Refractory Psychosis as a Red Flag for End of Life in Individuals With Dementia With Lewy Bodies: A Case Series and Re-analysis of Prior Qualitative Data.

Objectives: Many individuals with dementia with Lewy bodies (DLB) die of disease-related complications, but predicting the end of life can be challenging. We identified a phenotype associated with approaching end of life.

Methods: We present 4 exemplar cases where individuals with DLB experienced refractory psychosis before death.

Epidemiology of Epstein-Barr Virus Chronic High Viral Load in Kidney Transplant Recipients.

Background: Epstein-Barr virus (EBV) chronic high viral load (CHVL) may be defined by >16 000 copies/mL whole blood or >200 copies/10 peripheral blood mononuclear cells in >50% samples exceeding 6 mo. EBV CHVL has only been characterized in a few small pediatric studies, with heterogeneous results and unclear clinical significance.

Methods: This single-center observational study evaluated adult and pediatric kidney transplant recipients transplanted between 2010 and 2021 on tacrolimus/mycophenolate-based/prednisone immunosuppression.

The impact of preoperative venous thromboembolism on patients undergoing TURBT: Perioperative outcomes and healthcare costs from US insurance claims data.

Objectives: To assess the impact of a positive history of venous thromboembolism (VTE) on perioperative outcomes, including length of in-hospital stay, readmission rates, 90-day postoperative complications, and healthcare costs in bladder cancer (BCa) patients undergoing transurethral resection of bladder tumour (TURBT) in the United States.

Patients And Methods: Patients aged ≥18 years with a BCa diagnosis undergoing TURBT were identified in the Merative® Marketscan® Research de-identified databases between 2007 and 2021. Multivariable logistic regression adjusted by relevant perioperative confounders was used to investigate the association between diagnosis of VTE before TURBT and 90-day complication rates, new postoperative VTE events, re-hospitalization, and total hospital expenditures (2021 US dollars).

Spectrum of Otological Manifestations in Treacher Collins Syndrome: A Case Series of 9 Patients.

Treacher Collins syndrome (TCS) is an uncommon congenital disorder predominantly involving craniofacial, orbital, and otological structures. The various ear malformations seen in 9 patients with TCS are described. TCS predominantly affects the external and middle ear structures, with inner ear structures being relatively spared, not unexpected given the dual embryological origin of the human ear.

Dynamic Contrast-enhanced MRI Processing Comparison for Distinguishing True Progression From Pseudoprogression in High-grade Glioma.

Background: Treatment-related changes may occur due to radiation and temozolomide in glioblastoma and can mimic tumor progression on conventional MRI. DCE-MRI enables quantification of the extent of blood-brain barrier (BBB) disruption, providing information about areas of suspicious postcontrast T1 enhancement. We compared DCE-MRI processing methods for distinguishing true disease progression from pseudoprogression in high-grade gliomas (HGGs).

Case 337.

A 38-year-old previously healthy male patient presented with left-sided facial pain over the prior 5 weeks. He first noticed the pain while washing and applying pressure to his face. The pain was described as shock-like, sharp and shooting, and radiating along the left cheek and temple.

Larsucosterol for the Treatment of Alcohol-Associated Hepatitis.

Background: Larsucosterol is a DNA methyltransferase inhibitor in development for alcohol-associated hepatitis (AH), a disease for which there is no approved therapy.

Methods: In this phase 2b trial, patients with severe AH were randomly assigned 1:1:1 to receive 30 mg or 90 mg of larsucosterol or placebo; a second dose was administered after 72 hours if the patient remained hospitalized. All patients received supportive care as determined by investigators.

Review of Associations of Diabetes and Insulin Resistance With Brain Health in Three Harmonised Cohort Studies of Ageing and Dementia.

Diabetes increases the risk of dementia, and insulin resistance (IR) has emerged as a potential unifying feature. Here, we review published findings over the past 2 decades on the relation of diabetes and IR to brain health, including those related to cognition and neuropathology, in the Religious Orders Study, the Rush Memory and Aging Project, and the Minority Aging Research Study (ROS/MAP/MARS), three harmonised cohort studies of ageing and dementia at the Rush Alzheimer's Disease Center (RADC). A wide range of participant data, including information on medical conditions such as diabetes and neuropsychological tests, as well as other clinical and laboratory-based data collected annually.

Characteristics of injury deaths among homeless and non-homeless US veterans (2017-2021).

Objective: The objective of this study is to assess whether experiencing homelessness may be associated with future risk of injury death and characterise these injury deaths by homelessness status among veterans who received healthcare through the US Department of Veterans Affairs (VA).

Methods: A retrospective cohort study was conducted among 6 128 921 veterans (399 125 homeless and 5 729 796 non-homeless) who received VA healthcare between 2017 and 2020 and were followed until 2021 using linked data from VA's Corporate Data Warehouse, Homeless Operations Management System and the VA/Department of Defense Joint Mortality Data Repository. Injury death rates were estimated by homelessness status with 95% CIs using the exact Poisson method.

Impact of Immunotherapy on the Care Patterns and Outcomes of Patients with Advanced Hepatocellular Carcinoma.

Background: Modern immunotherapy with checkpoint inhibitors revolutionized cancer treatment and outcomes. This study aims to demonstrate how immunotherapy has impacted the national landscape of systemic treatment and palliative care in advanced hepatocellular carcinoma (HCC).

Methods: Retrospective cohort selecting patients from the U.

Endovascular Thrombectomy for Extracranial Internal Carotid Artery Occlusions With Large Ischemic Strokes: Insights From the SELECT2 Trial.

Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).

Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.

Influence of lung function on macro- and micro-structural brain changes in mid- and late-life.

Introduction: Lung function has been associated with cognitive decline and dementia, but the extent to which lung function impacts brain structural changes remains unclear. We aimed to investigate the association of lung function with structural macro- and micro-brain changes across mid- and late-life.

Methods: The study included a total of 37 164 neurologic disorder-free participants aged 40-70 years from the UK Biobank, who underwent brain MRI scans 9 years after baseline.

Accuracy and variability in clinical predictions of speech recognition outcomes for cochlear implant users.

Objectives: An improvement in speech perception is a major well-documented benefit of cochlear implantation (CI), which is commonly discussed with CI candidates to set expectations. However, a large variability exists in speech perception outcomes. We evaluated the accuracy of clinical predictions of post-CI speech perception scores.

Operationalising a Haemophilia Gene Editing Lexicon for Practical Use.

Introduction: Gene editing therapies offer the possibility of substantial improvement in treatment and quality of life for people with haemophilia (PWH) in a landscape of dynamic therapeutic advancement. Developing a common and understandable language to discuss gene editing will be essential to ensure these treatments can be deployed in a safe and effective manner with fully informed and shared decision-making between healthcare professionals (HCPs) and PWH. A lexicon explaining and clarifying key concepts is one potential tool to address these aims.

Concomitant Cartilage Procedures With Meniscal Allograft Transplantation Do Not Substantially Alter Failure or Survival Rates Relative to Meniscal Allograft Transplantation Without Cartilage Procedures: A Systematic Review.

Background: Timely recognition and addressing of concomitant cartilage damage at the time of meniscal allograft transplantation (MAT) is critical to warrant future success. However, there remains a scarcity of data comparing outcomes between MAT with and without cartilage procedures.

Purpose: To compare patient-reported outcomes and rates of complications, failures, reoperations, and graft survivorship after MAT with concomitant cartilage procedures (MAT/Cart) and MAT without (MAT/NoCart).

Molecular hallmarks of excitatory and inhibitory neuronal resilience and resistance to Alzheimer's disease.

Background: A significant proportion of individuals maintain healthy cognitive function despite having extensive Alzheimer's disease (AD) pathology, known as cognitive resilience. Understanding the molecular mechanisms that protect these individuals can identify therapeutic targets for AD dementia. This study aims to define molecular and cellular signatures of cognitive resilience, protection and resistance, by integrating genetics, bulk RNA, and single-nucleus RNA sequencing data across multiple brain regions from AD, resilient, and control individuals.

The Clinical Utility of Anorectal Manometry: A Review of Current Practices.

Anorectal manometry (ARM) is a diagnostic test that utilizes pressure sensors to dynamically measure intraluminal anal and rectal pressures, thus providing an objective evaluation of anorectal functional parameters (tone, contractility, and relaxation), coordination and reflex activity, and sensation. ARM is a useful test for numerous indications including for the assessment and management of functional anorectal disorders such as fecal incontinence, functional defecatory disorders, and functional anorectal pain, preoperative assessment of anorectal function, and in facilitating/assessing response to biofeedback training. In addition, while many functional anorectal disorders present with overlapping symptoms (ie constipation, anorectal pain), ARM allows delineation of more specific disease processes and may guide treatment more effectively.

Benchmarking antimicrobial use to antimicrobial resistance: a comparative study of two hospitals using current National Healthcare Safety Network (NHSN) metrics.

Objective: We aimed to determine whether benchmarking antimicrobial use (AU) to antimicrobial resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation.

Design: We retrospectively measured AU (antimicrobial therapy days per 1,000 days present) and AU/AR ratios (specific antimicrobial therapy days per corresponding AR event) in two hospitals during 2020 through 2022. We then had antimicrobial stewardship committee members evaluate each AU and corresponding AU/AR value and indicate whether they believed it represented potential overuse, appropriate use, or potential underuse of the antimicrobials, or whether they could not provide an assessment.

Insurance-Based Disparities in Cardiac Allograft Vasculopathy Following Heart Transplantation Are Mediated by Care at High Volume Centers.

Background: Socioeconomic disadvantage and Medicaid insurance have been linked with inferior survival following heart transplantation, yet the contributing mechanisms remain to be elucidated. We evaluated the association of Medicaid with the development of cardiac allograft vasculopathy(CAV).

Methods: We considered heart transplant recipients ≥18years within the 2004-2022 Organ Procurement and Transplantation Network.

XIS-PM: A daily spatiotemporal machine-learning model for PM in the contiguous United States.

Air-pollution monitoring is sparse across most of the United States, so geostatistical models are important for reconstructing concentrations of fine particulate air pollution (PM) for use in health studies. We present XGBoost-IDW Synthesis (XIS), a daily high-resolution PM machine-learning model covering the contiguous US from 2003 through 2023. XIS uses aerosol optical depth from satellites and a parsimonious set of additional predictors to make predictions at arbitrary points, capturing near-roadway gradients and allowing the estimation of address-level exposures.

Linear and angular impulse generated by high school pitchers during fastballs and changeups.

This study revealed how high school pitchers generated momenta during fastballs and changeups at a whole-body level. Baseball pitchers control ground reaction forces to generate whole-body momentum. Pitchers attempt to throw as fast and accurately as possible during fastballs but also need to throw off-speed pitches like changeups to deceive batters.

Rotating Hinge Revision Total Knee Arthroplasty With and Without Porous Cone Adjunct Fixation.

Introduction: As the number of revision total knee arthroplasties (rTKA) continues to rise, there is increasing interest in the use of contemporary rotating hinge prostheses. These devices often incorporate porous cones to fill bone defects and enhance long-term fixation. This study evaluated the clinical and functional outcomes and survivorship in rTKA patients utilizing a rotating hinge prosthesis with flexible titanium (FT) cones, porous tantalum (PT) cones, or no cones.

Migraine Genetic Susceptibility Does Not Strongly Influence Migraine Characteristics and Outcomes in a Treated, Real-World, Community Cohort.

: Migraine is a common neurological disorder with highly variable characteristics. While genome-wide association studies have identified genetic risk factors that implicate underlying pathways, the influence of genetic susceptibility on disease characteristics or treatment response is incompletely understood. We examined the relationships between a previously developed standardized integrative migraine polygenic genetic risk score (PRS) and migraine characteristics in a real-world, treated patient cohort.