Association Between Early Immunosuppression Center Variability and One-Year Outcomes After Pediatric Liver Transplant.

Background: Despite the existence of institutional protocols, liver transplant centers often have variability in early immunosuppression practices. We aimed to measure within-center variability in early immunosuppression after pediatric liver transplant (LT) and examine its association with one-year outcomes.

Methods: We analyzed pediatric LTs from 2013 to 2018 in the United Network for Organ Sharing registry, with data aggregated by center.

SPRINT Treatment Among Adults With Chronic Kidney Disease From 2 Large Health Care Systems.

Importance: It is unclear whether the effects of intensive vs standard blood pressure (BP) targets seen in clinical trials generalize to patients with chronic kidney disease (CKD) encountered in everyday practice due to differences in the distribution of cardiovascular risk factors and coexisting conditions.

Objective: To evaluate whether the beneficial and adverse effects of intensive vs standard BP control observed in the Systolic Blood Pressure Intervention Trial (SPRINT) are transportable to a target population of adults with CKD in clinical practice.

Design, Setting, And Participants: This comparative effectiveness study identified 2 populations with CKD who met the eligibility criteria for SPRINT between January 1 and December 31, 2019, in the Veterans Health Administration (VHA) and Kaiser Permanente of Southern California (KPSC).

Meta-Analysis: Prevalence of Youth Mental Disorders in Sub-Saharan Africa.

Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need. We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years.

An objective quantitative diagnosis of depression using a local-to-global multimodal fusion graph neural network.

This study developed an artificial intelligence (AI) system using a local-global multimodal fusion graph neural network (LGMF-GNN) to address the challenge of diagnosing major depressive disorder (MDD), a complex disease influenced by social, psychological, and biological factors. Utilizing functional MRI, structural MRI, and electronic health records, the system offers an objective diagnostic method by integrating individual brain regions and population data. Tested across cohorts from China, Japan, and Russia with 1,182 healthy controls and 1,260 MDD patients from 24 institutions, it achieved a classification accuracy of 78.

Monitoring of cancer ferroptosis with [F]hGTS13, a system xc- specific radiotracer.

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults, characterized by resistance to conventional therapies and poor survival. Ferroptosis, a form of regulated cell death driven by lipid peroxidation, has recently emerged as a promising therapeutic target for GBM treatment. However, there are currently no non-invasive imaging techniques to monitor the engagement of pro-ferroptotic compounds with their respective targets, or to monitor the efficacy of ferroptosis-based therapies.

Utilization of ChatGPT for Rhinology Patient Education: Limitations in a Surgical Sub-Specialty.

Objective: To analyze the accuracy of ChatGPT-generated responses to common rhinologic patient questions.

Methods: Ten common questions from rhinology patients were compiled by a panel of 4 rhinology fellowship-trained surgeons based on clinical patient experience. This panel (Panel 1) developed consensus "expert" responses to each question.

Machine learning of endoscopy images to identify, classify, and segment sinonasal masses.

Background: We developed and assessed the performance of a machine learning model (MLM) to identify, classify, and segment sinonasal masses based on endoscopic appearance.

Methods: A convolutional neural network-based model was constructed from nasal endoscopy images from patients evaluated at an otolaryngology center between 2013 and 2024. Images were classified into four groups: normal endoscopy, nasal polyps, benign, and malignant tumors.

Finding the Value: Identifying the Key Elements of Recorded Clinic Visits From the Perspective of Patients, Clinicians, and Caregivers.

Objective: We aimed to understand what patients, caregivers and clinicians identified as the most important information from their audio-recorded clinic visits and why.

Methods: We recruited patients, caregivers and clinicians from primary and speciality care clinics at an academic medical centre in New Hampshire, U.S.

Antimicrobial Peptides Against Arboviruses: Mechanisms, Challenges, and Future Directions.

This review delves into the potential of antimicrobial peptides (AMPs) as promising candidates for combating arboviruses, focusing on their mechanisms of antiviral activity, challenges, and future directions. AMPs have shown promise in preventing arbovirus attachment to host cells, inducing interferon production, and targeting multiple viral stages, illustrating their multifaceted impact on arbovirus infections. Structural elucidation of AMP-viral complexes is explored to deepen the understanding of molecular determinants governing viral neutralization, paving the way for structure-guided design.

Mutant Calreticulin in MPN: Mechanistic Insights and Therapeutic Implications.

Purpose Of Review: More than a decade following the discovery of Calreticulin (CALR) mutations as drivers of myeloproliferative neoplasms (MPN), advances in the understanding of CALR-mutant MPN continue to emerge. Here, we summarize recent advances in mehanistic understanding and in targeted therapies for CALR-mutant MPN.

Recent Findings: Structural insights revealed that the mutant CALR-MPL complex is a tetramer and the mutant CALR C-terminus is exposed on the cell surface.

Prevalence and predictors of Barrett's esophagus and esophageal cancer in patients with eosinophilic esophagitis.

Data on Barrett's esophagus (BE) and esophageal cancer (EC) outcomes in patients with eosinophilic esophagitis (EoE) are limited. We aimed to determine the risk of prevalent BE (<1 year after endoscopy), incident BE (≥1 year after endoscopy), and incident EC in patients with versus without EoE, and to identify predictors of BE/EC in EoE patients. We identified adult patients in the Merative MarketScan Database who underwent first-time upper endoscopy between 2008 and 2020.

Measurable residual disease and posttransplantation gilteritinib maintenance for patients with FLT3-ITD-mutated AML.

BMT CTN 1506 ("MORPHO"; NCT02997202) was a randomized phase 3 study of gilteritinib compared to placebo as maintenance therapy after hematopoietic stem cell transplantation (HCT) for patients with FLT3-ITD-mutated acute myeloid leukemia (AML). A key secondary endpoint was to determine the impact on survival of pre- and/or post-HCT measurable residual disease (MRD), as determined using a highly sensitive assay for FLT3-ITD mutations. Generally, gilteritinib maintenance therapy was associated with improved relapse-free survival (RFS) for participants with detectable peri-HCT MRD, whereas no benefit was evident for those lacking detectable MRD.

Transgenerational associations between newborn metabolic profiles and bronchopulmonary dysplasia in neonates born to mothers with an obese phenotype.

Maternal obesity increases risk for bronchopulmonary dysplasia (BPD) by up to 42%. Identifying metabolic features that may contribute to the association between maternal pre-pregnancy body mass index (BMI) and BPD is critical in defining the molecular relationship between these conditions. We investigated the association between maternal obesity and BPD using newborn screen metabolites as an explanatory variable.

Increased MASH-associated liver cancer in younger demographics.

Background: The incidence of cancer and the prevalence of metabolic disease and metabolic dysfunction-associated steatotic liver disease is increasing in young adults. However, updated global data on metabolic dysfunction-associated steatohepatitis (MASH)-associated primary liver cancer (PLC) in young adults remains scarce.

Methods: This study analyzed data from the Global Burden of Disease study between 2000 and 2021 to assess the age-standardized incidence, mortality, and disability-adjusted life years rates from MASH-associated PLC in young adults (15-49 y).

Reviewing "Nil Per Os" Guidance for Clear Fluids in Children Before Anesthesia: Survey of the Pediatric Anesthesia Leadership Council.

Background: Several international pediatric anesthesia societies have endorsed a change in the traditional nil per os (NPO) cutoff of clear fluids (CF) from 2 hours to 1 hour. These recommendations were compiled from large-scale outcomes, gastric ultrasound, and quality improvement studies. The American Society of Anesthesiologists (ASA) recently published their updated guidelines.

Positional lagophthalmos variability in facial nerve palsy with and without upper eyelid loading.

Purpose: Lagophthalmos from facial nerve palsy is traditionally measured with patients in an upright position and may fail to identify positional variability. This study aims to assess the effects of body position, surgical technique, implant material, and patient demographics on lagophthalmos.

Methods: A multicenter prospective study was performed to evaluate positional changes in paralytic lagophthalmos and the effects of various patient and surgical factors.

Single-Cell Analysis in Cerebrovascular Research: Primed for Breakthroughs and Clinical Impact.

Data generated using single-cell RNA-sequencing has the potential to transform understanding of the cerebral circulation and advance clinical care. However, the high volume of data, sometimes generated and presented without proper pathophysiological context, can be difficult to interpret and integrate into current understanding of the cerebral circulation and its disorders. Furthermore, heterogeneity in the representation of brain regions and vascular segments makes it difficult to compare results across studies.

Whole-Body MRI in Children: Concepts and Controversies- Expert Panel Narrative Review.

The use of whole-body MRI (WBMRI) in children, from infancy to adolescence, has expanded rapidly over the past decade, with increasing uptake and a broadening range of clinical indications. Current indications include screening for presymptomatic lesions in cancer predisposition syndromes; tumor staging in known malignancies; investigating fevers of unknown origin; as well as diagnosing and monitoring rheumatologic diseases, vascular anomalies and neuromuscular disorders. This AJR Expert Panel Narrative Review aims to offer a comprehensive discussion of WBMRI in pediatric patients, exploring protocols and other technical considerations, clinical indications, implementation challenges and troubleshooting, as well as controversies in widespread adoption, while considering emerging trends and directions.

Bosniak Classification of Cystic Renal Masses Version 2019: Proportion of Malignancy by Class and Subclass-Systematic Review and Meta-Analysis.

Bosniak classification version 2019 (v2019) was a major revision to version 2005 (v2005) that defined cystic renal mass subclasses based on wall or septa features. To determine the proportion of malignancy within cystic renal masses stratified by Bosniak classification v2019 class and feature-based subclass. MEDLINE and EMBASE databases were searched on July 24, 2023 for studies published in 2019 or later that reported cystic renal masses that underwent renal-mass CT or MRI, were assessed using Bosniak v2019, and had a reference standard (histopathology indicating benignity or malignancy or ≥5-year imaging follow-up indicating benignity).