Disparities in treatment delays among metastatic breast cancer patients: insights from nationwide electronic health records, 2011-2022.

Purpose: While previous research has highlighted treatment delay inequities in early-stage breast cancer and identified potential contributing factors, there is limited research on disparities in treatment delays for metastatic breast cancer (MBC). This study investigates these disparities in MBC treatment initiation, aiming to identify key factors crucial for improving timely access to care.

Method: Nationwide Flatiron Health electronic health records-derived deidentified database, including females aged 18+ diagnosed with either De novo or relapsed MBC in the U.

Superatoms as Superior Catalysts: ZrO versus Pd.

Single-atom catalysts are the focus of studies for over a decade due to their enhanced reactivity at smaller sizes. However, they have limitations as they offer only one active site, which may not be sufficient for reactions requiring the co-adsorption of multiple reactants. Additionally, atoms can migrate on a substrate and coalesce, resulting in decreased reactivity.

Early Patching Behaviors that Improve the Chances of Good Visual Acuity in Children Treated for Unilateral Congenital Cataract.

Objective: Achieving near normal vision following unilateral congenital cataract surgery is possible but requires early surgery, optical correction and consistent patching. Patching is often challenging for children and their caregivers. The goal of these analyses is to examine the association between reported consistency in patching during the first year after surgery and visual acuity.

Concordance and test-retest consistency of sleep biomarker-based neurodegenerative disorder profiling.

Biomarkers that aid in early detection of neurodegeneration are needed to enable early symptomatic treatment and enable identification of people who may benefit from neuroprotective interventions. Increasing evidence suggests that sleep biomarkers may be useful, given the bi-directional relationship between sleep and neurodegeneration and the prominence of sleep disturbances and altered sleep architectural characteristics in several neurodegenerative disorders. This study aimed to demonstrate that sleep can accurately characterize specific neurodegenerative disorders (NDD).

Macular patterns of neuronal and visual field loss in recovered optic neuritis identified by machine learning.

We used machine learning to investigate the residual visual field (VF) deficits and macula retinal ganglion cell (RGC) thickness loss patterns in recovered optic neuritis (ON). We applied archetypal analysis (AA) to 377 same-day pairings of 10-2 VF and optical coherence tomography (OCT) macula images from 93 ON eyes and 70 normal fellow eyes ≥ 90 days after acute ON. We correlated archetype (AT) weights (total weight = 100%) of VFs and total retinal thickness (TRT), inner retinal thickness (IRT), and macular ganglion cell-inner plexiform layer (GCIPL) thickness.

Evaluating Self-Directed Rehabilitation for Knee and Hip Arthroplasty During the COVID-19 Pandemic: A Multicenter Study.

The COVID-19 pandemic has triggered the adoption of new technologies to reduce the need for in-person physical therapy (PT). This study evaluated the impact of the COVID-19 pandemic on PT utilization and outcomes of patients prescribed a smartphone-based care management platform (sbCMP) for self-directed rehabilitation (SDR). A secondary analysis of data collected in a multicenter, prospective cohort trial investigating a mobile platform to deliver SDR after arthroplasty was performed.

Novel radiogenomics approach to predict and characterize pneumonitis in stage III NSCLC.

Unresectable stage III NSCLC is now treated with chemoradiation (CRT) followed by immune checkpoint inhibitors (ICI). Pneumonitis, a common CRT complication, has heightened risk with ICI, potentially causing severe outcomes. Currently, there are no biomarkers to predict pneumonitis risk or differentiate between radiation-induced pneumonitis (RTP) and ICI-induced pneumonitis (IIP).

Production of virus-like particles of FMDV by 3C protease cleaving precursor polyprotein P1 in vitro.

Nonstructural protein 3C, a master protease of Picornaviridae, plays a critical role in viral replication by directly cleaving the viral precursor polyprotein to form the viral capsid protein and antagonizing the host antiviral response. Additionally, 3C protease, as a tool enzyme, is involved in regulating polyprotein expression. Here, the 3C mutant gene (3Cm), fused with a small ubiquitin-like modifier (SUMO) tag at the N-terminal and featuring a mutation at position 127, was inserted into the cold-shock plasmid pCold of Escherichia coli for expression.

Targeted Ganglionated Plexi Ablation With Nanoformulated Calcium Suppresses Postoperative AF Via Vagosympatholytic and Anti-Inflammatory Effects.

Background: The mechanisms underlying postoperative atrial fibrillation (POAF) remain unclear.

Objectives: The aim of this study was to test the hypothesis that targeted chemical ganglionated plexi (GP) modulation of all major left atrial-pulmonary vein GP using novel nanoformulated calcium chloride (nCaCl) can reverse postoperative neuroelectrical remodeling by suppressing vagosympathetic nerve activity and the localized inflammatory process, both critical substrates of POAF.

Methods: In a novel canine model of POAF with serial thoracopericardiotomies, sympathetic nerve activity (SNA), vagal nerve activity (VNA) and GP nerve activity (GPNA) were recorded; spontaneous and in vivo AF vulnerability were assessed; and atrial and circulating inflammatory markers and norepinephrine (NE) were measured to determine the neuroelectrical remodeling that promotes POAF and its subsequent modulation with nCaCl GP treatment (n = 6) vs saline sham controls (n = 6).

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.

Genetic Diversity and Expanded Phenotypes in Dystonia: Insights from Large-Scale Exome Sequencing.

Dystonia is one of the most prevalent movement disorders, characterized by significant clinical and etiological heterogeneity. Despite considerable heritability (~25%) and the identification of several disease-linked genes, the etiology in most patients remains elusive. Moreover, understanding the correlations between clinical manifestation and genetic variants has become increasingly complex.

Association that Neuroimaging and Clinical Measures Have with Change in Arm Impairment in a Phase 3 Stroke Recovery Trial.

Objective: Vagus nerve stimulation (VNS) paired with rehabilitation therapy improved motor status compared to rehabilitation alone in the phase III VNS-REHAB stroke trial, but treatment response was variable and not associated with any clinical measures acquired at baseline, such as age or side of paresis. We hypothesized that neuroimaging measures would be associated with treatment-related gains, examining performance of regional injury measures versus global brain health measures in parallel with clinical measures.

Methods: Baseline magnetic resonance imaging (MRI) scans in the VNS-REHAB trial were used to derive regional injury measures (extent of injury to corticospinal tract, the primary regional measure; plus extent of injury to precentral gyrus and postcentral gyrus; lesion volume; and lesion topography) and global brain health measures (degree of white matter hyperintensities, the primary global brain measure; plus volumes of cerebrospinal fluid, cortical gray matter, white matter, each thalamus, and total brain).

Dilapan-S versus Standard Methods for Cervical Ripening in Term Pregnancies: An Individual Patient Data Meta-Analysis.

Objectives: Dilapan-S is a cervical ripening agent approved by the FDA that has been found to be just as effective as other agents and can be utilized for outpatient ripening. No large-scale studies have been conducted to compare cesarean delivery rates between Dilapan-S and other ripening methods. Our objective was to combine these trials to compare cesarean delivery rates for Dilapan-S with other cervical ripening methods, overall and in sub-groups.

Preserved force control by the digits via minimal sparing of cortico-spinal connectivity after stroke.

The ability to regulate finger forces is critical for manipulating objects during everyday tasks but is impaired after damage to white matter tracts that transmit motor commands into the spinal cord. This study examines cortico-spinal connectivity required for force control by the digits after neurological injury. We report on a unique case of a stroke survivor who retained the ability to control finger forces at a level comparable to neurologically intact adults despite extensive loss of white matter volume and severely compromised transmission from cortical motor areas onto the final common pathway.

Clinical Outcomes of Therapeutic Interventions for Autoimmune Retinopathy: A Meta-analysis and Systematic Review.

Topic: Autoimmune retinopathy (AIR) is a group of rare inflammatory diseases treated with immunosuppression; however, there is no treatment consensus. This meta-analysis and review aims to investigate treatment effectiveness in slowing AIR progression.

Clinical Relevance: Autoimmune retinopathy is a group of diseases characterized by progressive vision loss that is both difficult to diagnose and treat.

Effect of Rurality on Type of Clinicians Delivering Psychotherapy and Prescribing Antidepressants to Veterans.

Objective: Mental health care is delivered by teams that include social workers, psychologists, nonphysician prescribing clinicians (NPPCs), and physicians. The objective of this study was to determine whether patient rurality has an effect on the types of U.S.

Geographic Variation in Prosthesis Prescription Disparities Between White and Black Veterans After Major Lower Limb Amputation: A Retrospective Cohort Analysis.

Objective: To examine racial disparities in lower limb prosthesis (LLP) prescription practices between White and Black veterans across different geographic levels within the United States Veterans Health Administration (VHA) and explore how racial disparities in LLP prescription practices differ by amputation level.

Design: Retrospective cohort study.

Setting: VHA facilities across the United States.

Networks extracted from nonlinear fMRI connectivity exhibit unique spatial variation and enhanced sensitivity to differences between individuals with schizophrenia and controls.

Schizophrenia is a chronic brain disorder associated with widespread alterations in functional brain connectivity. Although data-driven approaches such as independent component analysis are often used to study how schizophrenia impacts linearly connected networks, alterations within the underlying nonlinear functional connectivity structure remain largely unknown. Here we report the analysis of networks from explicitly nonlinear functional magnetic resonance imaging connectivity in a case-control dataset.

Scalable policy adoption and sustainable implementation of surgical care in the Americas.

On September 29, 2023, the Republic of Ecuador convened a meeting to address surgical system strengthening and urge political leaders to invest in surgical infrastructure. The meeting included experts in health diplomacy, innovative financing, implementation strategy and national surgical plans. The event occurred in parallel with the Sixtieth Directing Council of the Pan American Health Organization, Seventy-fifth session of the World Health Organization Regional Committee for the Americas.

Extreme wrinkling of the nuclear lamina is a morphological marker of cancer.

Nuclear atypia is a hallmark of cancer. A recent model posits that excess surface area, visible as folds/wrinkles in the lamina of a rounded nucleus, allows the nucleus to take on diverse shapes with little mechanical resistance. Whether this model is applicable to normal and cancer nuclei in human tissues is unclear.

Estimates of optimal supplies of animal-sourced foods differ by food system goal and socioeconomic context.

Reduced consumption of animal-sourced food (ASF) has been recommended for environmental and human health objectives; however, ASF can be important for food security and diet affordability. We explored country-level relationships among various metrics of food supply, socioeconomic context, food security, diet affordability, and agricultural greenhouse gas emissions (GHGe) to characterize how optimal inclusion ranges for ASF vary with socioeconomic factors and food system goals. Data from 2015 to 2022 for 153 countries were sourced to generate Bayesian Networks representing relationships among the studied food system metrics.

Heterogeneous endocrine cell composition defines human islet functional phenotypes.

Phenotyping and genotyping initiatives within the Integrated Islet Distribution Program (IIDP), the largest source of human islets for research in the U.S., provide standardized assessment of islet preparations distributed to researchers, enabling the integration of multiple data types.