Mutational signatures define immune and Wnt-associated subtypes of ampullary carcinoma.

Background And Objective: Ampullary carcinoma (AMPAC) taxonomy is based on morphology and immunohistochemistry. This classification lacks prognostic reliability and unique genetic associations. We applied an approach of integrative genomics characterising patients with AMPAC exploring molecular subtypes that may guide personalised treatments.

Reaching experts for enhanced referral (REFER) to pain psychology: a modified Delphi approach with multidisciplinary paediatric pain providers at a specialised center in the USA.

Background: To minimise the referral gap to pain psychology, the purpose of this study was to describe clinician-perceived patient suitability for pain psychology referral, develop a referral plan and outline essential elements of a referral conversation via a modified Delphi approach with multidisciplinary paediatric pain providers.

Methods: We employed a three-round modified Delphi approach consulting multidisciplinary paediatric pain providers (n=18) including physicians, psychologists, physical therapists, occupational therapists and nurse practitioners (PT, OT, NP). Based on the responses to an online survey (Round 1), initial statements regarding the pain psychology referral process were developed.

Paediatric Personalized Research Network Switzerland (SwissPedHealth): a joint paediatric national data stream.

Introduction: Children represent a large and vulnerable patient group. However, the evidence base for most paediatric diagnostic and therapeutic procedures remains limited or is often inferred from adults. There is an urgency to improve paediatric healthcare provision based on real-world evidence generation.

Effectiveness of sequential bilateral repetitive transcranial stimulation versus bilateral theta burst stimulation for patients with treatment-resistant depression (BEAT-D): A randomized non-inferiority clinical trial.

Background: Bilateral repetitive transcranial magnetic stimulation (BL-rTMS) over the dorsolateral prefrontal cortex is effective for treatment-resistant depression (TRD). Owing to a shorter treatment time, bilateral theta burst stimulation (BL-TBS) can be more efficient protocol. The non-inferiority of BL-TBS to BL-rTMS was established in late-life TRD; however, this has not been determined in adults of other age groups.

Sex and Gender Considerations in Orthopaedic Research: Existing Barriers, What's Needed by Institutions and Research Departments, and How to Guide Junior Investigators and Faculty.

JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting.

Therapeutic Drug Monitoring in Patients with Ulcerative Colitis on Infliximab: A Cost-Effectiveness Analysis.

Background And Aims: Ulcerative colitis (UC) can be treated with infliximab (IFX). Therapeutic drug monitoring (TDM) can yield superior outcomes, but its cost-effectiveness is unknown.

Methods: We used a decision analytic Markov model to conduct a cost-effectiveness analysis comparing proactive TDM, reactive TDM, no TDM, and combinations of proactive and reactive TDM in 25-year-old patients with UC started on IFX.

Evaluating the quality and readability of ChatGPT-generated patient-facing medical information in rhinology.

Purpose: The artificial intelligence (AI) chatbot ChatGPT has become a major tool for generating responses in healthcare. This study assessed ChatGPT's ability to generate French preoperative patient-facing medical information (PFI) in rhinology at a comparable level to material provided by an academic source, the French Society of Otorhinolaryngology (Société Française d'Otorhinolaryngologie et Chirurgie Cervico-Faciale, SFORL).

Methods: ChatGPT and SFORL French preoperative PFI in rhinology were compared by analyzing responses to 16 questions regarding common rhinology procedures: ethmoidectomy, sphenoidotomy, septoplasty, and endonasal dacryocystorhinostomy.

Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism: A Network Meta-Analysis of Diagnostic Test Accuracy.

Importance: Intraoperative parathyroid hormone (IOPTH) monitoring is recommended by the American Association of Endocrine Surgeons for use during parathyroidectomy for patients with primary hyperparathyroidism (PHPT), but there is no clinician consensus regarding the IOPTH monitoring criteria that optimize diagnostic accuracy.

Objective: To evaluate and rank the diagnostic properties of IOPTH monitoring criteria used during surgery for patients with PHPT.

Data Sources: A bayesian diagnostic test accuracy network meta-analysis (DTA-NMA) was performed, in which peer-reviewed citations from January 1, 1990, to July 22, 2023, were searched for in MEDLINE, Embase, Web of Science, CENTRAL, and CINAHL.

Extending the Environmental influences on Child Health Outcomes (ECHO) Cohort through 2030: Rationale and study protocol.

Early life environmental exposures, even those experienced before conception, can shape health and disease trajectories across the lifespan. Optimizing the detection of the constellation of exposure effects on a broad range of child health outcomes across development requires considerable sample size, transdisciplinary expertise, and developmentally sensitive and dimensional measurement. To address this, the National Institutes of Health (NIH) Environmental influences on Child Health Outcomes (ECHO) Cohort Study is an observational longitudinal pediatric cohort study.

Distinct Gut Microbiota Profiles in Normal Weight Obesity and Their Association With Cardiometabolic Diseases: Results From Two Independent Cohort Studies.

Background: Normal weight obesity (NWO) is characterized by excess body fat in individuals with normal body mass index (BMI). This study aimed to investigate gut microbiota alterations in NWO and their potential associations with cardiometabolic diseases (CMD) risk in two independent cohorts.

Methods: Our NWO-CMD mortality analysis included 168 099 adults with normal BMI from two large open-access databases, while our NWO-gut microbiota study involved 5467 adults with normal BMI from two independent cohorts: the WELL-China cohort and the Lanxi cohort.

High Shear Stress Reduces ERG Causing Endothelial-Mesenchymal Transition and Pulmonary Arterial Hypertension.

Background: Computational modeling indicated that pathological high shear stress (HSS; 100 dyn/cm) is generated in pulmonary arteries (PAs; 100-500 µm) in congenital heart defects causing PA hypertension (PAH) and in idiopathic PAH with occlusive vascular remodeling. Endothelial-to-mesenchymal transition (EndMT) is a feature of PAH. We hypothesize that HSS induces EndMT, contributing to the initiation and progression of PAH.

Evidence of compensatory neural hyperactivity in a subgroup of breast cancer survivors treated with chemotherapy and its association with brain aging.

Introduction: Chemotherapy-related cognitive impairment (CRCI) remains poorly understood in terms of the mechanisms of cognitive decline. Neural hyperactivity has been reported on average in cancer survivors, but it is unclear which patients demonstrate this neurophenotype, limiting precision medicine in this population.

Methods: We evaluated a retrospective sample of 80 breast cancer survivors and 80 non-cancer controls, aged 35-73, for which we had previously identified and validated three data-driven, biological subgroups (biotypes) of CRCI.

Knowledge, Attitudes, and Decision-Making About Reproductive Health and Epilepsy: A Survey of Health Care Providers and Women With Epilepsy.

Background And Objectives: Cisgender women with epilepsy (WWE) have distinct reproductive health needs. It is unknown to what extent WWE and their health care providers (HCPs) are aware of recent research advances regarding the reproductive health of WWE. This study aimed to survey US health care providers and WWE about their knowledge, attitudes, and decision-making pertaining to reproductive health; their awareness of key findings from recent relevant research; and whether learning of these findings would change their decision-making.

Standalone Canaloplasty and Trabeculotomy Using the OMNI Surgical System in Eyes with Primary Open-Angle Glaucoma: A 36-Month Analysis from the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight): Standalone Outcomes of Canaloplasty and Trabeculotomy.

Purpose: To characterize long-term real-world clinical outcomes of standalone canaloplasty and trabeculotomy using the OMNI Surgical System (Sight Sciences) in patients with primary open-angle glaucoma (POAG).

Design: Retrospective, clinical cohort study utilizing the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) data.

Subjects: Patients/eyes in the IRIS Registry with POAG or ocular hypertension with known laterality on or after January 1, 2016 and undergoing standalone canaloplasty and trabeculotomy using the OMNI Surgical System with at least 6 months and up to 36 months of postoperative follow-up were included.

Endoplasmic reticulum protein TXNDC5 modulates thyroid eye disease TGF-β1-induced myofibroblast transdifferentiation.

Aim: There remain limited therapies to treat thyroid eye disease (TED) orbital fibrosis, highlighting the urgency to develop novel targets. Transforming growth factor-β1 (TGF-β1)-induced myofibroblast transdifferentiation from orbital fibroblasts are important pathogenetic factor of TED. Endoplasmic reticulum (ER) stress may play a role in TED pathogenesis since it has been linked to liver, kidney, heart and lung fibrotic remodelling.

Trends in naloxone co-prescriptions.

Background: The opioid epidemic remains a significant public health crisis in the United States. Naloxone has been identified as a critical component in combating this crisis. However, co-prescription rates among patients receiving opioids remain suboptimal, especially among certain high-risk populations.

Pilot study evaluation of the eQUANT™ system for accelerated antimicrobial susceptibility testing of gram-negative organisms directly from positive blood cultures.

We describe results from a multicenter pilot study evaluating the eQUANT system for rapid generation of a standardized inoculum (0.5 McFarland equivalent) directly from blood cultures positive for target gram-negative bloodstream pathogens for same-day antimicrobial susceptibility testing (AST) by disk diffusion, MicroScan and Vitek2 methods. Out of 167 blood cultures that met study criteria (monomicrobial with one of 9 target gram-negative species), colony counts from eQUANT suspensions of 164 (98.

Urothelial carcinoma in situ with "early papillary formation" vs "lateral spread/shoulder lesion" of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations.

Objectives: Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.

Methods: It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.

Results: Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as "CIS with early papillary features" (38% for groups 1 and 2 vs 13% for group 3).

Intraepithelial ILC1-Like NK Cells Increase Lymphocyte Infiltration into the Tumor Microenvironment via the CXCL10 Axis.

Intraepithelial type 1 innate lymphoid cells (ieILC1s) are tissue-resident lymphocytes in the microenvironment of head and neck squamous cell carcinoma. Here, we evaluate how these cells influence T-cell trafficking to tumors. We generated cytotoxic ieILC1-like cells from natural killer (NK) cells in vitro.

Microsimulation Estimates of Decision Uncertainty and Value of Information Are Biased but Consistent.

Purpose: Individual-level state-transition microsimulations (iSTMs) have proliferated for economic evaluations in place of cohort state transition models (cSTMs). Probabilistic economic evaluations quantify decision uncertainty and value of information (VOI). Previous studies show that iSTMs provide unbiased estimates of expected incremental net monetary benefits (EINMB), but statistical properties of iSTM-produced estimates of decision uncertainty and VOI remain uncharacterized.

Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents.

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis.

Brief Report: Protease Inhibitors Versus Nonnucleoside Reverse Transcriptase Inhibitors and the Risk of Cancer Among People With HIV.

Background: The effect of initial antiretroviral therapy (ART) class on cancer risk in people with HIV (PWH) remains unclear.

Setting: Cohort study of 36,322 PWH enrolled (1996-2014) in the North American AIDS Cohort Collaboration on Research and Design.

Methods: We followed individuals from ART initiation (protease inhibitor [PI]-, non-nucleoside reverse transcriptase inhibitor [NNRTI]-, or integrase strand transfer inhibitor [INSTI]-based) until incident cancer, death, loss-to-follow-up, 12/31/2014, 85 months (intention-to-treat analyses [ITT]), or 30 months (per-protocol [PP] analyses).

A generalized equation for predicting peak oxygen consumption during treadmill exercise testing: mitigating the bias from total body mass scaling.

Background: Indexing peak oxygen uptake (VOpeak) to total body mass can underestimate cardiorespiratory fitness (CRF) in women, older adults, and individuals with obesity. The primary objective of this multicenter study was to derive and validate a body size-independent scaling metric for VOpeak. This metric was termed exercise body mass (EBM).