The Melody Valve in Small Children Undergoing First Mitral Valve Replacement: Better Than Mechanical?

Background: In small children with left atrioventricular valve dysfunction, valve repair is preferred but some will require valve replacement. No prosthetic valve has growth potential, bioprostheses have poor durability, and mechanical prostheses have high rates of thromboembolic and hemorrhagic complications. We reviewed our experience with a modified bovine jugular vein valve designed for use in the right ventricular outflow tract (Melody valve, Medtronic) and compared this with contemporary mechanical valve replacement.

Non-Caucasian Race/Ethnicity Predisposes to Unfavorable Stage and Grade at Upper Tract Urothelial Carcinoma Diagnosis.

Objective: To test whether race/ethnicity affects stage or grade distribution at upper tract urothelial carcinoma (UTUC) diagnosis.

Methods: Within the Surveillance, Epidemiology, and End Results (SEER) database 2004-2020, UTUC patients were identified. Multivariable logistic regression models tested for the association between race/ethnicity and stage as well as grade at diagnosis according to renal pelvis vs.

Impact of population screening for Lynch syndrome insights from the All of Us data.

Lynch Syndrome (LS) is a common genetic cancer condition that allows for personalized cancer prevention and early cancer detection in identified gene carriers. We used data from the All of Us (AOU) Research Initiative to assess the prevalence of LS in the general U.S.

Joint k-b space diffusion-weighted image reconstruction and apparent diffusion coefficient fitting for diffusion-weighted turbo-spin-echo imaging.

Background: Diffusion-weighted (DW) turbo-spin-echo (TSE) imaging offers improved geometric fidelity compared to single-shot echo-planar-imaging (EPI). However, it suffers from low signal-to-noise ratio (SNR) and prolonged acquisition times, thereby restricting its applications in diagnosis and MRI-guided radiotherapy (MRgRT).

Purpose: To develop a joint k-b space reconstruction algorithm for concurrent reconstruction of DW-TSE images and the apparent diffusion coefficient (ADC) map with enhanced image quality and more accurate quantitative measurements.

Dysregulation of Airway and Systemic Interferon Responses Promote Asthma Exacerbations in Urban Children.

Background: Determining why some upper respiratory illnesses provoke asthma exacerbations remains an unmet need.

Objective: To identify transcriptome-wide gene expression changes associated with colds that progress to exacerbation.

Methods: 208 urban children (6-17 years) with exacerbation-prone asthma were prospectively monitored for up to two cold illnesses.

Contour uncertainty assessment for MD-omitted daily adaptive online head and neck radiotherapy.

Background And Purpose: Daily online adaptive radiotherapy (DART) increases treatment accuracy by crafting daily customized plans that adjust to the patient's daily setup and anatomy. The routine application of DART is limited by its resource-intensive processes. This study proposes a novel DART strategy for head and neck squamous cell carcinoma (HNSCC), automizing the process by propagating physician-edited treatment contours for each fraction.

DNA damage and its links to neuronal aging and degeneration.

DNA damage is a major risk factor for the decline of neuronal functions with age and in neurodegenerative diseases. While how DNA damage causes neurodegeneration is still being investigated, innovations over the past decade have provided significant insights into this issue. Breakthroughs in next-generation sequencing methods have begun to reveal the characteristics of neuronal DNA damage hotspots and the causes of DNA damage.

Sleep Deprivation Elevates Resting and Exercise Blood Pressures and Augments Pressor Response at Exercise Onset.

Purpose: Sleep deprivation and elevated blood pressure (BP) increase the risk of cardiovascular diseases. However, the effects of sleep deprivation on BP response, especially at exercise onset remain unclear. We aimed to elucidate the effects of experimental sleep deprivation (ESD) on resting and exercise BPs, including that at exercise onset, and investigate whether a night-time nap during ESD changes the ESD-altered BP.

Endophenotype presentation of athletes with concussion contingent on sex and time since injury.

Introduction: Athletes with concussions experience heterogeneous symptoms and clinical trajectories. Subclassification provides diagnostic clarity that may improve prognostication and individualized treatments.

Methods: We hypothesized that endophenotypes of adolescent athletes with concussions differ based on sex and time since injury.

Atrial Fibrillation and Retinal Stroke.

Importance: Atrial fibrillation (AF) is the most common, chronic, cardiac arrythmia in older US adults. It is not known whether AF is independently associated with increased risk of retinal stroke (central retinal artery occlusion), a subtype of ischemic stroke that causes severely disabling visual loss in most cases and is a harbinger of further vascular events.

Objective: To determine whether there is an association between AF and retinal stroke.

Registry versus claims-based index dates for studies of cancer diagnosis in administrative data.

Purpose: Studies of healthcare encounters leading to cancer diagnosis have increased over recent years. While some studies examine healthcare utilization before the cancer registry date of diagnosis, relevant pre-diagnosis interactions are not always immediately prior to this date due to date abstraction guidelines. We evaluated agreement of a registry date with a claims-based index and examined Emergency Department (ED) involvement in cancer diagnosis as an example of possible pre-diagnostic healthcare misclassification that could arise from improper date choice.

Pain Coping Skills Training for Patients Receiving Hemodialysis: The HOPE Consortium Randomized Clinical Trial.

Importance: Chronic pain is common among individuals with dialysis-dependent kidney failure.

Objective: To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.

Design, Setting, And Participants: This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US.

Outcomes of Older Adults and Frail Patients Receiving Idecabtagene Vicleucel: A CIBMTR Study.

Idecabtagene vicleucel (ide-cel) is an anti-BCMA CAR-T cell therapy approved for patients with relapsed/refractory multiple myeloma (RRMM) after 2 prior lines of therapy. There is limited data on outcomes of CAR T in older adults and frail patients with RRMM. In this study, we utilized data from the Center for International Blood and Marrow Transplantation Registry to describe the safety and efficacy of ide-cel in these clinically important subgroups.

Non-selective b adrenergic receptor inhibitors impair hematopoietic regeneration in mice and humans after hematopoietic cell transplants.

Peripheral nerves promote mouse bone marrow regeneration by activating b2 and b3 adrenergic receptor signaling, raising the possibility that non-selective b blockers could inhibit engraftment after hematopoietic cell transplants (HCTs). We observed no effect of b blockers on steady-state mouse hematopoiesis. However, mice treated with a non-selective b blocker (carvedilol), but not a b1-selective inhibitor (metoprolol), exhibited impaired hematopoietic regeneration after syngeneic or allogeneic HCTs.

Randomized Controlled Trial to Compare AmnioExcel Human Amniotic Allograft in Weekly Versus Biweekly Treatment of Diabetic Foot Ulcers.

Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse.

Clinical Conundrum: Climbing at the Extremes of High Elevation with Nonischemic Cardiomyopathy.

Cornwell, William, Aaron L Baggish, Christoph Dehnert, Benjamin D Levine, and Andrew M Luks. Clinical Conundrum: Climbing at the Extremes of High Elevation with Nonischemic Cardiomyopathy. 00:00-00, 2024.

The comparative efficacy and safety of Tiger II versus judkins catheters in coronary angiogram via the radial artery access: a meta-analysis.

Background: Trans-radial coronary angiogram (TR-CAG) has gained popularity due to lower complication rates compared to transfemoral access. Operators can use either conventional catheters, such as Judkins, or single dedicated catheters, such as Tiger-II. This meta-analysis compared the safety and efficacy of Tiger-II versus Judkins catheters in TR-CAG.

Mortality of gastrointestinal cancers attributable to smoking, alcohol, and metabolic risk factors, and its association with socioeconomic development status 2000-2021: GI Cancer Mortality and Risk Factors.

Objective: Gastrointestinal (GI) cancers account for one-third of global cancer mortality, with nearly half being preventable. This study updates the global burden of GI cancers attributed to major risk factors: smoking, alcohol, and metabolic disturbances.

Methods: We utilized data from the Global Burden of Disease Study 2021 to examine trends in death and age-standardized death rates related to GI cancers caused by smoking, alcohol, high body mass index (BMI), and high fasting blood glucose (FBG) from 2000 to 2021.

Calcium-sensing receptor- and ADAM10-mediated klotho shedding is regulated by tetraspanin 5.

Soluble, circulating Klotho (sKlotho) is essential for normal health and renal function. sKlotho is shed from the renal distal convoluted tubule (DCT), its primary source, via enzymatic cleavage. However, the physiologic mechanisms that control sKlotho production, trafficking, and shedding are not fully defined.