Preventative treatment of tuberous sclerosis complex with sirolimus: Phase I safety and efficacy results.

Objective: Tuberous sclerosis complex (TSC) results from overactivity of the mechanistic target of rapamycin (mTOR). Sirolimus and everolimus are mTOR inhibitors that treat most facets of TSC but are understudied in infants. We sought to understand the safety and potential efficacy of preventative sirolimus in infants with TSC.

Optimizing Cervical Epidural Steroid Injections: A Case Report.

Cervical radiculopathy is characterized by pain, numbness, and weakness in the upper limbs. This is typically caused by nerve root compression. While conservative treatments like physical therapy and oral analgesics are often used, they may not be effective in more severe cases.

Enriched environment prevents hypernociception and depression-like behavior in a psychiatric disorder and neuropathic pain comorbidity experimental condition.

Pain is a multifactorial debilitating condition associated with some psychiatric comorbidities such as generalized anxiety and depression. Concerning pharmacological treatment, which is often inefficient or associated with intense side effects, the physical and social context may be fundamental for patient's health improvement. In this sense, we sought to assess the impact of an enriched environment (EE) on neuropathic pain (NP) and depression comorbid.

Race disparities in dental care use from adolescence to middle adulthood in the USA.

Background: This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11-43) and investigates racial and ethnic disparities in these patterns.

Methods: Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993-2018; ages 11-43). Semiparametric group-based trajectory model identified distinct dental care use trajectories.

Decoding cancer etiology with cellular reprogramming.

Cancer research remains clinically unmet in many areas due to limited access to patient samples and the lack of reliable model systems that truly reflect human cancer biology. The emergence of patient-derived induced pluripotent stem cells and engineered human pluripotent stem cells (hPSCs) has helped overcome these challenges, offering a versatile alternative platform for advancing cancer research. These hPSCs are already proving to be valuable models for studying specific cancer driver mutations, offering insights into cancer origins, pathogenesis, tumor heterogeneity, clonal evolution, and facilitating drug discovery and testing.

DEK::AFF2 Fusion Sinonasal and Skull Base Nonkeratinizing Squamous Cell Carcinoma: A Clinical Outcome Study Compared With Conventional Sinonasal Squamous Cell Carcinoma.

DEK::AFF2 fusion nonkeratinizing squamous cell carcinoma (NKSCC) is an emerging entity in the sinonasal tract, temporal bone, and skull base. However, the clinical behavior of these tumors has not been well studied. Here, we report the largest cohort of DEK::AFF2 carcinomas to determine if morphology, mitotic rate, and/or Ki-67 IHC are associated with patient outcomes, including a comparison with high-risk human papillomavirus (HPV)-associated and independent patients.

Neuroinflammatory Response in the Traumatic Brain Injury: An Update.

The central nervous system (CNS) comprises membranes and barriers that are vital to brain homeostasis. Membranes form a robust shield around neural structures, ensuring protection and structural integrity. At the same time, barriers selectively regulate the exchange of substances between blood and brain tissue, which is essential for maintaining homeostasis.

Brown-Séquard syndrome after blunt cervical spine trauma in a patient with preinjury multilevel hemilaminectomies and OPLL: illustrative case.

Background: Brown-Séquard syndrome (BSS) is a rare neurological condition characterized by injury to one-half of the spinal cord. In the context of trauma, BSS is typically seen with penetrating injuries. Here, the authors present the unique case of a patient presenting with BSS after blunt trauma.

Racial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016-2020.

Background: Racial and ethnic disparities in health care delivery can lead to inadequate peripartum pain management and associated adverse maternal outcomes. An epidural blood patch (EBP) is the definitive treatment for moderate to severe postdural puncture headache (PDPH), a potentially debilitating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States.

An exploration of anxiety and depressive symptoms among sexual and gender minority young adults visiting a drop-in center for youth experiencing homelessness.

Background: Research suggests that marginalized young adults, particularly sexual and gender minorities (SGM), face distinctive healthcare transition challenges. SGM often navigate a complex intersection of identities, experiences, and stressors that can contribute to mental health disparities. However, they often lack access to appropriate support and resources tailored to their needs, which can result in increased psychological distress.

Blocking feedback immunosuppression of antigen presentation in brain tumor during oncolytic virotherapy with oHSV-mshPKR.

Glioblastoma (GBM) is the most frequent malignant brain tumor. We recently discovered that oncolytic herpes simplex virus engineered to disable tumor-intrinsic protein kinase R (PKR) signaling (oHSV-shPKR) could increase oHSV oncolysis and anti-tumor immune response. However, here we show that disabling tumor-intrinsic PKR signaling can also induce the activation of the indoleamine 2,3-dioxygenase (IDO) signaling pathway.

Artificial Intelligence Assessment of Chest Radiographs for COVID-19.

Background: The sensitivity of reverse-transcription polymerase chain reaction (RT-PCR) is limited for diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Chest computed tomography (CT) is reported to have high sensitivity; however, given the limited availability of chest CT during a pandemic, the assessment of more readily available imaging, such as chest radiographs, augmented by artificial intelligence may substitute for the detection of the features of coronavirus disease 2019 (COVID-19) pneumonia.

Methods: We trained a deep convolutional neural network to detect SARS-CoV-2 pneumonia using publicly available chest radiography imaging data including 8,851 normal, 6,045 pneumonia, and 200 COVID-19 pneumonia radiographs.

Risk Factors for Diagnostic Change from Glaucoma Suspect to Primary Open-Angle Glaucoma and Vice Versa over Two Years.

Objective: This study investigates the incidence and causes of diagnostic changes from primary open angle glaucoma suspect (POAGS) to primary open angle glaucoma (POAG), and vice versa, in clinical practice.

Design: This is a retrospective, single site, case-control study.

Participants: It includes patients over age 40 diagnosed with either POAG or POAGS between 2013-2020.

Vagus nerve stimulation in treatment-resistant depression: A one-year, randomized, sham-controlled trial.

Background: Few treatments are available for individuals with marked treatment-resistant depression (TRD).

Objective: Evaluate the safety and effectiveness of FDA-approved adjunctive vagus nerve stimulation (VNS) in patients with marked TRD.

Methods: This 12-month, multicenter, double-blind, sham-controlled trial included 493 adults with marked treatment-resistant major depression who were randomized to active or no-stimulation sham VNS for 12 months.

Survival analysis of clear cell renal cell carcinoma based on radiomics and deep learning features from CT images.

Purpose: To create a nomogram for accurate prognosis of patients with clear cell renal cell carcinoma (ccRCC) based on computed tomography images.

Methods: Eight hundred twenty-two ccRCC patients with contrast-enhanced computed tomography images involved in this study were collected. A rectangular region of interest surrounding the tumor was used to extract quantitative radiomics and deep-learning features, which were filtered by Cox proportional hazard regression model and least absolute shrinkage and selection operator.

Effectiveness of Ventilation via an Endotracheal Tube in Pharynx Versus a Facemask in Patients With Potentially Difficult Airway: A Randomized, Crossover, and Blind Trial.

Background: The difficult airway is frequently encountered across many scenarios. The extreme form is a "cannot intubate and cannot oxygenate" scenario, which lacks a reliable rescue technique. Previous case reports or studies with small sample sizes indicate the feasibility and efficiency of an endotracheal tube in the pharynx (TTIP) to ventilate patients.

Recovery Residences Are an Innovative Site for HIV Prevention Interventions Targeting People Who Inject Drugs: Preliminary Data From Project HOMES.

Of 1.2 million Americans who would benefit from pre-exposure prophylaxis (PrEP), only 36% were prescribed PrEP in 2023. Project HOMES is an ongoing study that evaluates recovery residences for individuals in medication-assisted recovery from opioid use disorder across five Texas cities.

Designing a blockchain technology platform for enhancing the pre-exposure prophylaxis care continuum.

Objectives: Pre-exposure prophylaxis (PrEP) is a key biomedical intervention for ending the HIV epidemic in the United States, but its uptake is impeded by systemic barriers, including fragmented workflows and ineffective data coordination. This study aims to design PrEPLinker, a blockchain-based, client-centered platform to enhance care to address these challenges by improving care coordination and enabling clients to securely manage their identity and PrEP-related data.

Materials And Methods: Using Houston, Texas, as a use case, we conducted a needs assessment with PrEP collaborators to evaluate existing workflows and identify barriers in the PrEP care continuum.

Effects of vagus nerve stimulation on daily function and quality of life in markedly treatment-resistant major depression: Findings from a one-year, randomized, sham-controlled trial.

Background: Depression treatments aim to minimize symptom burden and optimize quality of life (QoL) and psychosocial function.

Objective: Compare the effects of adjunctive versus sham vagus nerve stimulation (VNS) on QoL and function in markedly treatment-resistant depression (TRD).

Methods: In this multicenter, double-blind, sham-controlled trial, 493 adults with TRD and ≥4 adequate but unsuccessful antidepressant treatment trials (current episode) were randomized to active (n = 249) or sham (n = 244) VNS (plus treatment as usual) over a 12-month observation period.

Association of Same-day Antiplatelet Loading and Outcomes after TransCarotid Artery Revascularization.

Objective: Prior studies have emphasized the importance of compliance with preoperative dual antiplatelet therapy (DAPT) in patients undergoing TransCarotid artery revascularization (TCAR). This investigation examines differences in perioperative outcomes following TCAR in those receiving loading dose of antiplatelet medications on the day of the procedure versus those already maintained on DAPT.

Methods: Consecutive TCAR procedures from the Vascular Quality Initiative (2016-2022) were identified.

Untargeted metabolome atlas for sleep-related phenotypes in the Hispanic community health study/study of Latinos.

Background: Sleep is essential to maintaining health and wellbeing of individuals, influencing a variety of outcomes from mental health to cardiometabolic disease. This study aims to assess the relationships between various sleep-related phenotypes and blood metabolites.

Methods: Utilising data from the Hispanic Community Health Study/Study of Latinos, we performed association analyses between 40 sleep-related phenotypes, grouped in several domains (sleep disordered breathing (SDB), sleep duration, sleep timing, self-reported insomnia symptoms, excessive daytime sleepiness (EDS), and heart rate during sleep), and 768 metabolites measured via untargeted metabolomics profiling.

Antibody-Drug Conjugates Targeting the EGFR Ligand Epiregulin Elicit Robust Anti-Tumor Activity in Colorectal Cancer.

As colorectal cancer (CRC) remains a leading cause of cancer-related death, identifying therapeutic targets and approaches is essential to improve patient outcomes. The EGFR ligand epiregulin (EREG) is highly expressed in RAS wildtype and mutant CRC with minimal expression in normal tissues, making it an attractive target for antibody-drug conjugate (ADC) development. In this study, we produced and purified an EREG monoclonal antibody (mAb), H231, that had high specificity and affinity for human and mouse EREG.