A Multidisciplinary Approach to Diagnosing Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN): Practical Recommendations and Insights from Countries of the Gulf Cooperation Council.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive orphan hematopoietic malignancy characterized by cutaneous and systemic hematologic involvement. BPDCN is frequently misidentified, but early, accurate diagnosis is critical to extending patient survival using tagraxofusp, a first-in-class CD123-targeted therapy, and increasing their chances of receiving a potentially curative stem cell transplantation. Cases of BPDCN in countries of the Gulf Cooperation Council are lower than the extrapolated incidence from other geographic locations due to lack of awareness of key diagnostic features, lack of consensus on the minimal phenotype for diagnosis, and lack of local immunohistochemistry testing facilities, contributing to underdiagnosis in this region.

Evaluating Tumor Tissue Modified Viral (TTMV)-HPV DNA for the Early Detection of Anal Squamous Cell Carcinoma Recurrence.

Background: The incidence and mortality of anal squamous cell carcinoma (ASCC) are rising, with greater than 80% of cases linked to human papillomavirus (HPV), primarily HPV16. Post-treatment surveillance can be challenging due to the limitations of anoscopy, digital anal rectal exam (DARE), and imaging. Plasma tumor tissue modified viral (TTMV)-HPV DNA has shown strong sensitivity, specificity, and predictive value in detecting the recurrence of HPV-driven oropharyngeal cancer.

Exploring the Role of Communication Asset Mapping (CAM) as a Strategy to Promote Hereditary Cancer Risk Assessment Information Within African American Communities.

: African Americans (AAs) carry the largest burden for almost every type of cancer in the US and are also more likely to die from cancer. Approximately 10% of cancers can be explained by a hereditary factor and detected earlier. Many AAs, however, have inequitable access to hereditary cancer risk assessment (HCRA) tools and information, further exacerbating disparities in cancer rates.

"It Would Ruin My Life": Pacific Islander Male Adolescents' Perceptions of Mental Health Help-Seeking-An Interpretative Phenomenological Analysis Focus Group Study.

Given rising mental health concerns among Pacific Islander (PI) adolescents, this population remains underserved by available mental health resources. This interpretative phenomenological analysis with focus groups (IPA-FG) examined the lived experiences and perceptions of 19 male PI adolescents (ages 14-16) from Native Hawaiian, Maori, Samoan, and Tongan backgrounds regarding mental health help-seeking behaviors. Four overarching themes emerged: stigma and judgment, cultural misalignment in professional services, impact of disclosure and perceived punitive consequences, and a complex ecosystem of trusted relationships as mental health support.

Endoscopic Stenting of a Fully Covered Self-Expandable Metal Stent with a Hole in Each Cavity in Malignant Hilar Biliary Obstruction: A Preclinical Proof-of-Concept Study and Initial Human Experience.

Background And Aim: Stent placement for biliary drainage in patients with malignant hilar biliary obstruction (MHBO) has been a topic of long-standing debate, and the best approach remains controversial. Therefore, we aimed to evaluate the efficacy, safety, and removability of multi-hole fully covered self-expandable metal stents (MH-FCSEMSs) in a preclinical experiment using swine hilar bile duct obstruction (HBDO) models and to assess the feasibility and safety of stent placement in patients with MHBO.

Methods: Three minipigs underwent endoscopic retrograde cholangiopancreatography (ERCP)-guided endobiliary-radio frequency ablation (EB-RFA) to establish Bismuth type II hilar bile duct stenosis models.

A community-engaged qualitative study of factors affecting sleep among Hispanic/Latinos with short sleep duration.

Background: Despite having high prevalence of short sleep duration, poor sleep quality, and sleep disorders in adult Hispanics living in the US, there is limited understanding of the underlying barriers to sleep and effective interventions in these groups. This study aimed to increase understanding of sleep duration and attitudes toward sleep interventions among Hispanic adults.

Methods: We conducted 5 online focus group discussions with male and female participants aged 18-65 recruited from the Hispanic community who reported sleeping <7 hours per night.

Exploring the impact of insurance switching on the cost-effectiveness of population genetic screening for familial hypercholesterolemia to US payers.

Background: Widespread familial hypercholesterolemia screening requires a large upfront economic investment, but the health benefits and cost savings of cardiovascular disease prevention directed by screening occur over many years.

Objective: We evaluated the cost-effectiveness of population genetic screening for familial hypercholesterolemia compared to cascade testing to US payers while accounting for patient insurance switching between commercial and Medicare insurance.

Methods: We developed a hybrid decision-tree Markov model to assess genetic screening in 20-year-old adults over a lifetime horizon in which cohort members transitioned between commercial payers representing three commercial plans and Medicare.

Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR.

Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).

Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.

Clinical utility of the lymphocyte proliferation assay, an in vitro functional readout of the adaptive immune response.

Despite great advancements in the discovery of genetic variants underlying inborn errors of immunity, functional assessment of the immunological profile of patients in routine clinical practice remains challenging. The lymphocyte proliferation assay using H-thymidine incorporation has been the gold standard for decades for functional evaluation of T cells in the clinical laboratory, however, recently developed flow cytometric methods allowing for single cell analysis provide non-radioactive alternatives. Understanding the technical and analytical challenges of test development, validation and maintenance is essential for correct interpretation and test utilization, to assure appropriate and timely patient care.

Can I pickle Doc? Return to Pickleball and other Racket Sports after Total Joint Arthroplasty.

Background: Participation in pickleball and other racket sports is growing, particularly among older adults who may also be candidates for joint arthroplasty (JA). Currently, there is limited data on performance, safety, and return to racket sports after JA.

Methods: An online survey was sent to 7,200 patients who had undergone at least one primary JA at a single academic center over the past 10 years (five surgeons).

Drop Dynamics during Condensation on Superhydrophobic Surfaces in Vapor Shear Flow.

Accurate models for predicting drop dynamics, such as maximum drop departure sizes, are crucial for estimating heat transfer rates during condensation on superhydrophobic (SH) surfaces. Previous studies have focused on examining the heat transfer rates for SH surfaces under the influence of gravity or vapor flowing over the surface. This study investigates the impact of surface solid fraction and texture scale on drop mobility in a condensing environment with a humid air flow.

Virtual patients using large language models: Scalable, contextualized simulation of clinician-patient dialog with feedback.

Background: Virtual patients (VPs) are computer screen-based simulations of patient-clinician encounters. VP use is limited by cost and low scalability.

Objective: Show proof-of-concept that VPs powered by large language models (LLMs) generate authentic dialogs, accurate representations of patient preferences, and personalized feedback on clinical performance; and explore LLMs for rating dialog and feedback quality.

The measurement reliability and equivalence of print versus online versions of the Youth Activity Profile.

Purpose: The Youth Activity Profile (YAP) is a 7-day self-report designed to quantify physical activity and sedentary behaviors among youth. This study evaluated the reliability of the online version of the YAP and equivalence with the paper-based version.

Method: A total of 2,490 participants from 17 schools in Iowa and Texas completed the YAP.

Stand density and local climate drive allocation of GPP to aboveground woody biomass.

The partitioning of photosynthate among various forest carbon pools is a key process regulating long-term carbon sequestration, with allocation to aboveground woody biomass carbon (AGBC) in particular playing an outsized role in the global carbon cycle due to its slow residence time. However, directly estimating the fraction of gross primary productivity (GPP) that goes to AGBC has historically been difficult and time-consuming, leaving us with persistent uncertainties. We used an extensive dataset of tree-ring chronologies co-located at flux towers to assess the coupling between AGBC and GPP, calculate the fraction of fixed carbon that is allocated to AGBC, and understand the drivers of variability in this fraction.

Proximal remote sensing: an essential tool for bridging the gap between high-resolution ecosystem monitoring and global ecology.

A new proliferation of optical instruments that can be attached to towers over or within ecosystems, or 'proximal' remote sensing, enables a comprehensive characterization of terrestrial ecosystem structure, function, and fluxes of energy, water, and carbon. Proximal remote sensing can bridge the gap between individual plants, site-level eddy-covariance fluxes, and airborne and spaceborne remote sensing by providing continuous data at a high-spatiotemporal resolution. Here, we review recent advances in proximal remote sensing for improving our mechanistic understanding of plant and ecosystem processes, model development, and validation of current and upcoming satellite missions.

Influence of Preoperative Depression on Cervical Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.

Study Design: Systematic review and Meta-analysis.

Objectives: To quantify the association of preoperative depression on patient reported outcome measures (PROMS) after cervical spine surgery.

Methods: We systematically searched PubMed, Cochrane, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.

The efficiency of venturi versus peristaltic based phacoemulsification in femtosecond laser cataract surgery: Venturi vs peristaltic based phacoemulsification for cataract.

Purpose: To compare the efficiency of peristaltic vs venturi vacuum platforms when applied to the femtosecond treated cataract.

Setting: Outpatient Eye Center, Mercy Health System, Springfield, MO, USA.

Design: This is a prospective randomized controlled trial of 111 patients with moderate nuclear sclerosis scheduled for bilateral routine laser cataract surgery (clinicaltrials.

Species Differences in the Biotransformation of Aflatoxin B1: Primary Determinants of Relative Carcinogenic Potency in Different Animal Species.

It has been known since the early days of the discovery of aflatoxin B1 (AFB1) that there were large species differences in susceptibility to AFB1. It was also evident early on that AFB1 itself was not toxic but required bioactivation to a reactive form. Over the past 60 years there have been thousands of studies to delineate the role of ~10 specific biotransformation pathways of AFB1, both phase I (oxidation, reduction) and phase II (hydrolysis, conjugation, secondary oxidations, and reductions of phase I metabolites).

Electrocardiographic Assessment of National-Level Triathletes: Sinus Bradycardia and Other Electrocardiographic Abnormalities.

Background: High-intensity endurance training induces specific cardiac adaptations, often observed through electrocardiographic (ECG) changes. This study investigated the prevalence of ECG abnormalities in national-level Australian triathletes compared to sedentary controls.

Methods: A cross-sectional observational study was conducted involving 22 triathletes and 7 sedentary controls.

A Pilot Randomized Controlled Trial of a Single-Session Digital Acceptance and Commitment Therapy Intervention.

Adherence challenges are common among digital mental health interventions (DMHIs). Single-session DMHIs may help by providing a low-intensity intervention that takes less time to complete. This pilot randomized controlled trial sought to evaluate the acceptability and preliminary efficacy of a single-session DMHI based on acceptance and commitment therapy (ACT) in a non-clinical sample of college students.

Does Caregiver Engagement Predict Outcomes of Adolescent Wilderness Therapy?

Existing research shows some links between wilderness therapy outcomes and familial functioning. However, wilderness therapy programs do not agree on what kind of caregiver involvement is required to improve adolescent program outcomes, nor has research examined different types of family engagement and their impact on adolescent treatment outcomes. Thus, the present study explored the research question: Does caregiver engagement in adolescent wilderness therapy foster improved outcomes? The study sample consisted of 4067 adolescent wilderness therapy clients from 12 different wilderness therapy programs.

Long term outcomes associated with the use of perioperative systemic chemotherapy on low grade appendiceal mucinous neoplasms with pseudomyxoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Introduction: Low grade appendiceal mucinous neoplasms (LAMN) are indolent tumors that lack invasive potential but may present as pseudomyxoma peritonei. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) significantly improves both overall and recurrence free survival. While systemic chemotherapy is generally considered ineffective for LAMN, little literature is available to support this notion.

Voxel Volumes and Biomass: Estimating Vegetation Volume and Litter Accumulation of Exotic Annual Grasses Using Automated Ultra-High-Resolution SfM and Advanced Classification Techniques.

In much of the northern Great Basin of the western United States, rangelands, and semi-arid ecosystems invaded by exotic annual grasses such as cheatgrass () and medusahead () are experiencing an increasingly short fire cycle, which is compounding and persistent. Improving and expanding ground-based field methods for measuring the above-ground biomass (AGB) may enable more sample collections across a landscape and over succession regimes and better harmonize with other remote sensing techniques. Developments and increased adoption of unoccupied aerial systems (UAS) and instrumentation for vegetation monitoring enable greater understanding of vegetation in many ecosystems.