Toward a Computable Phenotype for Determining Eligibility of Lung Cancer Screening Using Electronic Health Records.

Purpose: Lung cancer screening (LCS) has the potential to reduce mortality and detect lung cancer at its early stages, but the high false-positive rate associated with low-dose computed tomography (LDCT) for LCS acts as a barrier to its widespread adoption. This study aims to develop computable phenotype (CP) algorithms on the basis of electronic health records (EHRs) to identify individual's eligibility for LCS, thereby enhancing LCS utilization in real-world settings.

Materials And Methods: The study cohort included 5,778 individuals who underwent LDCT for LCS from 2012 to 2022, as recorded in the University of Florida Health Integrated Data Repository.

Local Inflammation Precedes Diaphragm Wasting and Fibrotic Remodelling in a Mouse Model of Pancreatic Cancer.

Background: Cancer cachexia represents a debilitating muscle wasting condition that is highly prevalent in gastrointestinal cancers, including pancreatic ductal adenocarcinoma (PDAC). Cachexia is estimated to contribute to ~30% of cancer-related deaths, with deterioration of respiratory muscles suspected to be a key contributor to cachexia-associated morbidity and mortality. In recent studies, we identified fibrotic remodelling of respiratory accessory muscles as a key feature of human PDAC cachexia.

Transdisciplinary perspectives for health systems science.

Health systems science uses systems thinking as part of a transdisciplinary approach that transcends traditional disciplinary boundaries. It integrates and synthesizes knowledge from multiple disciplines to address real-world problems in healthcare with pragmatic solutions. This editorial defines health systems from the perspectives of systems thinking, science, and engineering, discusses their current challenges and opportunities, and envisions how health systems science as a field can advance the continuous learning and improvement of health systems.

Reversible light-responsive protein hydrogel for on-demand cell encapsulation and release.

The design of biomaterials that can reconfigure on-demand in response to external stimuli is an emerging area in materials research. However, achieving reversible assembly of protein-based biomaterials by light input remains a major challenge. Here, we present the engineering of a new protein material that is capable of switching between liquid and solid state reversibly, controlled by lights of different wavelengths.

Nivolumab combination therapies in patients with advanced gastric and gastroesophageal junction cancer: the phase II FRACTION gastric cancer study.

Background: Nivolumab-based therapies are efficacious with acceptable safety in patients with gastric cancer (GC) and gastroesophageal junction cancer (GEJC). Novel nivolumab-based combination immunotherapies may offer enhanced efficacy in these indications. FRACTION-GC was a signal-seeking, randomized, open-label, phase II adaptive-design trial assessing efficacy and safety of nivolumab in combination with ipilimumab [cytotoxic T lymphocyte antigen-4 (CTLA-4) antibody], relatlimab (lymphocyte-activation gene 3 antibody), or IDO1i (BMS986205, an indoleamine-2,3-dioxygenase-1 inhibitor) in patients with unresectable, advanced/metastatic GC/GEJC.

New device, old algorithm? Bridging generations in perioperative coagulation management.

Viscoelastic testing permits targeted correction of coagulopathy in bleeding patients. As new generations of viscoelastic testing platforms become available, research exploring similarities and differences with older devices can provide insight for institutions seeking to use the newer technologies. Care must be taken to ensure such studies are designed to produce clinically meaningful guidance for adapting existing treatment algorithms to accommodate the latest viscoelastic testing technology.

Quality Analysis of Online Resources for Patients Undergoing Coronary Artery Bypass Grafting.

Background: Online resources are becoming the primary educational resource for patients. Quality and reliability of websites about coronary artery bypass graft (CABG) procedures are unknown.

Methods: We queried 4 search engines (Google, Bing, Yahoo!, and Dogpile) for the terms , , , and .

Impella 5.5 Use in the Setting of Severe Aortic Insufficiency: A Relative Contraindication.

Moderate or severe aortic insufficiency is a contraindication to transvalvular Impella left ventricular assist device (Abiomed) use out of concern for worsening valvular insufficiency and recirculation. This report describes the case of a 75-year-old man with severe eccentric aortic insufficiency and systemic hypoperfusion who was supported with a transvalvular Impella 5.5 device for 6 days as preoperative rehabilitation before aortic valve replacement.

Five-year comparison of clinical and echocardiographic outcomes of pure aortic stenosis with pure aortic regurgitation or mixed aortic valve disease in the COMMENCE trial.

Objective: To compare outcomes of aortic valve replacement (AVR) in patients with pure aortic stenosis (Pure AS) and those with pure aortic regurgitation (Pure AR) or mixed AS and AR (MAVD) in the COMMENCE trial.

Methods: Of 689 patients who underwent AVR in the COMMENCE trial, patients with moderate or severe AR with or without AS (Pure AR + MAVD; n = 135) or Pure AS (n = 323) were included. Inverse probability of treatment weighting Kaplan-Meier survival curves were used for time-to-event endpoints, and longitudinal changes in hemodynamics were evaluated using mixed-effects models.

Cannabis use before and after metabolic and bariatric surgery: literature review.

As accessibility and legalization of cannabis rise throughout the United States (US), programs have sought guidance about whether its use should be considered a contraindication or, if not a contraindication, what recommendations patients should receive regarding appropriate use before and after metabolic and bariatric surgery (MBS). In this review, medical, nutritional, pharmacological, and psychological considerations are presented by a multidisciplinary group of members of the American Society for Metabolic and Bariatric Surgery (ASMBS). Research suggests several risks associated with long-term cannabis use in the general population, but research in the MBS population, specifically, is limited.

The effect of antibiotic prophylaxis duration on infection rates and outcomes after head and neck reconstruction with bony free flaps and hardware.

Background: Although the literature supports a shorter course of 24 h of prophylaxis after head and neck free flap reconstruction, studies supporting this duration do not differentiate between flap types. There is a paucity of evidence on the optimal duration of prophylaxis for osteocutaneous free flaps with hardware, which may have higher rates of post-operative complications compared to other free flaps. This study aimed to examine the effect of different lengths of antibiotic prophylaxis on surgical site infection (SSI) rates after head and neck reconstruction with osteocutaneous free flaps and hardware.

Disparities in Utilization of Immune Checkpoint Inhibitor Therapy Among Older Patients With Advanced Non-Small Cell Lung Cancer: A SEER-Medicare Analysis.

Purpose: In the United States, there are disparities in access to care for patients with non-small cell lung cancer (NSCLC) on the basis of socioeconomic and racial/ethnic factors. This study investigates the association between race/ethnicity and the utilization of immune checkpoint inhibitor (ICI) therapy among older patients with advanced NSCLC (aNSCLC).

Methods: This retrospective study used data from the SEER-Medicare-linked database.

Impact of prescribing vancomycin capsules vs liquid at discharge on readmissions for C. difficile infection.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

E-cigarettes and arterial health: A review of the link between vaping and atherosclerosis progression.

Recent studies have suggested an evolving understanding of the association between vaping, specifically electronic cigarette (e-cigarette) use, and the progression of atherosclerosis, a significant contributor to cardiovascular disease. Despite the prevailing perception of vaping as a safer alternative to traditional tobacco smoking, accumulating evidence suggests that the aerosols emitted by e-cigarettes contain harmful constituents that may promote endothelial dysfunction, oxidative stress, inflammation, and dyslipidemia-key mechanisms implicated in atherosclerosis pathogenesis. While past research, including experimental studies and clinical investigations, has shed light on the potential cardiovascular risks associated with vaping, gaps in knowledge persist.

Optimal site for applying transcutaneous bilirubinometer as an outpatient screening tool for neonatal jaundice: a comparison between the sternum and forehead.

Background: The gold standard for assessing neonatal jaundice (NJ) is the serum total serum bilirubin (TSB) level by the diazo method. A transcutaneous bilirubinometer (TCB) provides a convenient, noninvasive readout within minutes. The reliability of TCB as the diagnostic tool and the proper site for TCB measurement remains unsettled.

Association between microvascular free-flap arterial anastomosis caliber and risk for development of osteoradionecrosis.

Objectives: Osteoradionecrosis (ORN) following radiation therapy (RT) is a serious complication for patients undergoing head and neck cancer treatment. Recent literature has found an association between ipsilateral external carotid artery (ECA) diameter and the development of ORN. This study evaluates microvascular free-flap arterial anastomosis diameter and the development of ORN.

A liberalized diet does not improve caloric intake during neutropenia in patients undergoing hematopoietic stem cell transplants: A prospective randomized controlled trial.

Background: The neutropenic diet has been a long-standing approach to preventing infection in patients with hematopoietic stem cell transplants (HSCTs), although data on its efficacy are inconclusive and its restrictive nature might contribute to harm by reducing dietary intake in this patient population who typically experiences poor oral intake. The aim was to determine if a liberalized diet (LD), in comparison with a neutropenic hospital diet (ND), would improve energy intake and lessen weight loss during neutropenia in patients with HSCTs.

Methods: A randomized controlled trial was conducted in a single-center HSCT/hematologic malignancy unit.

"Martin Mattress": Surgical Technique for Achieving Hemostasis in Redo Aortic Root Operations.

A 71-year-old gentleman with prior bioprosthetic aortic valve replacement was admitted with aortic valve dehiscence and an aortic root abscess. He underwent reoperative sternotomy, aortic root, mitral valve, and hemiarch replacement. To augment hemostasis, we implanted the "Martin Mattress"-a pericardial patch sutured to the fibrous ridge within the innominate vein, superior vena cava, right atrium, right ventricular outflow tract, and pulmonary artery-which is preferred to modified Cabrol fistula techniques in infectious root pathology.

Effectiveness of ceftazidime-avibactam versus ceftolozane-tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study.

Background: Ceftolozane-tazobactam and ceftazidime-avibactam are preferred treatment options for multidrug-resistant Pseudomonas aeruginosa infections; however, real-world comparative effectiveness studies are scarce. Pharmacokinetic and pharmacodynamic differences between the agents might affect clinical response rates. We aimed to compare the effectiveness of ceftolozane-tazobactam and ceftazidime-avibactam for treatment of invasive multidrug-resistant P aeruginosa infections.

Efficacy and Safety of Denileukin Diftitox-Cxdl, an Improved Purity Formulation of Denileukin Diftitox, in Patients With Relapsed or Refractory Cutaneous T-Cell Lymphoma.

Purpose: Denileukin diftitox (DD)-cxdl is a fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2. This phase III, multicenter, open-label, single-arm registrational trial evaluated the efficacy and safety of DD-cxdl in patients with relapsed/refractory (R/R) cutaneous T-cell lymphoma (CTCL).

Patients And Methods: In the main study, which followed a dose-finding lead-in, DD-cxdl was administered intravenously daily (5 days; 9 µg/kg/d once daily) every 21 days for up to eight cycles.

Efficient Enzymatic Glycan Engineering of Extracellular Vesicles Using Nanomaterial-Interfaced Microfluidics.

Extracellular vesicles (EVs) present a promising modality for numerous biological and medical applications, including therapeutics. Developing facile methods to engineer EVs is essential to meeting the rapidly expanding demand for various functionalized EVs in these applications. Herein, we developed a technology that integrates enzymatic glycoengineering and microfluidics for effective EV functionalization.

A pilot study of a gratitude journaling intervention to enhance spiritual well-being and exercise self-efficacy in Black breast cancer survivors.

Background: Breast cancer (BC) survivorship presents significant health disparities, particularly affecting Black women, who experience a 40% higher BC death rate compared to White women. These disparities are exacerbated by comorbidities, which contribute to poorer overall health outcomes. Additionally, Black BC survivors often face psychosocial challenges, including increased stress and lower well-being, which can lead to adverse physical health effects.

Peripheral immune cell response to stimulation stratifies Parkinson's disease progression from prodromal to clinical stages.

The motor stage of idiopathic Parkinson's disease (iPD) can be preceded for years by a prodromal stage characterized by non-motor symptoms like REM sleep behavior disorder (RBD). Here, we show that multiple stages of iPD, including the pre-motor prodromal stage, can be stratified according to the inflammatory and immunometabolic responses to stimulation of peripheral blood mononuclear cells . We identified increased stimulation-dependent secretion of TNF, IL-1β, and IL-8 in monocytes from RBD patients and showed diminished proinflammatory cytokine secretion in monocytes and T cells in early and moderate stages of PD.