Decoding brain structure to stage Alzheimer's disease pathology in Down syndrome.

Introduction: Alzheimer's disease (AD) in Down syndrome (DS) is associated with changes in brain structure. It is unknown if thickness and volumetric changes can identify AD stages and if they are similar to other genetic forms of AD.

Methods: Magnetic resonance imaging scans were collected for 178 DS adults (106 nonclinical, 45 preclinical, and 27 symptomatic).

Experience with sodium glucose cotransporter-2 inhibitors in adult patients with Fontan circulation.

Background: We still know little about the effective pharmacological treatment of heart failure (HF) associated with the Fontan circulation. One of the new options may be sodium glucose cotransporter-2 inhibitors (SGLT2i), which have been proven effective in classic forms of left ventricular HF.

Objectives: To evaluate the effect and safety of SGLT2i inclusion in adults with Fontan circulation.

Minimally Invasive vs Open Surgery for Thoracolumbar Fractures Treatment: A Meta-analysis of Randomized Controlled Trials and Prospective Studies.

Study Design: Meta-Analysis.

Objective: The purpose of this systematic review and meta-analysis was to pool the available data comparing MIS to open surgery for thoracolumbar fractures and provide a more comprehensive assessment on this topic.

Background: There remains a debate over whether minimally invasive surgery (MIS) or open fixation provides superior outcomes for patients with thoracolumbar fractures.

Determinants of Racial and Ethnic Differences in Maternal Cardiovascular Health in Early Pregnancy.

Background: Suboptimal cardiovascular health (CVH) in pregnancy is associated with adverse maternal and offspring outcomes. To guide public health efforts to reduce disparities in maternal CVH, we determined the contribution of individual- and neighborhood-level factors to racial and ethnic differences in early pregnancy CVH.

Methods: We included nulliparous individuals with singleton pregnancies who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW) and participated in the nuMoM2b cohort study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be).

SAHD-10: Development and initial validation of a short version of the Schedule of Attitudes Toward Hastened Death based on a large multinational sample.

Objectives: Wishes to hasten death (WTHDs) are common in patients with serious illness. The Schedule of Attitudes Toward Hastened Death (SAHD) is a validated 20-item instrument for measuring WTHD. Two short versions have also been developed based on statistical item selection.

Epidemiologic and clinical characteristics and course of acute heart failure and cardiogenic shock diagnosed in emergency departments.

Objective: To describe the characteristics of patients diagnosed with acute heart failure (AHF) in emergency departments (EDs) who develop cardiogenic shock (CS) not associated with ST-segment elevation acute coronary syndrome (STACS).

Methods: Information for patients diagnosed with AHF in 23 Spanish EDs and registered between 2009 and 2019 were included for analysis if the patients developed symptoms consistent with CS. We described baseline clinical characteristics related to cardiac decompensation and CS, as well as 30-day mortality.

Emerging interleukin-1 receptor-associated kinase 4 (IRAK4) inhibitors or degraders as therapeutic agents for autoimmune diseases and cancer.

Interleukin-1 receptor-related kinase (IRAK4) is a widely expressed serine/threonine kinase involved in the regulation of innate immunity. IRAK4 plays a pivotal role as a key kinase within the downstream signaling pathway cascades of interleukin-1 receptors (IL-1R) and Toll-like receptors (TLRs). The signaling pathways orchestrated by IRAK4 are integral to inflammatory responses, and its overexpression is implicated in the pathogenesis of inflammatory diseases, autoimmune disorders, and cancer.

Prognostic significance of immune reconstitution following CD19 CAR T-cell therapy for relapsed/refractory B-cell lymphoma.

Immune deficits after CD19 chimeric antigen receptor (CAR) T-cell therapy can be long-lasting, predisposing patients to infections and non-relapse mortality. In B-cell non-Hodgkin lymphoma (B-NHL), the prognostic impact of immune reconstitution (IR) remains ill-defined, and detailed cross-product comparisons have not been performed to date. In this retrospective observational study, we longitudinally characterized lymphocyte subsets and immunoglobulin levels in 105 B-NHL patients to assess patterns of immune recovery arising after CD19 CAR-T.

Strategic Management of Valve Infolding in Evolut TAVR Procedures: Enhancing Outcomes and Ensuring Patient Safety.

Transcatheter aortic valve repair (TAVR) presents a minimally invasive alternative to traditional surgical valve replacement, albeit not without its own set of complications. A rare complication is the infolding of the self-expanding valve, which can precipitate cardiac arrest. The estimated incidence rate of this complication stands at 1.

A Randomized Trial of Cardiac Catheterization With Fasting Versus Liberal Oral Intake: The CALORI Trial.

Background: Routine preprocedural fasting before cardiac catheterization remains common practice, despite a lack of robust evidence to support this practice. We investigated the impact of a liberal nonfasting strategy vs a standardized nil per os (NPO) regimen prior to cardiac catheterization.

Methods: Adult inpatients undergoing elective or urgent cardiac catheterization were randomized (1:1 ratio) to either NPO past midnight or ad libitum intake of liquids and solids (without dietary constraints) until immediately prior to the procedure.

Percutaneous Mechanical Aspiration for Infective Endocarditis: Proceedings From an Inaugural Multidisciplinary Summit and Comprehensive Review.

The clinical presentation and epidemiology of infective endocarditis (IE) have evolved over time. While the cornerstones of IE treatment remain antimicrobial therapy and surgery, percutaneous mechanical aspiration (PMA) has emerged as an option for carefully selected patients as a complementary modality, based on retrospective data, case series, and expert experience. In this comprehensive review, we summarize the proceedings from an inaugural summit dedicated to the discussion of PMA in the global management of IE, consisting of experts across multiple disciplines from diverse geographic regions and care environments.

Caste, wealth and geographic equity in program reach and expected outcomes: an exploratory analyses of in Nepal.

Introduction: Monitoring and evaluation of maternal and child nutrition programs typically concentrates on overall population-level results. There is limited understanding, however, of how intervention reach and expected outcomes differ among sub-populations, necessary insight for addressing inequalities. These analyses aim to determine if maternal exposure to social and behavior change (SBC) interventions is associated with scales of maternal practices (antenatal care, iron and folic acid in pregnancy, diet in pregnancy, postnatal care, iron and folic acid postpartum, and maternal dietary diversity) and child practices (institutional birth, health mothers' group participation, growth monitoring and promotion, early initiation of breastfeeding and infant and young child feeding) in Nepal, overall and by wealth, caste, and geography.

Global Perspectives on Returning Genetic Research Results in Parkinson Disease.

Background And Objectives: In the era of precision medicine, genetic test results have become increasingly relevant in the care of patients with Parkinson disease (PD). While large research consortia are performing widespread research genetic testing to accelerate discoveries, debate continues about whether, and to what extent, the results should be returned to patients. Ethically, it is imperative to keep participants informed, especially when findings are potentially actionable.

Measuring the impact of new risk factors within survival models.

Survival is poor for patients with metastatic cancer, and it is vital to examine new biomarkers that can improve patient prognostication and identify those who would benefit from more aggressive therapy. In metastatic prostate cancer, 2 new assays have become available: one that quantifies the number of cancer cells circulating in the peripheral blood, and the other a marker of the aggressiveness of the disease. It is critical to determine the magnitude of the effect of these biomarkers on the discrimination of a model-based risk score.

Patterns of Weight Change Trajectories and Treatment Response in an Integrated Adult Primary Care Weight Management Practice.

Introduction: Given the significant interindividual variable responses to interventions for obesity, the early identification of factors associated with a differential in weight loss would benefit real-world approaches in clinical practice.

Objective: This study evaluated the factors associated with individual variability in response to enrolling in a weight management program integrated into an academic-based primary care practice.

Methods: Data were retrospectively collected and analyzed for patients referred to a primary care-based weight management practice between 2012 and 2020.

Isolation and Identification of Mercury-Dissolved Organic Matter Complexes in Mercury-Humic Acid Suspensions.

Rationale: The complexation with dissolved organic matter (DOM) is a pivotal factor influencing transformations, transport, and bioavailability of mercury (Hg) in aquatic environments. However, identifying these complexes poses a significant challenge because of their low concentrations and the presence of coexisting ions.

Methods: In this study, mercury-dissolved organic matter (Hg-DOM) complexes were isolated through solid-phase extraction (SPE) from Hg-humic acid suspensions, and complexes were putatively identified using ultrahigh resolution Fourier transform ion cyclotron resonance mass spectrometry (FTICR-MS).

Magnetic chromatography improves colloidal and MRI attributes of magnetoliposomes enabling evaluation of the impact of size on bio-distribution in an model of pancreatic cancer.

Magnetic chromatography was exploited to fractionate suspensions of magnetoliposomes (SML: lumen-free lipid-encapsulated clusters of multiple magnetic iron-oxide nanoparticles) improving their colloidal properties and relaxivity (magnetic resonance image contrast capability). Fractionation (i) removed sub-populations that do not contribute to the MRI response, and thus (ii) enabled evaluation of the size-dependence of relaxivity for the MRI-active part, which was surprisingly weak in the 55-90 nm range. MC was therefore implemented for processing multiple PEGylated SML types having average sizes ranging from 85 to 105 nm, which were then shown to have strongly size-dependent uptake in an pancreatic cancer model.

Current Applications and Future Directions for Vascular Stents with Stem Cells in the Treatment of Intracranial Aneurysms: A Mini-Review.

Vascular stents and stem cells have been used in high-acuity cases for many decades, particularly in cardiology. Providing the physician with another avenue of treatment, they have had a reasonable amount of success. However, there has been very little research conducted on seeding vascular stents with stem cells when treating intracranial aneurysms.

Identifying genetic differences between bipolar disorder and major depression through multiple genome-wide association analyses.

Background: Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).

Aims: We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.

The MyLungHealth study protocol: a pragmatic patient-randomised controlled trial to evaluate a patient-centred, electronic health record-integrated intervention to enhance lung cancer screening in primary care.

Introduction: Early lung cancer screening (LCS) through low-dose CT (LDCT) is crucial but underused due to various barriers, including incomplete or inaccurate patient smoking data in the electronic health record and limited time for shared decision-making. The objective of this trial is to investigate a patient-centred intervention, MyLungHealth, delivered through the patient portal. The intervention is designed to improve LCS rates through increased identification of eligible patients and informed decision-making.