Tenecteplase for the Treatment of Pediatric Arterial Ischemic Stroke: A Safety Surveillance Report.

Objectives: Intravenous tenecteplase (TNK) is increasingly used to treat adult patients with acute arterial ischemic stroke, but the risk profile of TNK in childhood stroke is unknown. This study aims to prospectively gather safety data regarding TNK administration in children.

Methods: Since December 2023, a monthly email survey was sent to participants recruited from the International Pediatric Stroke Study and Pediatric Neurocritical Care Research Group querying recent experience with TNK in childhood stroke.

Mutations in chikungunya virus nsP4 decrease viral fitness and sensitivity to the broad-spectrum antiviral 4'-Fluorouridine.

Chikungunya virus (CHIKV) is an arthritogenic alphavirus that has re-emerged to cause large outbreaks of human infections worldwide. There are currently no approved antivirals for treatment of CHIKV infection. Recently, we reported that the ribonucleoside analog 4'-fluorouridine (4'-FlU) is a highly potent inhibitor of CHIKV replication, and targets the viral nsP4 RNA dependent RNA polymerase.

Rural Roads to cognitive Resilience (RRR): A prospective cohort study protocol.

Background: Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer's disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning.

Six-Month Outcomes in the Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children Study.

Importance: Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication of COVID-19 infection. Data on midterm outcomes are limited.

Objective: To characterize the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] <55%), coronary artery aneurysms (z score ≥2.

Safety and Efficacy of IV Onasemnogene Abeparvovec for Pediatric Patients With Spinal Muscular Atrophy: The Phase 3b SMART Study.

Background And Objectives: Safety and efficacy of IV onasemnogene abeparvovec has been demonstrated for patients with spinal muscular atrophy (SMA) weighing <8.5 kg. SMART was the first clinical trial to evaluate onasemnogene abeparvovec for participants weighing 8.

Role of Trained Immunity in Heath and Disease.

Purpose Of Review: This review aims to explore the role of immune memory and trained immunity, focusing on how innate immune cells like monocytes, macrophages, and natural killer cells undergo long-term epigenetic and metabolic rewiring. Specifically, it examines the mechanisms by which trained immunity, often triggered by infection or vaccination, could impact cardiac processes and contribute to both protective and pathological responses within the cardiovascular system.

Recent Findings: Recent research demonstrates that vaccination and infection not only activate immune responses in circulating monocytes and tissue macrophages but also affect immune progenitor cells within the bone marrow environment, conferring lasting protection against heterologous infections.

Incidence and Prevalence of Post-COVID-19 Myalgic Encephalomyelitis: A Report from the Observational RECOVER-Adult Study.

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may occur after infection. How often people develop ME/CFS after SARS-CoV-2 infection is unknown.

Objective: To determine the incidence and prevalence of post-COVID-19 ME/CFS among adults enrolled in the Researching COVID to Enhance Recovery (RECOVER-Adult) study.

Experience of The National Emergency Tele-Critical Care Network.

The COVID-19 pandemic exposed significant frailties of the U.S. healthcare system, especially inequities facing rural areas during surges when critical access and small community hospitals could not transfer patients to referral centers that were already overcapacity.

Are women really (not) more talkative than men? A registered report of binary gender similarities/differences in daily word use.

Women are widely assumed to be more talkative than men. Challenging this assumption, Mehl et al. (2007) provided empirical evidence that men and women do not differ significantly in their daily word use, speaking about 16,000 words per day (WPD) each.

Associations of personality trait level and change with mortality risk in 11 longitudinal studies.

People who are higher in conscientiousness, extraversion, and agreeableness and lower in neuroticism tend to live longer. The present research tested the hypothesis that personality trait change in middle and older adulthood would also be associated with mortality risk, above and beyond personality trait level. Personality trait change may causally influence mortality risk through corresponding changes in health behaviors, social processes, and stress experience.

Mental Health Consequences of Opioid Pain Medication Use Behaviors and Motives Among Adolescents and Young Adults With Cancer: Results From a National Survey.

Background: Adolescents and young adults (AYA) with cancer experience long-term consequences into survivorship that impact quality of life, including mental health symptoms, substance use, and persistent pain. Given the elevated rates of pain, AYA cancer survivors are at increased risk for opioid pain medication (OPM) exposure, increasing risk for opioid-related negative consequences, particularly for those with mental health symptoms. Minimal research has documented that a considerable proportion of AYAs with cancer receive OPM that continues into survivorship, yet the lack of consensus on the definition of problematic opioid use coupled with the high clinical need for OPM makes it particularly challenging to understand the impact of OPM use in this population.

Stress Management Program for Scanxiety in People With Advanced Lung Cancer: Intervention Adaptation and Stakeholder Feedback.

Background: Although scanxiety is common and impactful for people with advanced lung cancer, few interventions address this psychosocial concern.

Aims: To create a stress management program for scanxiety.

Methods: We conducted a structured intervention adaptation process guided by the ADAPT-ITT framework.

Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule.

Objective: The Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAI). Little is known about the risk for IAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAI when either one or two PECARN intraabdominal injury rule variables are positive.

A scoping review and synthesis of the literature on the relation between mobility impairment and cognitive impairment.

Purpose/objective: The present review examined the evidence for a potentially bidirectional association between mobility function and cognitive function in midlife and older adulthood.

Research Method/design: In 2023-2024, we conducted a scoping review by carrying out systematic searches on Google Scholar, PubMed, and PsycINFO for articles that included measures of mobility function and cognitive function.

Results: Of the 1,504 articles screened, 40 were included for review.

Treatment of focal anaplastic Wilms tumor: A report from the Children's Oncology Group AREN0321 and AREN03B2 studies.

Background: In the fifth National Wilms Tumor Study, patients received vincristine and dactinomycin (VA) without radiation for stage I focal anaplastic Wilms tumor (FAWT) and VA plus doxorubicin (DD4A) and radiation for stage II-IV FAWT. Four-year event-free survival (EFS) and overall survival (OS) for stage I FAWT were 67.5% and 88.

Association Between Positive Airway Pressure Therapy and Healthcare Costs Among Older Adults with Comorbid Obstructive Sleep Apnea and Common Chronic Conditions: An Actuarial Analysis.

Study Objectives: To determine the association between adherence to positive airway pressure and healthcare costs among a national sample of older adults with comorbid OSA and common chronic conditions.

Methods: Our data source was a random sample of Medicare administrative claims for years 2016-2019. Inclusion criteria included age >65 years and new diagnosis of OSA.

Disparities in Triple Negative Breast Cancer Among Hispanic Population Living in Latin America Versus the United States.

Introduction: Triple-negative breast cancer (TNBC) has a prevalence of 12%-24% in the Hispanic population. Previous research has demonstrated that disparities in healthcare access significantly influence patient outcomes. We aimed to compare the clinicopathological characteristics and outcomes of Hispanic females with TNBC living in Latin America (HPLA) to the Hispanic population in the United States (HPUS).

Transcranial Doppler Arterial Pressure Gradient Is Associated With Delayed Infarction After Subarachnoid Hemorrhage.

Background And Purpose: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.

Methods: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures.

Vascular Access for Home Hemodialysis: A Perspective on Tunneled Central Venous Catheters at Home.

Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access.

Recurrent negative autobiographical memories and mental health.

Background: Recurrent symptom-relevant negative autobiographical memories are common in patients with emotional disorders such as anxiety and depression, even among those without a trauma-related diagnosis. Recurrent negative autobiographical memories may also contribute to distress in non-clinical populations.

Methods: To examine the prevalence of recurrent negative autobiographical memories and associated psychological features, we recruited a student sample ( = 101) and a treatment-seeking sample of patients with emotional disorders ( = 123).

Management of Intraoperative Sickle Crisis During Kidney Transplant in a Patient With Sickle Cell Disease: A Case Report.

A 31-year-old male patient with a history of sickle cell disease (SCD) with stage V chronic kidney disease (CKD) presented for a deceased donor kidney transplant. During surgery, the transplanted kidney showed mottling and limited cortical flow, raising concerns for an intraoperative sickle cell crisis versus hyperacute rejection. Postoperative imaging revealed decreased vascularity, and the patient was treated with RBC exchange.

A simple phylogenetic approach to analyze hypermutated HIV proviruses reveals insights into their dynamics and persistence during antiretroviral therapy.

Hypermutated proviruses, which arise in a single Human Immunodeficiency Virus (HIV) replication cycle when host antiviral APOBEC3 proteins introduce extensive guanine to adenine mutations throughout the viral genome, persist in all people living with HIV receiving antiretroviral therapy (ART). However, hypermutated sequences are routinely excluded from phylogenetic trees because their extensive mutations complicate phylogenetic inference, and as a result, we know relatively little about their within-host evolutionary origins and dynamics. Using >1400 longitudinal single-genome-amplified HIV sequences isolated from six women over a median of 18 years of follow-up-including plasma HIV RNA sequences collected over a median of 9 years between seroconversion and ART initiation, and >500 proviruses isolated over a median of 9 years on ART-we evaluated three approaches for masking hypermutation in nucleotide alignments.

Developing a Research Center for Artificial Intelligence in Medicine.

Artificial intelligence (AI) and machine learning (ML) are driving innovation in biosciences and are already affecting key elements of medical scholarship and clinical care. Many schools of medicine are capitalizing on the promise of these new technologies by establishing academic units to catalyze and grow research and innovation in AI/ML. At Stanford University, we have developed a successful model for an AI/ML research center with support from academic leaders, clinical departments, extramural grants, and industry partners.

Impact of NAFLD-related SNPs on the carotid atherosclerosis development; a five-year prospective observational study.

Background And Aims: The prevalence of metabolic dysfunction associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), has become a significant public health concern with an increased atherosclerotic cardiovascular disease risk. This study investigates the impact of NAFLD-related single nucleotide polymorphisms (SNPs) on carotid atherosclerosis development in a Japanese population without diabetes, dyslipidemia, and hypertension.

Methods: The prospective observational study, part of the Kyushu and Okinawa Population Study (KOPS), included 945 participants (median age 55 [47, 63]) without carotid atherosclerosis, increased alcohol intake, diabetes, dyslipidemia, hypertension, or chronic hepatitis at baseline.

Brachial thromboembolectomy and retrograde innominate artery stenting in acute limb ischemia.

Acute limb ischemia is a critical vascular emergency often resulting from embolic sources, requiring prompt intervention to prevent significant morbidity and mortality. This paper presents a case of a 74-year-old female with acute limb ischemia due to a thromboembolus in the distal brachial artery and a nonocclusive mobile thrombus in the innominate artery. The patient underwent urgent brachial artery thromboembolectomy and subsequent retrograde innominate artery stenting via right open transcarotid approach.