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.

Estimating prevalence of opioid misuse in North Carolina counties from 2016-2021: An integrated abundance model approach.

Background: The overdose epidemic remains largely driven by opioids, but county-level prevalence of opioid misuse is unknown. Without this information, public health and policy responses are limited by a lack of knowledge on the scope of the problem.

Methods: Using an integrated abundance model, we estimate annual county-level prevalence of opioid misuse for counties in North Carolina from 2016 to 2021.

Oncology Provider and Patient Perspectives on a Cardiovascular Health Assessment Tool utilized during Post-treatment Survivorship Care in Community Oncology (Results from WF-1804CD): Mixed Methods Observational Study.

Background: Most cancer survivors have multiple cardiovascular risk factors, increasing their risk of poor cardiovascular and cancer outcomes. The Automated Heart-Health Assessment (AH-HA) tool is a novel electronic health record clinical decision support tool based on the American Heart Association's Life's Simple 7 cardiovascular health (CVH) metrics to promote CVH assessment and discussion in outpatient oncology. Before proceeding to future implementation trials, it is critical to establish the acceptability of the tool among providers and survivors.

Supervised Functional Principal Component Analysis Under the Mixture Cure Rate Model: An Application to Alzheimer'S Disease.

Brain imaging data is one of the primary predictors for assessing the risk of Alzheimer's disease (AD). This study aims to extract image-based features associated with the possibly right-censored time-to-event outcomes and to improve predictive performance. While the functional proportional hazards model is well-studied in the literature, these studies often do not consider the existence of patients who have a very low risk and are approximately insusceptible to AD.

Chain Mediating Effect of Social Support and Trust in Physician on Stroke Caregivers' Decision Self-Efficacy and Decision Conflict.

To explore the chain mediating role of social support and trust in between decision self-efficacy and decision conflict of stroke caregivers. Convenient sampling was used to select stroke caregivers who were admitted to the department of neurology, neurosurgery and rehabilitation in a four-3A hospital in Henan Province from September 2023 to April 2024. General information questionnaire, Decisional Self-efficacy Scale, Social Support Scale, Wake Forest Physician Trust Scale and Decisional Conflict Scale were adopted.

Pigmented Syringomatous Carcinoma/Sweat Gland Carcinoma of the Vulva With Melanocytic Colonization: An Uncommon Presentation of a Rare Sweat Gland Neoplasm.

Primary vulvar carcinomas are rare and constitute a diverse group of neoplasms. These primary tumors are typically classified based on their presumed tissue of origin or histological characteristics. Among these, carcinomas of sweat gland origin are particularly significant.

Glucose-Sensing Carbohydrate Response Element-Binding Protein in the Pathogenesis of Diabetic Retinopathy.

Glucose-sensing ChREBP and MondoA are transcriptional factors involved in the lipogenic, inflammatory, and insulin signaling pathways implicated in metabolic disorders; however, limited ocular studies have been conducted on these proteins. We aimed to investigate the potential role of ChREBP in the pathogenesis of diabetic retinopathy (DR). We used diabetic human and mouse retinal cryosections analyzed by immunohistochemistry.

Enhanced Interleukin 6 Trans-Signaling Modulates Disease Process in Amyotrophic Lateral Sclerosis Mouse Models.

Charcot first described ALS in 1869, but the specific mechanisms that mediate the disease pathology are still not clear. Intense research efforts have provided insight into unique neuroanatomical regions, specific neuronal populations and genetic associations for ALS and other neurodegenerative diseases; however, the experimental results also suggest a convergence of these events to common toxic pathways. We propose that common toxic pathways can be therapeutically targeted, and this intervention will be effective in slowing progression and improving patient quality of life.

Analyzing Gait Dynamics and Recovery Trajectory in Lower Extremity Fractures Using Linear Mixed Models and Gait Analysis Variables.

In a prospective study, we examined the recovery trajectory of patients with lower extremity fractures to better understand the healing process in the absence of complications. Using a chest-mounted inertial measurement unit (IMU) device for gait analysis and collecting patient-reported outcome measures, we focused on 12 key gait variables, including Mean Leg Lift Acceleration, Stance Time, and Body Orientation. We employed a linear mixed model (LMM) to analyze these variables over time, incorporating both fixed and random effects to account for individual differences and the time since injury.

Effects of surgical approach and downstaging in esophageal adenocarcinoma patients treated with neoadjuvant chemotherapy: a 2010-2020 National Cancer Database (NCDB) study.

Background: Neoadjuvant Chemoradiation (nCRT) has been shown to improve survival in patients with Esophageal Adenocarcinoma (EAC). The objective of this study is to assess the patient characteristics associated with tumor downstaging in a large national database. Additionally, we evaluated surgical approach and change in clinical versus pathological staging as predictors of patient survival.

Semaglutide in obesity-related heart failure with preserved ejection fraction and type 2 diabetes across baseline HbA levels (STEP-HFpEF DM): a prespecified analysis of heart failure and metabolic outcomes from a randomised, placebo-controlled trial.

Background: About half of patients with heart failure with mildly reduced or preserved ejection fraction (HFpEF) have type 2 diabetes. In the STEP-HFpEF DM trial of adults with obesity-related HFpEF and type 2 diabetes, subcutaneous once weekly semaglutide 2·4 mg conferred improvements in heart failure-related symptoms and physical limitations, bodyweight, and other heart failure outcomes. We aimed to determine whether these effects of semaglutide differ according to baseline HbA.

Characteristics influencing COVID-19 testing and vaccination among Spanish-speaking Latine persons in North Carolina.

Background: Latine populations in the United States continue to be disproportionately affected by COVID-19 with high rates of infection and mortality. Our community-based participatory research partnership examined factors associated with COVID-19 testing and vaccination within a particularly hidden, underserved, and vulnerable population: Spanish-speaking Latines.

Methods: In 2023, native Spanish-speaking Latine interviewers conducted phone-based structured individual assessments with 180 Spanish-speaking, predominantly immigrant Latines across North Carolina.

Multimodal data integration to predict atrial fibrillation.

Aims: Many studies have utilized data sources such as clinical variables, polygenic risk scores, electrocardiogram (ECG), and plasma proteins to predict the risk of atrial fibrillation (AF). However, few studies have integrated all four sources from a single study to comprehensively assess AF prediction.

Methods And Results: We included 8374 (Visit 3, 1993-95) and 3730 (Visit 5, 2011-13) participants from the Atherosclerosis Risk in Communities Study to predict incident AF and prevalent (but covert) AF.

Survival impact of immune-related adverse events in extensive stage small cell lung cancer patients: a retrospective cohort study.

Background: Prior research indicates a connection between immune-related adverse events (irAEs) and improved progression-free survival (PFS) and overall survival (OS) in non-small cell lung cancer. However, limited data exists for extensive stage small cell lung cancer (ES-SCLC).

Methods: This study included all ES-SCLC patients who received at least one dose of an immune checkpoint inhibitor between 2 January 2011 and 4 July 2022 using a large retrospective registry from a single institution.

Distributed training of foundation models for ophthalmic diagnosis.

Vision impairment affects nearly 2.2 billion people globally, and nearly half of these cases could be prevented with early diagnosis and intervention-underscoring the urgent need for reliable and scalable detection methods for conditions like diabetic retinopathy and age-related macular degeneration. Here we propose a distributed deep learning framework that integrates self-supervised and domain-adaptive federated learning to enhance the detection of eye diseases from optical coherence tomography images.

Klebsiella pneumoniae employs a type VI secretion system to overcome microbiota-mediated colonization resistance.

Microbial species must compete for space and nutrients to persist in the gastrointestinal (GI) tract, and our understanding of the complex pathobiont-microbiota interactions is far from complete. Klebsiella pneumoniae, a problematic, often drug-resistant nosocomial pathogen, can colonize the GI tract asymptomatically, serving as an infection reservoir. To provide insight on how K.

Grocery intervention and DNA-based assessment to improve diet quality in pediatric obesity: a pilot randomized controlled study.

Objective: We assessed the impact of a food-provisioning intervention on diet quality in children with obesity.

Methods: Participants (n = 33, aged 6-11 years) were randomly assigned to either usual care (intensive health behavior and lifestyle treatment) or intervention (usual care + food provisioning; high-fiber, low-dairy diet) for 4 weeks. The primary outcome was a change in child diet quality at Week 4.

Hemodialysis Outcomes Score In Trauma (HOST): A novel and easy model for predicting death in patients receiving pre-injury hemodialysis.

Introduction: We sought to construct a simple clinical mortality prediction model in trauma patients that required pre-injury hemodialysis: Hemodialysis Outcomes Score in Trauma (HOST).

Methods: Trauma patients on pre-injury hemodialysis admitted between July 2013 to December 2021 were reviewed. Univariate and multivariable analysis was used to determine independent predictors of mortality and construct the HOST score.

The cost-effectiveness of vaccination against COVID-19 illness during the initial year of vaccination.

Background: Substantial investments by government programs and private health plans subsidized the costs of COVID-19 vaccine doses and vaccine administration. The objective of this study was to evaluate the cost-effectiveness of vaccination against COVID-19 illness during the initial year of COVID-19 vaccination (2021).

Methods: Using a simulation model, we projected outcomes for hypothetical cohorts of US adults aged 18 and older, stratified by age and risk status for complications, comparing vaccination and no vaccination in the context of recommended concomitant prevention strategies (e.

Tularemia in a Psoriasis Patient on Biologic Therapy After Relocation to Western South Dakota.

Background: Francisella tularensis is an aerobic, gram negative coccobacillus bacterium that causes tularemia. F. tularensis spreads primarily through ticks, biting flies, droplet inhalation, contaminated mud or water, or infected animal bites, and it can survive in animal carcasses with the most common mode of transmission occurring via inoculation into the skin and inhalation/ingestion.