Feasibility of measuring magnetic resonance elastography-derived stiffness in human thoracic aorta and aortic dissection phantoms.

Type B aortic dissection (TBAD) represents a serious medical emergency with up to a 50% associated 5-year mortality caused by thoracic aorta, dissection-associated aneurysmal (DAA) degeneration, and rupture. Unfortunately, conventional size-related diagnostic methods cannot distinguish high-risk DAAs that benefit from surgical intervention from stable DAAs. Our goal is to use DAA stiffness measured with magnetic resonance elastography (MRE) as a biomarker to distinguish high-risk DAAs from stable DAAs.

Effects of adipose allograft matrix on viability of humeral head cartilage and rotator cuff tendon.

Background: Rotator cuff repairs may fail because of compromised blood supply, suture anchor pullout, or poor fixation to bone. To augment the repairs and promote healing of the tears, orthobiologics, such a platelet-rich plasma (PRP), and biologic scaffolds have been applied with mixed results. Adipose allograft matrix (AAM), which recruits native cells to damaged tissues, may also be a potential treatment for rotator cuff tears.

The Impact of Antibiotics on Latency When Given at the Time of Membrane Rupture Prior to Viability.

Background: It is well established that antibiotics administered in preterm prelabor rupture of membranes increases latency to delivery. While data is limited for membrane rupture prior to viability, antibiotics may also increase latency in this population.

Objective: To assesses the effect of prophylactic antibiotics on the duration of latency in individuals with previable prelabor rupture of membranes.

Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.

Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.

Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.

Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.

Differences in myocardial involvement between new onset and longstanding systemic lupus erythematosus patients assessed by cardiovascular magnetic resonance.

Objectives: Subclinical myocardial involvement is common in systemic lupus erythematosus (SLE), but differences between new onset and longstanding SLE are not fully elucidated. This study compared myocardial involvement in new onset versus longstanding SLE using cardiovascular magnetic resonance (CMR).

Materials And Methods: We prospectively enrolled 24 drug-naïve new onset SLE patients, 27 longstanding SLE patients, and 20 healthy controls.

Therapeutic doses of efzofitimod demonstrate efficacy in pulmonary sarcoidosis.

Background: In a phase 1b/2a clinical trial of efzofitimod in patients with corticosteroid-requiring pulmonary sarcoidosis, treatment resulted in dose-dependent improvement in key end-points. We undertook a analysis pooling dose arms that achieved therapeutic concentrations of efzofitimod (Therapeutic group) those that did not (Subtherapeutic group).

Methods: Peripheral blood mononuclear cells incubated with tuberculin-coated beads were exposed to varying concentrations of efzofitimod in an assay to determine concentrations that inhibited granuloma formation.

Expert Clinical Management of Inflammatory Immune-Related Arthritis in Patients with Cancer Receiving Immune Checkpoint Inhibitors.

Introduction: Treatment guidelines for immune-related inflammatory arthritis (irAE-IA) in patients with cancer receiving immune checkpoint inhibitors (ICIs) are vague with respect to the use of specific agents. Patients are usually referred to rheumatologists for treatment. We conducted a survey of expert rheumatologists to determine current practices.

Incidence of bradycardia with the use of remdesivir for coronavirus disease of 2019 and risk factor analysis.

Background: Remdesivir is commonly used for inpatient treatment of coronavirus disease of 2019 (COVID-19) and may be associated with bradycardia. The objective is to investigate the incidence of bradycardia in patients with COVID-19 receiving remdesivir and evaluate potential risk factors associated with bradycardia.

Methods: This single-center, retrospective, cohort study evaluated the incidence of bradycardia during and up to 48 h after remdesivir administration in adults admitted to the medical center for treatment of COVID-19.

Targeting the Type I Interferon Pathway in Glomerular Kidney Disease: Rationale and Therapeutic Opportunities.

Type I interferons (IFNs) are immunostimulatory molecules that can activate the innate and adaptive immune systems. In cases of immune dysfunction, prolonged activation of the type I IFN pathway has been correlated with kidney tissue damage in a wide range of kidney disorders, such as lupus nephritis (LN) and focal segmental glomerulosclerosis (FSGS). Genetic mutations, such as risk variants in conjunction with elevated type I IFN expression, are also associated with higher rates of chronic kidney disease in patients with LN and collapsing FSGS.

Sleep Disturbance and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury and Orthopedic Injury.

Objective: Sleep disturbance (SD) is common after pediatric mild traumatic brain injury (mTBI) and may predict increased postconcussive symptoms (PCS) and prolonged recovery. Our objective was to investigate the relation of SD with PCS in children with mTBI and those with orthopedic injury (OI).

Setting: Emergency departments (EDs) at 2 children's hospitals in the Midwestern United States.

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).

Eruptive keratoacanthoma secondary to immune checkpoint inhibitors: a narrative review.

The use of immunotherapy is an emerging treatment option for advanced malignancies. Cutaneous adverse events following cancer immunotherapy are well-documented in the literature. The rarer cutaneous adverse effects are less characterized, including eruptive keratoacanthomas (KA).

Impact of Academic Medical Centers on Surgical Outcomes of Neighboring Non-Academic Medical Centers.

Introduction: We aimed to investigate the geographic variation of Academic Medical Centers (AMCs) across different healthcare markets and the impact on surgical outcomes in nearby non-AMCs.

Methods: Patients who underwent major surgery between 2016 and 2021 were identified from the Medicare Standard Analytic Files. Healthcare markets were delineated using Dartmouth Atlas hospital referral regions.

Household Exposure to Substance Abuse and the Risk of New Persistent Opioid Use After Cancer Surgery.

Background: Household-level factors may also influence the risk of new persistent opioid use (NPOU). We sought to assess the risk of NPOU among individuals with household exposure to substance abuse.

Methods: Opioid-naïve individuals who underwent oncological procedures were identified using the IBM MarketScan database.

Genomic Profiling of Biliary Tract Cancers: Comprehensive Assessment of Anatomic and Geographic Heterogeneity, Co-Alterations and Outcomes.

Background: Biliary tract cancers (BTCs) represent distinct biological and genomic entities. Anatomic and geographic heterogeneity in genomic profiling of BTC subtypes, genomic co-alterations, and their impact on long-term outcomes are not well defined.

Methods: Genomic data to characterize alterations among patients with BTCs were derived from the AACR GENIE registry (v15.

Changes in Cardiovascular Health at Midlife and Subsequent Cardiovascular Outcomes in Individuals With Diabetes.

Background: Whether improvements in cardiovascular health (CVH) in midlife mitigate cardiovascular disease (CVD) risk in patients with diabetes remains underexplored.

Objectives: The aim of the study was to examine the relationships between changes in CVH during midlife and subsequent risks of CVD events and all-cause mortality among individuals with and without diabetes.

Methods: The study utilized data from the Atherosclerosis Risk in Communities Study.

Phase-specific changes in hip joint loading during gait following sacroiliac joint fusion: Findings from a finite element analysis.

Background: Low back pain affects over 80 % of adults, with sacroiliac joint dysfunction accounting for 15-30 % of these cases. Sacroiliac fusion is a surgical procedure for refractory joint pain. While the biomechanics of the joint and its fusion relative to the spinal column are well-known, the hip-spine relationship post-fusion remains unclear.

Safety of accessing brachial veins for large-bore upper extremity venous thrombectomy using ClotTriever Thrombectomy System.

Purpose: To evaluate access site adverse events following ClotTriever-mediated large-bore mechanical thrombectomy via small upper extremity deep veins (< 6-mm).

Materials And Methods: Twenty patients, including 24 upper extremity venous access sites, underwent ClotTriever-mediated large-bore thrombectomy of the upper extremity and thoracic central veins for symptomatic deep vein obstruction unresponsive to anticoagulation. Patients without follow-up venous duplex examinations (n = 3) were excluded.

Investigation of stakeholder perceptions of the wheelchair service delivery process.

The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.

Emergency department and inpatient interhospital transfers for patients with status epilepticus.

Objective: Interhospital transfers for status epilepticus (SE) are common, and some are avoidable and likely lower yield. The use of interhospital transfer may differ in emergency department (ED) and inpatient settings, which contend with differing clinical resources and financial incentives. However, transfer from these two settings is understudied, leaving gaps in our ability to improve the hospital experience, cost, and triage for this neurologic emergency.

Aggressive Digital Papillary Adenocarcinoma: A Meta-Analysis of the Presentation, Treatment, and Outcomes of a Rare Hand Tumor.

Background: Aggressive digital papillary adenocarcinoma (ADPA) is a rare skin adnexal tumor with a predilection for the hand. The presentation, treatment, and outcomes of ADPA remain poorly defined due to the scarcity of reports and low-level evidence of published findings.

Methods: We performed a meta-analysis following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines with the intent to provide hand surgeons a better understanding of the diagnosis and treatment of the disease.

Activity of Platinum Chemotherapy in Men With Prostate Cancer With and Without DNA Damage Repair Mutations.

Introduction: Alterations in homologous recombination repair (HRR) genes occur in 20%-30% of men with metastatic castration-resistant prostate cancer (mCRPC) which may increase sensitivity to platinum chemotherapy. Specifically, exceptional responses to platinum chemotherapy have been reported among patients with BRCA mutations. This study aimed to evaluate the efficacy of platinum chemotherapy in patients with mCRPC with and without HRR.