Trastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: A systematic review and updated meta-analysis.

Background: Trastuzumab deruxtecan (T-DXd) has shown promising activity in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and central nervous system (CNS) involvement. In this updated meta-analysis, we explore the effectiveness of T-DXd in a large subset of patients with HER2-positive BC and CNS disease.

Methods: A systematic search was made on September 16th, 2024, for studies investigating T-DXd in the scenario of HER2-positive BC and brain metastases (BMs) and/or leptomeningeal disease (LMD).

Intra-Arterial Tenecteplase Following Endovascular Reperfusion for Large Vessel Occlusion Acute Ischemic Stroke: The POST-TNK Randomized Clinical Trial.

Importance: The impact of adjunctive intra-arterial tenecteplase administration following near-complete to complete reperfusion by endovascular thrombectomy (EVT) for acute ischemic stroke is unknown.

Objective: To assess the efficacy and adverse events of adjunctive intra-arterial tenecteplase in patients with large vessel occlusion stroke who had achieved near-complete to complete reperfusion (defined as a score on the expanded Thrombolysis in Cerebral Infarction [eTICI] scale of 2c to 3) after EVT.

Design, Setting, And Participants: Investigator-initiated, randomized, open-label, blinded outcome assessment trial implemented at 34 hospitals in China among 540 patients with stroke due to proximal intracranial large vessel occlusion within 24 hours of the time they were last known to be well, with an eTICI score of 2c to 3 after EVT, and without prior intravenous thrombolysis.

Intra-Arterial Urokinase After Endovascular Reperfusion for Acute Ischemic Stroke: The POST-UK Randomized Clinical Trial.

Importance: Persisting or new thrombi in the distal arteries and the microcirculation have been reported to limit the benefits of successful endovascular thrombectomy for patients with acute ischemic stroke. It remains uncertain whether intra-arterial thrombolysis by urokinase following near-complete to complete reperfusion by thrombectomy improves outcomes among patients with ischemic stroke due to large vessel occlusion.

Objective: To assess the efficacy and adverse events of intra-arterial urokinase after near-complete to complete reperfusion by thrombectomy for acute ischemic stroke due to large vessel occlusion.

Technology in the Trenches: The Impact of evolving technologies on Combat Mental Health.

Purpose Of Review: Medicine and specifically mental health have been affected by emerging technologies advancing mental health treatment while at the same time bringing new challenges and stressors to the battlefield, military systems, and the warfighter.

Recent Findings: This article reviews the evolving positive and negative impacts of technology on combat mental health and treatment. A history of technology and military mental health concerns and services is followed by an overview of present benefits and risks.

Change in sleep, gastrointestinal symptoms, and mood states at high altitude (4500m) for 6 months.

Purpose: This study aimed to investigate the alterations in sleep quality and sleep patterns among military personnel at altitudes ranging from 1500 to 4500 m, as well as the associated factors influencing their sleep.

Methods: This study employed a longitudinal prospective survey conducted over a period of six months, from November 2023 to June 2024. A total of 90 soldiers were recruited for participation.

Neoplastic premalignant pancreatobiliary lesions: current update on the spectrum of lesions and their imaging appearances.

Common pancreatobiliary epithelial malignancies such as pancreatic ductal adenocarcinoma, cholangiocarcinoma and gallbladder carcinoma have poor prognosis. A small but significant portion of these malignancies arise from mass-forming grossly and radiologically visible premalignant epithelial neoplasms in the pancreatobiliary tree. Several lesions, including a few recently described entities, fall under this category and predominantly include papillary epithelial lesions with or without mucin production.

Controlled Nitrogen Release by Hydroxyapatite Nanomaterials in Leaves Enhances Plant Growth and Nitrogen Uptake.

Nitrogen fertilizer delivery inefficiencies limit crop productivity and contribute to environmental pollution. Herein, we developed Zn- and Fe-doped hydroxyapatite nanomaterials (ZnHAU, FeHAU) loaded with urea (∼26% N) through hydrogen bonding and metal-ligand interactions. The nanomaterials attach to the leaf epidermal cuticle and localize in the apoplast of leaf epidermal cells, triggering a slow N release at acidic conditions (pH 5.

Electrocardiogram-based machine learning for risk stratification of patients with suspected acute coronary syndrome.

Background And Aims: The importance of risk stratification in patients with chest pain extends beyond diagnosis and immediate treatment. This study sought to evaluate the prognostic value of electrocardiogram feature-based machine learning models to risk-stratify all-cause mortality in those with chest pain.

Methods: This was a prospective observational cohort study of consecutive, non-traumatic patients with chest pain.

Quantitative susceptibility mapping of iron deposition in sporadic cerebral cavernous malformation-related epilepsy.

Objective: To evaluate iron deposition patterns in patients with cerebral cavernous malformation-related epilepsy (CRE) using quantitative susceptibility mapping (QSM) for detailed analysis of iron distribution associated with a history of epilepsy and severity.

Methods: This study is part of the Quantitative Susceptibility Biomarker and Brain Structural Property for Cerebral Cavernous Malformation Related Epilepsy (CRESS) cohort, a prospective multicenter study. QSM was used to quantify iron deposition in patients with sporadic cerebral cavernous malformation (CCMs).

Severity of Impaired Oxygenation and Conservative Oxygenation Targets in Mechanically Ventilated Children: A Post Hoc Subgroup Analysis of the Oxy-PICU Trial of Conservative Oxygenation.

Objectives: A conservative oxygenation strategy is recommended in adult and pediatric guidelines for the management of acute respiratory distress syndrome to reduce iatrogenic lung damage. In the recently reported Oxy-PICU trial, targeting peripheral oxygen saturations (Spo2) between 88% and 92% was associated with a shorter duration of organ support and greater survival, compared with Spo2 greater than 94%, in mechanically ventilated children following unplanned admission to PICU. We investigated whether this benefit was greater in those who had severely impaired oxygenation at randomization.

Enhancing Hemocompatibility in ECMO Systems With a Fibrinolytic Interactive Coating: in Vitro Evaluation of Blood Clot Lysis Using a 3D Microfluidic Model.

Blood-contacting medical devices, especially extracorporeal membrane oxygenators (ECMOs), are highly susceptible to surface-induced coagulation because of their extensive surface area. This can compromise device functionality and lead to life-threatening complications. High doses of anticoagulants, combined with anti-thrombogenic surface coatings, are typically employed to mitigate this risk, but such treatment can lead to hemorrhagic complications.

Wide field imaging biomarkers: A different perspective.

Wide field retinal imaging has emerged as a transformative technology over the last few decades, revolutionizing our ability to visualize the intricate landscape of the retina. By capturing expansive retinal areas, these techniques offer a panoramic view going beyond traditional imaging methods. In this review, we explore the significance of retinal imaging-based biomarkers to help diagnose ocular and systemic conditions.

Mimicking the Reactivity of LPMOs with a Mononuclear Cu Complex.

Lytic polysaccharide monooxygenases (LPMOs) are Cu-dependent metalloenzymes that catalyze the hydroxylation of strong C-H bonds in polysaccharides using O or HO as oxidants (monooxygenase/peroxygenase). In the absence of C-H substrate, LPMOs reduce O to HO (oxidase) and HO to HO (peroxidase) using proton/electron donors. This rich oxidative reactivity is promoted by a mononuclear Cu center in which some of the amino acid residues surrounding the metal might can accept and donate protons and/or electrons during O and HO reduction.

Axillary to Superior Mesenteric Artery Bypass as a Viable Solution for Chronic Mesenteric Ischemia.

Chronic mesenteric ischemia (CMI) is a progressive condition that primarily affects the elderly, causing chronic abdominal pain and malnutrition. Timely treatment is essential to prevent further deconditioning or bowel ischemia. Surgical repair options include both endovascular and open procedures.

Instagram Versus Reality: Who Are Actually Plastic Surgeons?

Background: Instagram has become one of the most powerful marketing tools available to plastic surgeons because patients have increasingly turned to online resources to find physicians. Within, we review the online presence of self-ascribed plastic surgeons in the United States to identify potential misinformation and dishonest advertising.

Methods: The Inflact database was queried for the search terms: "plastic surgeon/surgery," "plastic and reconstructive surgeon/surgery," "aesthetic surgeon/surgery," and "cosmetic surgeon/surgery.

Provider perspectives on caring for patients with limited English proficiency-a national survey of the Society of Gynecologic Oncology.

Background: In diversity, equity and inclusion research, overcoming barriers in language discordant patient care is one of the largest and most challenging gaps. It is well established that patients with limited English proficiency (LEP) have higher rates of misdiagnosis, medical errors, and serious adverse events, and recommended best practices for LEP patient care are often not followed.

Objective: Our team sought to elicit provider perspectives regarding the barriers they face in caring for LEP patients-especially the unique challenges faced when caring for patients with complex and sensitive diagnoses such as gynecologic cancer.