Surgical Treatment of Lymphedema at LE&RN Comprehensive Centers of Excellence.

Despite major advancements in lymphatic care, there remains a lack of consensus across institutions regarding the evaluation and surgical management of lymphedema. The aim of this study is to describe the practices for diagnosis and surgical treatment of lymphedema across accredited Lymphatic Education & Research Network (LE&RN) comprehensive Centers of Excellence (COEs).A survey was distributed to directors of the 16 LE&RN comprehensive COEs in January 2023.

From big data and experimental models to clinical trials: Iterative strategies in microbiome research.

Microbiome research has expanded significantly in the last two decades, yet translating findings into clinical applications remains challenging. This perspective discusses the persistent issue of correlational studies in microbiome research and proposes an iterative method leveraging in silico, in vitro, ex vivo, and in vivo studies toward successful preclinical and clinical trials. The evolution of research methodologies, including the shift from small cohort studies to large-scale, multi-cohort, and even "meta-cohort" analyses, has been facilitated by advancements in sequencing technologies, providing researchers with tools to examine multiple health phenotypes within a single study.

Three new Microbacterium species isolated from the Marmara Sea mucilage event: Microbacterium istanbulense sp. nov., Microbacterium bandirmense sp. nov., Microbacterium marmarense sp. nov.

Three bacterial strains, Mu-43, Mu-80, and Mu-86, were isolated from the 2021 and 2022 mucilage event in the Marmara Sea and were taxonomically characterized. 16S rRNA gene sequence analysis confirmed that these strains belong to the genus Microbacterium. A polyphasic approach involving genomic and phenotypic analysis was employed to determine their taxonomic positions.

Comparative analysis of accident mechanisms and injury patterns of e-moped, and e-scooter operators.

Objective: To compare accident-related injuries and degree of risk for operators/riders of e-mopeds and e-scooters.

Methods: A retrospective medical charts review in a tertiary medical center was performed. All individuals aged 13 years and older who were referred to a single tertiary referral center after 2 wheels vehicle injury were enrolled.

Impact of Bulk Viscosity on the Postmerger Gravitational-Wave Signal from Merging Neutron Stars.

In the violent postmerger of binary neutron-star mergers strong oscillations are present that impact the emitted gravitational-wave (GW) signal. The frequencies, temperatures, and densities involved in these oscillations allow for violations of the chemical equilibrium promoted by weak interactions, thus leading to a nonzero bulk viscosity that can impact dynamics and GW signals. We present the first simulations of binary neutron-star mergers employing the self-consistent and second-order formulation of the equations of relativistic hydrodynamics for dissipative fluids proposed by Müller, Israel, and Stewart.

Phase II Evaluation of Ultra-Hypofractionated Postoperative Radiation Therapy for Breast Cancer: Toxicity and Efficacy in a Single-Center Nonrandomized Prospective Study.

Purpose: To evaluate the toxicity profile and efficacy of postoperative ultra-hypofractionated radiation therapy in elderly patients with breast cancer.

Materials And Methods: This is a nonrandomized, single-center, prospective Phase II trial. Patients with breast cancer older than 65 years were treated with ultra-hypofractionated radiation therapy in 5 fractions of 5.

Safety and efficacy of a fitusiran antithrombin-based dose regimen in people with hemophilia A or B: the ATLAS-OLE study.

Fitusiran, a subcutaneous investigational siRNA therapeutic, lowers antithrombin (AT) to increase thrombin generation and rebalance hemostasis in people with hemophilia. This phase 3 open-label extension study (ATLAS‑OLE, NCT03754790) evaluated safety and efficacy of antithrombin-based dose regimen (AT-DR) in males ≥ 12 years with severe hemophilia A/B, with/without inhibitors. The original 80 mg monthly (QM) dose regimen (ODR) was optimized to AT-DR targeting AT activity levels 15-35% to mitigate thrombotic risk (starting dose 50 mg once every 2 months [Q2M], individually adjusted to 20 mg Q2M or 20/50/80 mg QM as needed).

Maintenance Chemotherapy in Patients With High-Risk Rhabdomyosarcoma: Long-Term Survival Analysis of the European Soft Tissue Sarcoma Study Group RMS 2005 Trial.

The European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) RMS 2005 trial evaluated maintenance chemotherapy in high-risk rhabdomyosarcoma (RMS). Patients were randomly assigned to either discontinue treatment (standard arm) or receive six 28-day cycles of vinorelbine (25 mg/m) once per day on days 1, 8, and 15, plus once daily low-dose cyclophosphamide (25 mg/m; experimental arm). Initial results showed improved overall survival (OS), but disease-free survival (DFS) improvement was not statistically significant.

Identifying, Engaging, and Supporting Care Partners in Clinical Settings: Protocol for a Patient Portal-Based Intervention.

Background: In the United States, the landscape of unpaid care delivery is both challenging and complex, with millions of individuals undertaking the vital role of helping families (broadly defined) manage their health care and well-being. This includes 48 million caregivers of adults, 42 million of whom are caregivers of adults aged 50 years or older. These family care partners provide critical and often daily support for tasks such as dressing and bathing, as well as managing medications, medical equipment, appointments, and follow-up care plans.

GPT-4 as a Clinical Decision Support Tool in Ischemic Stroke Management: Evaluation Study.

Background: Cerebrovascular diseases are the second most common cause of death worldwide and one of the major causes of disability burden. Advancements in artificial intelligence have the potential to revolutionize health care delivery, particularly in critical decision-making scenarios such as ischemic stroke management.

Objective: This study aims to evaluate the effectiveness of GPT-4 in providing clinical support for emergency department neurologists by comparing its recommendations with expert opinions and real-world outcomes in acute ischemic stroke management.

Interphase Design for Lithium-Metal Anodes.

Electrode-electrolyte interphases are critical determinants of the reversibility and longevity of lithium (Li)-metal batteries (LMBs). However, upon cycling, the inherently delicate interphases, formed from electrolyte decomposition, become vulnerable to chemomechanical degradation and corrosion, resulting in rapid capacity loss and thus short battery life. Here, we present a comprehensive analysis of the complex interplay between the thermodynamic and kinetic properties of interphases on Li-metal anodes, providing insights into interphase design to address these challenges.

Non-canonical HIV drug resistance mutations: need to close existing gaps.

An increasing number of people living with HIV (PLHIV) are failing treatment without HIV drug resistance in the drug target region. While sub-optimal adherence is likely the cause of treatment failure in many PLHIV, resistance emerging at non-canonical (HIV drug resistance mutations occurring outside the drug target site) drug target site sites is also plausible. Non-canonical drug resistance mechanisms have been identified for integrase strand transfer inhibitors (INSTIs), protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and NRTIs.

Hereditary Angioedema with Normal C1 Inhibitor: an Updated International Consensus Paper on Diagnosis, Pathophysiology, and Treatment.

Hereditary angioedema (HAE) has been recognized for almost 150 years. The newest form of HAE, where C1 inhibitor levels are normal (HAE-nC1INH), was first described in 2000. Over the last two decades, new types of apparent non-mast cell-mediated angioedema with normal quantity and activity of C1INH have been described, in some cases with proven genetic pathogenic variants that co-segregate with angioedema expression within families.

Virtual Post Mortem in Fetuses and Newborns for the Verification of Congenital Heart Malformations.

Post-mortem examinations of fetuses and newborns with congenital anomalies pose significant challenges, especially in cases of induced termination of pregnancy. To address this, we explored the use of virtual post-mortem examination (VPM) via computed tomography angiography (CTA) as a potential alternative. The study was conducted at Sheba Medical Center from January 2013 to June 2019.

Decline of community-acquired alveolar pneumonia positive for respiratory syncytial virus in hospitalized children following implementation of PCV in Israel.

Background: We assessed the impact of pneumococcal conjugate vaccine (PCV) implementation on respiratory syncytial virus-positive community-acquired alveolar pneumonia (RSV-CAAP) in young children in southern Israel.

Methods: This study was nested within a prospective population-based active surveillance system during 2004-2019. All children <60 months residing in the region and served by the region's only hospital were included.

An indication-based analysis of the yield and findings of esophageal high-resolution manometry.

Background: High-resolution manometry (HRM) is the gold standard for the diagnosis of esophageal motility disorders. While studies have previously reported on HRM findings in patients with dysphagia and/or chest pain, we sought to compare the yield and findings of HRM based on different indications for motility testing.

Methods: A retrospective study was performed including all successful HRM studies performed at two tertiary medical centers between 2018 and 2023.

Cancer-associated fibroblasts serve as decoys to suppress NK cell anti-cancer cytotoxicity in breast cancer.

Cancer-associated fibroblasts (CAFs) are abundant components of the breast tumor microenvironment and major contributors to immune-modulation. CAFs regulate the activity of many immune cells including T-cells, macrophages and dendritic cells, however little is known about their interaction with natural killer (NK) cells, which constitute an important arm of anti-tumor immunity. Using mouse models of breast cancer and ex-vivo co-cultures, we find that CAFs inhibit NK cell cytotoxicity towards cancer cells.

Sexual orientation and internalized homophobia of middle aged and older gay and lesbian adults: The role of social relationships.

Objectives: Research is needed about the role of families in relation to issues faced by middle-aged and older gay and lesbian adults, such as internalized homophobia and families of choice. This study examines how families of choice and families of origin shape experiences of internalized homophobia in midlife and older gay and lesbian adults, a population uniquely affected by the cumulative effects of societal stigma over the life course.

Methods: We sampled 409 adults aged 50+ (range: 50-85) who self-identify as lesbian women or gay men.

Using Creative Activities to Improve the Postoperative Experience of Adult Patients.

Unlike pediatric care that often benefits from child-life services, adult hospitals rarely offer structured engagement activities for postsurgical patients. To address this, we conducted a prospective, randomized survey-based study to evaluate the impact of creative engagement activities on adult inpatient experiences. Patients undergoing surgery between January and September 2023 were randomly assigned to either standard postoperative course or one that received an entertainment packet.

Hearing Preservation Techniques in Pediatric Cochlear Implantation: A Systematic Review and Meta-Analysis.

Objective: Preserving residual hearing following cochlear implantation (CI) improves outcomes and allows patients to use electrical and acoustic stimulation. Hearing preservation and minimizing intracochlear trauma during implantation have become key areas of research and device development in recent years. This meta-analysis evaluated whether patient characteristics or surgical methodology impact hearing preservation postpediatric CI.

Clinical Outcomes With Normothermic Pulsatile Organ Perfusion in Heart Transplantation: A Report From the OCS Heart Perfusion Registry.

Background: A preservation system, the Organ Care System (OCS; TransMedics) uses normothermic pulsatile perfusion during organ transport for heart transplantation. This system has demonstrated favorable outcomes in hearts recovered from extended-criteria donors after brain death (DBD) and donors after circulatory death (DCD).

Methods: The OCS Heart Perfusion Registry collects data on US heart transplantations using the OCS, static cold storage (SCS), or thoracoabdominal normothermic regional perfusion (NRP) recovered from DBD or DCD donors.

Advancing cancer care through digital access in the USA: a state-of-the-art review of patient portals in oncology.

Patient portal use among patients with cancer has increased significantly in recent years. This state-of-the-art review seeks to address and analyse literature involving patient portal use by patients with cancer and their care partners. In this review, we queried articles from PubMed published between January 2018 and April 2024 that describe recent trends and the current presence of portals in cancer care for patients, proxy users and/or care partners.

Pulling back the mitochondria's iron curtain.

Mitochondrial functionality and cellular iron homeostasis are closely intertwined. Mitochondria are biosynthetic hubs for essential iron cofactors such as iron-sulfur (Fe-S) clusters and heme. These cofactors, in turn, enable key mitochondrial pathways, such as energy and metabolite production.

Foot reflexology in autoimmune diseases: Effectiveness and mechanisms.

Foot reflexology (FR) is a Chinese-originated and non-invasive complementary therapy increasingly used by functional, alternative and para-medical professionals. Enhance attempts are made to study FR in non-functional organic conditions. The present invited Editorial discusses the application of FR in autoimmune diseases (AD), highlighting a few successful studies demonstrating symptomatic relief and objective improvements.