantation with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.

Association between somatic microsatellite instability, hypermutation status, and specific T cell subsets in colorectal cancer tumors.

Background: Microsatellite instability-high (MSI-high) tumors comprise ~15% of sporadic colorectal cancers (CRC) and are associated with elevated T cell infiltration. However, the universality of this response across T cell subtypes with distinct functions is unknown.

Methods: Including 1,236 CRC tumors from three observational studies, we conducted T cell profiling using a customized 9-plex (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT, MKI67, and DAPI) multispectral immunofluorescence assay.

Enabling immune checkpoint blockade efficacy in T-lymphopenia by restoring CD8 T cell dynamics with IL-7 cytokine therapy.

Introduction: T-lymphopenia (TLP) is a frequently observed condition in cancer patients, often exacerbated by conventional chemo/radiotherapy, which impairs the efficacy of subsequent immune checkpoint blockade (ICB) therapy. This study aimed to understand the impact of TLP on ICB responsiveness and explore potential therapeutic strategies to enhance antitumor immunity.

Methods: To investigate ICB responsiveness depending on the severity of TLP, first, we established TLP mouse models that mimic clinically observed mild and severe TLP through thymectomy and anti-Thy1-induced peripheral T cell depletion.

Once daily Bromelain-based enzymatic debridement of venous leg ulcers versus gel vehicle (placebo) and non-surgical standard of care: a three-arm multicenter, double blinded, randomized controlled study.

Background: Debridement is considered the first step in treatment of chronic wounds, however, current enzymatic and autolytic debridement agents are slow or ineffective. Previous studies have shown positive initial results with EscharEx® (EX-02 formulation), a Bromelain-based enzymatic debridement agent in development for chronic wounds. The main objective of this study was to assess its efficacy in debriding venous leg ulcers (VLU), compared to gel vehicle (GV) as a placebo control and to non-surgical standard of care (NSSOC).

The Impact of Artificial Intelligence on Healthcare: A Comprehensive Review of Advancements in Diagnostics, Treatment, and Operational Efficiency.

Background And Aims: Artificial Intelligence (AI) beginning to integrate in healthcare, is ushering in a transformative era, impacting diagnostics, altering personalized treatment, and significantly improving operational efficiency. The study aims to describe AI in healthcare, including important technologies like robotics, machine learning (ML), deep learning (DL), and natural language processing (NLP), and to investigate how these technologies are used in patient interaction, predictive analytics, and remote monitoring. The goal of this review is to present a thorough analysis of AI's effects on healthcare while providing stakeholders with a road map for navigating this changing environment.

Differences in oral microbiota associated with type 2 diabetes mellitus between the Dai and Han populations.

Background: Type 2 diabetes mellitus (T2DM) development is closely linked to microbiota, influenced by geography, ethnicity, gender, and age. While the relationship between oral microbiota and T2DM has been explored, specific microbiota associated with T2DM in the Dai and Han populations remains unclear. This study aims to compare oral microbiota differences and identify keystone species between these populations, both with and without T2DM.

Transforming grayscale MRI images to color utilizing generative artificial intelligence to better understand multiple sclerosis.

Multiple sclerosis (MS) falls within the spectrum of central nervous system (CNS) demyelinating diseases that may lead to permanent neurological disability. Fundamental to the diagnosis and clinical surveillance is magnetic resonance imaging (MRI) that allows for the identification of T2-hyperintensities associated with autoimmune injury that demonstrate distinct spatial distribution patterns. Here, we describe the clinical experience of a 31-year-old, right-handed, White man seen in consultation at The University of Texas Southwestern Medical Center in Dallas, Texas, following complaints of headaches that began after head trauma related to military service.

Long-term prescription opioid use following surgery in the US (2017-2022): a population-based study.

Background: Over the last decade, numerous efforts have been made to combat the opioid crisis globally. The impact of these strategies has not been adequately measured and may differ across populations depending on baseline risk. We compared changes in long-term prescription opioid use following surgery within a national US cohort, between 2017 and 2022.

Isoform-selective and non-selective rho-kinase inhibitors do not affect collagenase-induced intracerebral hemorrhage outcomes in mice: Influence of sex and circadian cycle.

Rho-associated protein kinase (ROCK) inhibitors are therapeutic candidates in ischemic stroke and subarachnoid hemorrhage. However, their efficacy in intracerebral hemorrhage (ICH) is unknown. Here, we tested the efficacy of fasudil (10 mg/kg), an isoform-nonselective ROCK inhibitor, and NRL-1049 (10 mg/kg), a novel inhibitor with 43-fold higher selectivity for ROCK2 isoform compared with ROCK1, in a collagenase-induced ICH model in mice.

Identifying and Understanding Seizure Liability in Drug Development.

Seizures are complex electrophysiological disturbances affecting one or more populations of brain neurons. Seizures following test article (TA) exposure pose significant challenges in drug development. This paper considers the diverse neurological manifestations, mechanisms, and functional and structural assessments needed to investigate TA-related seizure liabilities, with a particular focus on nonclinical species.

Bag Technique: Best Practices for Managing the Home Care Bag.

Home care clinicians have transported equipment and supplies to their patients' homes for decades using a bag that's been referred to as a "nursing bag" or "medical bag," among others. Regardless of what the bag is called, how it and its contents are managed is essential to prevent the transmission of potentially pathogenic microorganisms from one patient's home to another when making home visits. Bag technique is a component of the standard precautions implemented in home care and an essential practice that applies to all patients receiving in-home care, regardless of their suspected or confirmed infectious state.