An Access-Focused Patient-Centric Value Assessment Framework for Medication Formulary Decision-Making in Immune-Mediated Inflammatory Diseases.

The healthcare system in the United States (US) is complex and often fragmented across national and regional health plans which exhibit substantial variability in benefit design and formulary policies for accessing medications. We propose an access-focused value assessment framework for formulary decision-making for medications to manage immune-mediated inflammatory diseases (IMIDs), where patients are at the center of this framework. Formulary decision-making for IMID medications can be a challenging, even daunting, task with continuously evolving and enhanced treat-to-target goals.

Inadequate Intensification of LDL-cholesterol lowering therapy after coronary revascularization: Insights from the GOULD registry.

Background: Patients with a history of coronary revascularization are at a higher risk for subsequent cardiovascular events and all-cause mortality. Lowering LDL-cholesterol (LDL-C) levels post-revascularization significantly reduces these risks.

Methods: This analysis compared LDL-C-lowering therapies at baseline and over time among patients with and without prior coronary revascularization in the GOULD registry (a prospective multicenter cohort study).

Pulmonary Embolism Education: Role of Generative Artificial Intelligence Models.

The growing use of generative artificial intelligence (AI) in the public sphere allows for a greater degree of disseminating information worldwide. For patients, there is a growing body of literature exploring how the generative artificial intelligence models can be used in improving the health literacy of patients, especially in cases of acute pulmonary embolism, where patients require deep, concise understanding of there disease and management. This study measured the readability of the generative responses created by publicly available AI models, and found that ChatGPT, Google Gemini, and Microsoft CoPilot do not currently meet the United States readability recommendations.

Prostaglandin E1 administration post liver transplantation and renal outcomes: A retrospective single center experience.

Background: Prostaglandin E1 (PGE1), or alprostadil, is a potent vasodilator that improves hepatic blood flow and reduces ischemia-reperfusion injury post-liver transplantation (LT). However, the benefits of PGE1 on renal function after LT have not yet been well described.

Aim: To assess the impact of PGE1 administration on renal function in patients who underwent liver or liver-kidney transplant.

Influenza knowledge and barriers to vaccination in immunosuppressed patients in the pediatric rheumatology clinic.

Background: Most patients with a pediatric rheumatic disease are at increased risk of influenza due to immunosuppressive medication use. Despite initial quality improvement efforts, our influenza vaccination rate plateaued at 72%, which prompted a survey of patients and families to assess provider vaccine recommendations, influenza knowledge, and barriers to influenza vaccination.

Methods: Patients on immunosuppressive medication or their parent were eligible to complete a survey between July 2019 and January 2020.

Leveraging artificial intelligence and machine learning to accelerate discovery of disease-modifying therapies in type 1 diabetes.

Progress in developing therapies for the maintenance of endogenous insulin secretion in, or the prevention of, type 1 diabetes has been hindered by limited animal models, the length and cost of clinical trials, difficulties in identifying individuals who will progress faster to a clinical diagnosis of type 1 diabetes, and heterogeneous clinical responses in intervention trials. Classic placebo-controlled intervention trials often include monotherapies, broad participant populations and extended follow-up periods focused on clinical endpoints. While this approach remains the 'gold standard' of clinical research, efforts are underway to implement new approaches harnessing the power of artificial intelligence and machine learning to accelerate drug discovery and efficacy testing.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Antiviral Use Among Children Hospitalized With Laboratory-Confirmed Influenza Illness: A Prospective, Multicenter Surveillance Study.

Background: Guidelines state that all hospitalized children with suspected or confirmed influenza receive prompt treatment with influenza-specific antivirals. We sought to determine the frequency of, and factors associated with, antiviral receipt among hospitalized children.

Methods: We conducted active surveillance of children presenting with fever or respiratory symptoms from 1 December 2016 to 31 March 2020 at 7 pediatric medical centers in the New Vaccine Surveillance Network.

Multielectrode Radiofrequency Balloon Catheter for Paroxysmal Atrial Fibrillation: Results From the Global, Multicenter, STELLAR Study.

Introduction: The safety and efficacy of paroxysmal atrial fibrillation (PAF) ablation with the HELIOSTAR multielectrode radiofrequency (RF) balloon catheter have been demonstrated in European studies; data from elsewhere are lacking. This prospective, multicenter study conducted in the United States, Italy, and China investigated the safety and efficacy of pulmonary vein isolation (PVI) using HELIOSTAR in drug-refractory symptomatic PAF.

Methods: The primary effectiveness endpoint (PEE) was 12-month freedom from documented atrial fibrillation/atrial flutter/atrial tachycardia plus freedom from acute procedural failure, nonstudy catheter failure, repeat ablation failure, direct current cardioversion (DCCV), and Class I/III antiarrhythmic drug (AAD) failure.

Exploring Multivalency in the Development of Anti-PD-L1 Peptides for Cancer Immunotherapy.

Purpose: The PD-1/PD-L1 pathway is one of the most effective immune checkpoint pathways utilized for cancer immunotherapy. Despite the success of anti-PD-1/PD-L1 mAbs, there is growing interest in developing low molecular weight anti-PD-1/PD-1 agents, such as peptides, because of their improved tumor penetration. We recently developed a small anti-PD-L1 peptide and demonstrated its promising anti-tumor activity.

Utilization and outcomes of serial cervical cancer screening in a National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in a non-Medicaid expansion state.

Purpose: Since 1990, the Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has offered free cervical cancer screening to low-income, uninsured patients, increasing single time point screening and early detection rates. Little is known about NBCCEDP's longitudinal effectiveness. The objective of this study was to assess utilization of Kansas's NBCCEDP, early detection works (EDW) for one-time versus serial screening and compare rates of cervical dysplasia between groups.

Smartphone Technology for Applications in Image-Guided Minimally Invasive Interventional Procedures.

Smartphones contain powerful and enabling technology components that can be re-applied toward procedural tasks commonly used in everyday clinical image-guided therapies and minimally invasive procedures that use three-dimensional information and feedback during procedures. Smartphone applications are a relatively young field of research that have potential in interventional radiology (IR) toward improvement of accuracy and standardization for needle-based procedures like biopsy and ablation. This review explores the adaptation of smartphones' built-in sensors for virtual and augmented reality uses in IR.

Magnetic resonance imaging-based biomarkers of multiple sclerosis and neuromyelitis optica spectrum disorder: a systematic review and meta-analysis.

Background/objective: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are neuroinflammatory conditions with overlapping clinical and imaging features. Distinguishing between these diseases is crucial for appropriate diagnosis and management. Magnetic resonance imaging (MRI) may have the potential to differentiate these disorders.

Temporal Trends in Mortality Related to Stroke and Atrial Fibrillation in the United States: A 21-Year Retrospective Analysis of CDC-WONDER Database.

Aims: Atrial Fibrillation (AF) is one of the most strongly associated risk factors for stroke. Our study aims to analyze changes in mortality from 1999 to 2020 in patients with AF and stroke.

Methods: Using the Centre for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER), we retrospectively analyzed annual age-adjusted mortality rates (AAMR) per million from 1999 to 2020 in stroke patients with AF.

The Role of Pulmonary Metastasectomy for Non-Primary Lung Cancer: Umbrella Review of Meta-Analyses.

Background And Objectives: Due to heterogeneous characteristics of primary cancers, the efficacy of pulmonary metastasectomy (PM) in nonprimary lung cancers has not been investigated. This study aims to investigate the clinical outcomes of PM for non-primary lung cancer.

Methods: A systematic search for meta-analyses on PM for nonprimary lung cancers was conducted, encompassing publications up to January 3, 2024.

Smartphone pupillometry with machine learning differentiates ischemic from hemorrhagic stroke: A pilot study.

Objectives: Similarities between acute ischemic and hemorrhagic stroke make diagnosis and triage challenging. We studied a smartphone-based quantitative pupillometer for differentiation of acute ischemic and hemorrhagic stroke.

Materials And Methods: Stroke patients were recruited prior to surgical or interventional treatment.

Rates, Risk Factors, and Outcomes of Nonvariceal Upper Gastrointestinal Bleeding in Patients Hospitalized for COVID-19 in the United States.

Objective: This study aimed to investigate the incidence and predictors of non-variceal upper gastrointestinal bleeding (NVUGIB) in hospitalized patients with coronavirus disease 2019 (COVID-19), as well as the inpatient outcomes associated with this complication.

Methods: This was an analysis of the National Inpatient Sample Database from January to December 2020. Adult COVID-19 patients were categorized into two groups based on NVUGIB development during hospitalization.

Reporting of Participant Race and Ethnicity from COVID-19 Randomized Controlled Drug and Biologicals Trials: A Scoping Review.

Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials according to study-level characteristics of randomized controlled trials (RCT) that test effectiveness of COVID-19 drugs could be insightful for future researchers. The objective of this scoping review was to describe frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics.

Analysis and Imaging of Osteocytes.

Osteocytes are the bone cells that are thought to respond to mechanical strains and fluid flow shear stress (FFSS) by activating various biological pathways in a process known as mechanotransduction. Confocal image-derived models of osteocyte networks are a valuable tool for conducting Computational Fluid Dynamics (CFD) analysis to evaluate shear stresses on the osteocyte membrane, which cannot be determined by direct measurement. Computational modeling using these high-resolution images of the microstructural architecture of bone was used to numerically simulate the mechanical loading exerted on bone and understand the load-induced stimulation of osteocytes.

GLP-1 Receptor Agonist in Non-obese Patients with Type-2 Diabetes Mellitus and Heart Failure with Preserved Ejection Fraction.

Background: Glucagon like peptide-1 receptor agonists (GLP-1RA) promote weight loss and improve heart failure-related symptoms, quality of life, and functional capacity in patients with obesity and heart failure with preserved ejection fraction (HFpEF). However, their clinical effectiveness in non-obese patients with diabetes and HFpEF is understudied.

Methods: The TriNetX research network was used to identify adult patients (≥18 years) with type 2 diabetes mellitus (T2DM), Heart failure with preserved ejection fraction ((Left ventricular ejection fraction ≥45%), elevated brain natriuretic peptide (≥150pg/mL) or N-terminal pro-B-type natriuretic peptide(≥450pg/mL) and a body mass index (BMI) <30 kg/m2 on or before August 31, 2022.