Anti-Amyloid Therapies for Alzheimer's Disease and Amyloid-Related Imaging Abnormalities: Implications for the Emergency Medicine Clinician.

Alzheimer's disease is the neurodegenerative disorder responsible for approximately 60% to 70% of all cases of dementia and is expected to affect 152 million by 2050. Recently, anti-amyloid therapies have been developed and approved by the Food and Drug Administration as disease-modifying treatments given as infusions every 2 to 5 weeks for Alzheimer's disease. Although this is an important milestone in mitigating Alzheimer's disease progression, it is critical for emergency medicine clinicians to understand what anti-amyloid therapies are and how they work to recognize, treat, and mitigate their adverse effects.

Emotional Health of Transgender Youth 24 Months After Initiating Gender-Affirming Hormone Therapy.

Purpose: Limited data exist about the emotional health of transgender youth, either before or after initiation of gender-affirming hormone (GAH). The objectives were: (1) Investigate and verify the factor structure of the National Institutes of Health Toolbox Emotional Battery (NIHTB-EB) among trans and non-binary (TNB) youth; (2) Examine changes in emotional health over 24 months of GAH treatment; and (3) Examine the extent to which changes in emotional health were associated with improved appearance congruence (AC).

Methods: Study respondents were from Trans Youth Care - United States (TYCUS) study, an observational, prospective, longitudinal study of adolescents initiating GAH enrolled between 2016 and 2019.

Development of TAR-200: A novel targeted releasing system designed to provide sustained delivery of gemcitabine for patients with bladder cancer.

Treatment options for recurrent high-risk non-muscle-invasive bladder cancer (HR NMIBC) and muscle-invasive bladder cancer (MIBC) are limited, highlighting a need for clinically effective, accessible, and better-tolerated alternatives. In this review we examine the clinical development program of TAR-200, a novel targeted releasing system designed to provide sustained intravesical delivery of gemcitabine to address the needs of patients with NMIBC and of those with MIBC. We describe the concept and design of TAR-200 and the clinical development of this gemcitabine intravesical system in the SunRISe portfolio of studies.

Navigating "regulatory fog": Challenges to rigorous abortion research after the Dobbs v. Jackson decision.

In 2022, the United States' Supreme Court ruling in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade and federal protections for abortion.

The Clinical Neuroscience of Lucid Dreaming.

During most dreams, the dreamer does not realize that they are in a dream. In contrast, lucid dreaming allows to become aware of the current state of mind, often accompanied by considerable control over the ongoing dream episode. Lucid dreams can happen spontaneously or be induced through diverse behavioural, cognitive or technological strategies.

Eighth Annual Society of Thoracic Surgeons Pedimacs Report.

Background: The Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), supported by The Society of Thoracic Surgeons, provides detailed information on pediatric patients supported with ventricular assist devices (VADs).

Methods: From September 19, 2012, to December 31, 2023, there were 1648 devices in 1349 patients (<19 years) from 39 North American Hospitals with 100 patients enrolled in 2023.

Results: Cardiomyopathy was the most common underlying etiology (59%), followed by congenital heart disease (26%) and myocarditis (8%).

Finerenone and new-onset diabetes in heart failure: a prespecified analysis of the FINEARTS-HF trial.

Background: Data on the effect of mineralocorticoid receptor antagonist therapy on HbA levels and new-onset diabetes are conflicting. We aimed to examine the effect of oral finerenone, compared with placebo, on incident diabetes in the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF) trial.

Methods: In this randomised, double-blind, placebo-controlled trial, 6001 participants with heart failure with New York Heart Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomly assigned to finerenone or placebo, administered orally.

Screening a library of temperature-sensitive mutants to identify secretion factors in .

Protein secretion is an essential cell process in bacteria, required for cell envelope biogenesis, export of virulence factors, and acquisition of nutrients, among other important functions. In the Sec secretion pathway, signal peptide-bearing precursors are recognized by the SecA ATPase and pushed across the membrane through a translocon channel made of the proteins SecY, SecE, and SecG. The Sec pathway has been extensively studied in the model organism , but the Sec pathways of other bacteria such as the human pathogen differ in important ways from this model.

Comparative Efficacy of Ventriculosubgaleal Shunt Versus Ventricular Reservoir in Achieving Shunt Independence for Infants With Posthemorrhagic Hydrocephalus by 6 Months.

Background And Objectives: Low-birth weight, premature infants often have severe intraventricular hemorrhage (IVH), which can result in posthemorrhagic hydrocephalus (PHH), sometimes requiring cerebrospinal fluid diversion. Initial temporizing management of PHH includes placement of a ventriculosubgaleal shunt (VSGS) or ventricular access device (VAD). Studies have found similar permanent shunt conversion rates between VSGS and VAD but were limited by sample scope and size.

Weight and Blood-Based Markers of Cachexia Predict Disability, Hospitalization and Worse Survival in Cancer Immunotherapy Patients.

Background: Cancer-associated cachexia can inhibit immune checkpoint inhibitor (ICI) therapy efficacy. Cachexia's effect on ICI therapy has not been studied in large cohorts of cancer patients aside from lung cancer. We studied associations between real-world routinely collected clinical cachexia markers and disability-free, hospitalization-free and overall survival of cancer patients.

Transtracheal ultrasound for identifying endotracheal intubation in adults.

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of transtracheal ultrasound for detecting endotracheal intubation in adult patients. Secondary objectives Secondary objectives include assessing the diagnostic accuracy of transtracheal ultrasound amongst the following subgroups: setting (e.

Safety of pre-operative venogram for hemodialysis access planning in pre-end-stage kidney disease patients.

Background: Although conventional pre-operative venography can accurately delineate venous anatomy as an alternative to ultrasound for hemodialysis access planning, it may carry a risk of contrast-induced acute kidney injury (AKI) and progression of renal failure in chronic kidney disease (CKD) patients not yet on dialysis. Therefore, the objective of this study was to evaluate the safety and efficacy of pre-operative venograms in pre-end-stage kidney disease (ESKD) patients.

Methods: We performed a retrospective cohort study (2018-2022) of consecutive pre-ESKD patients who underwent staged bilateral venograms for preoperative vein mapping prior to hemodialysis access creation at a tertiary care medical center.

An epigenetic pathway regulates MHC-II expression and function in B cell lymphoma models.

Mutations or homozygous deletions of MHC class II (MHC-II) genes are commonly found in B cell lymphomas that develop in immune-privileged sites and have been associated with patient survival. However, the mechanisms regulating MHC-II expression, particularly through genetic and epigenetic factors, are not yet fully understood. In this study, we identified a key signaling pathway involving the histone H2AK119 deubiquitinase BRCA1 associated protein 1 (BAP1), the interferon regulatory factor interferon regulatory factor 1 (IRF1), and the MHC-II transactivator class II transactivator (CIITA), which directly activates MHC-II gene expression.

Engagement in child psychiatry department appointments: An analysis of electronic medical records in one safety-net hospital in New England, USA.

Objective: This study examined whether being scheduled in a screening clinic versus scheduled directly with a long-term provider to conduct a mental health intake (MHI) is associated with engagement in child psychiatry services in New England, USA.

Method: We used electronic medical record data from one safety-net hospital serving a predominantly low-income and minoritised population. The study sample included 815 youths aged 0 to 25 years, referred or scheduled for a MHI between 1 January 2016 and 31 December 2016.

Lessons Learned From the Liver About the Undergraduate to Graduate Medical Education Transition.

The burden of cirrhosis and chronic liver disease is growing, yet there is a projected worsening deficit in hepatology providers. As such, cirrhosis and liver disease have been important inclusions within the core curricula of Internal Medicine. Formal assessments of provider preparedness resulting from the curriculum are lacking though.

Electrical Heterogeneity in Hispanic Background Subpopulations: The HCHS/SOL.

Background: The Hispanic/Latino population is not uniform. Prevalence and clinical outcomes of cardiac arrhythmias in ethnic background subgroups are variable, but the reasons for differences are unclear. Vectorcardiographic Global Electrical Heterogeneity (GEH) has been shown to be associated with adverse cardiovascular outcomes.

Promotion of Cardiovascular Health in Africa: The Alliance for Medical Research in Africa (AMedRA) Expert Panel.

This proposed scientific statement is focused on providing new insights regarding challenges and opportunities for cardiovascular health (CVH) promotion in Africa. The statement includes an overview of the current state of CVH in Africa, with a particular interest in the cardiometabolic risk factors and their evaluation through metrics. The statement also explains the main principles of primordial prevention, its relevance in reducing noncommunicable disease and the different strategies that have been effective worldwide.

Iliac Crest Bone Block Autograft Transfer for Ballistic Posterior Glenoid Fracture: A Case Report.

A 25-year-old male presented with a ballistic fracture of the right glenoid resulting in > 30% loss of the posterior glenoid articular surface and acute posterior glenohumeral instability that was treated with open reduction internal fixation with iliac crest autograft transfer. There is limited consensus on the operative management of ballistic intra-articular fractures due to the heterogeneity of these injuries. Acute posterior glenohumeral instability secondary to a ballistic fracture is a rare injury pattern.

Lessons learned from 5 years of pegvaliase in US clinics: A case series.

Objective: To provide insights and strategies for pegvaliase management in challenging cases with phenylketonuria (PKU) based on the first 5 years of experience with pegvaliase in real-world clinical practice.

Methods: Twelve PKU experts gathered during a one-day, in-person meeting to discuss clinical cases illustrating important lessons from their experiences treating patients with pegvaliase in real-world clinical practice. Challenges with pegvaliase experienced prior to and during treatment and corresponding strategies to overcome them were discussed.

Lead Adsorption and Desorption at the Barite (001) Surface in the Presence of EDTA.

Scaling minerals, such as barite, can cause detrimental consequences for oil/gas pipelines and water systems, but their formation can be inhibited by organic chelators such as ethylenediaminetetraacetic acid (EDTA). Here, we resolve how EDTA affects sorption and desorption of Pb at the barite (001) surface using a combination of X-ray scattering and microscopy measurements. In the presence of EDTA, Pb incorporated in the topmost part of the barite surface and adsorbed as inner-sphere complexes on the surface.

Cemdomespib Therapy Slows the Progression of Neuromuscular Weakness and Demyelination in the R75W-Connexin 32 Animal Model of Charcot-Marie-Tooth 1X Disease.

Mutations in connexin 32 (Cx32) are a common cause of Charcot-Marie-Tooth 1X (CMT1X) disease, an inherited peripheral neuropathy characterized by progressive neuromuscular weakness and demyelination. There are no approved pharmacologic therapies for CMT1X, and identifying new treatments that slow the onset and severity of neuromuscular decline may aid disease management. Cemdomespib is an orally bioavailable small molecule that improved demyelination and neuromuscular junction (NMJ) morphology in mice lacking Cx32 expression.

Vector AutoRegressive Moving Average Models: A Review.

Vector AutoRegressive Moving Average (VARMA) models form a powerful and general model class for analyzing dynamics among multiple time series. While VARMA models encompass the Vector AutoRegressive (VAR) models, their popularity in empirical applications is dominated by the latter. Can this phenomenon be explained fully by the simplicity of VAR models? Perhaps many users of VAR models have not fully appreciated what VARMA models can provide.

Temporomandibular disorders: A new list of key points to summarize the standard of care.

This letter is being sent to editors of major dental journals around the world. Attached to it is an Announcement that summarizes a recently published position paper which deals with the topic of standards of care for Temporomandibular Disorders (TMDs). That paper, entitled "Temporomandibular disorders: INfORM/IADR key points for good clinical practice based on standard of care", was developed by a group of expert researchers and clinicians over a one-year period.