Optimizing P2Y12 Inhibitor Therapy in Post-PCI Patients Through Genotype-Guided Strategies: A Systematic Review and Meta-Analysis.

Background: Clopidogrel non-responder is a common dilemma in the management of post-percutaneous coronary intervention (PCI) management. Clopidogrel is metabolized by CYP2C19. The genetic variations in CYP2C19 can affect the efficacy and bioavailability of the drug that can be checked via genotype testing of the gene.

Glucosinolate and Sugar Profiles in Space-Grown Radish.

The quest to establish permanent outposts in space, the Moon, and Mars requires growing plants for nutrition, water purification, and carbon/nutrient recycling, as well as the psychological well-being of crews and personnel on extra-terrestrial platforms/outposts. To achieve these essential goals, the safety, quality, and sustainability of plant material grown in space should be comparable to Earth-grown crops. In this study, radish plants were grown at 2500 ppm CO in two successive grow-outs on the International Space Station and at similar CO partial pressure at the Kennedy Space Center.

Development of age-specific population-based paediatric computational phantoms for image-based data mining and other radiotherapy applications.

Computational anatomical models have many applications in paediatric radiotherapy. Age-specific computational anatomical models were historically developed to represent average and/or healthy individuals, where cancer patients may present with anatomical variations caused by the disease and/or treatment effects. We developed RT-PAL, a library of computational age-specific voxelized anatomical models tailored to represent the paediatric radiotherapy population.

Impact of frailty index on cardiovascular outcomes and readmissions of patent foramen ovale closure procedure: a propensity matched national analysis.

Background: Transcatheter patent foramen ovale (PFO) occluder device is a procedure mostly performed to prevent secondary stroke as a result of paradoxical emboli traversing an intracardiac defect into the systemic circulation. The complications and outcomes following the procedure remain poorly studied. We aimed to investigate morbidity and mortality associated with occluder device procedures using hospital frailty index score stratification.

Patterns of practice of image guided particle therapy for cranio-spinal irradiation: A site specific multi-institutional survey of European Particle Therapy Network.

Purpose: To investigate the current practice patterns in image-guided particle therapy (IGPT) for cranio-spinal irradiation (CSI).

Methods: A multi-institutional survey was distributed to European particle therapy centres to analyse all aspects of IGPT. Based on the survey results, a Delphi consensus analysis was developed to define minimum requirements and optimal workflow for clinical practice.

The IMRiS Trial: A Phase 2 Study of Intensity Modulated Radiation Therapy in Extremity Soft Tissue Sarcoma.

Purpose: Primary soft tissue sarcoma (STS) is rare, with many tumors occurring in extremities. Local management is limb-sparing surgery and preoperative/postoperative radiation therapy (RT) for patients at high risk of local recurrence. We prospectively investigated late normal tissue toxicity and limb function observed after intensity modulated RT (IMRT) in extremity STS.

Pharmacotherapy and revascularization strategies of peripheral artery disease.

The global epidemiological transition of atherosclerotic vascular diseases is witnessing a rapid redistribution of its burden, shifting from high-income to low- and middle-income countries. With a wide clinical spectrum, spanning from intermittent claudication to more complex critical limb threatening ischemia, nonhealing ulcers, gangrene as well as acute limb ischemia, peripheral artery disease is often faced with the challenges of under-diagnosis and under-treatment despite its high prevalence. The management of peripheral arterial disease in patients with multiple comorbidities presents a formidable challenge and remains a pressing global health concern.

Dirigent isoflavene-forming PsPTS2: 3D structure, stereochemical, and kinetic characterization comparison with pterocarpan-forming PsPTS1 homolog in pea.

Pea phytoalexins (-)-maackiain and (+)-pisatin have opposite C6a/C11a configurations, but biosynthetically how this occurs is unknown. Pea dirigent-protein (DP) PsPTS2 generates 7,2'-dihydroxy-4',5'-methylenedioxyisoflav-3-ene (DMDIF), and stereoselectivity toward four possible 7,2'-dihydroxy-4',5'-methylenedioxyisoflavan-4-ol (DMDI) stereoisomers was investigated. Stereoisomer configurations were determined using NMR spectroscopy, electronic circular dichroism, and molecular orbital analyses.

Lead Cap Use in Interventional Cardiology: Time to Protect Our Head in the Cardiac Catheterisation Laboratory?

: Radiation exposure is an occupational hazard for interventional cardiologists and cardiac catheterisation laboratory staff that can manifest with serious long-term health consequences. Personal protective equipment, including lead jackets and glasses, is common, but the use of radiation protective lead caps is inconsistent. : A systematic review qualitative assessment of five observational studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines protocol was performed.

Image guidance and interfractional anatomical variation in paediatric abdominal radiotherapy.

Objectives: To identify variables predicting interfractional anatomical variations measured with cone-beam CT (CBCT) throughout abdominal paediatric radiotherapy, and to assess the potential of surface-guided radiotherapy (SGRT) to monitor these changes.

Methods: Metrics of variation in gastrointestinal (GI) gas volume and separation of the body contour and abdominal wall were calculated from 21 planning CTs and 77 weekly CBCTs for 21 abdominal neuroblastoma patients (median 4 years, range: 2 - 19 years). Age, sex, feeding tubes, and general anaesthesia (GA) were explored as predictive variables for anatomical variation.

Comparison of trends and outcomes of infective endocarditis in patients with versus without leukemia, 2002 to 2017, from a nationwide inpatient sample.

Patients with leukemia are at an increased risk for infective endocarditis secondary to their immunocompromised state, chemotherapy, and specific risk factors such as the presence of indwelling central venous catheters. There is a paucity of data regarding temporal trends and clinical outcomes of infective endocarditis in leukemia patients. Previous studies have shown a high rate of complications related to surgical valve procedures for treatment of infective endocarditis in patients with hematological malignancies.

Dirigent protein subfamily function and structure in terrestrial plant phenol metabolism.

Aquatic plant transition to land, and subsequent terrestrial plant species diversification, was accompanied by the emergence and massive elaboration of plant phenol chemo-diversity. Concomitantly, dirigent protein (DP) and dirigent-like protein subfamilies, derived from large multigene families, emerged and became extensively diversified. DP biochemical functions as gateway entry points into new and diverse plant phenol skeletal types then markedly expanded.

Deep learning based synthetic CT from cone beam CT generation for abdominal paediatric radiotherapy.

. Adaptive radiotherapy workflows require images with the quality of computed tomography (CT) for re-calculation and re-optimisation of radiation doses. In this work we aim to improve the quality of on-board cone beam CT (CBCT) images for dose calculation using deep learning.

Cardiovascular Outcomes of Redo-coronary Artery Bypass Graft Versus Percutaneous Coronary Intervention of Index Bypass Grafts Among Acute Coronary Syndrome: Regression Matched National Cohort Study.

Procedural and hospital outcomes of Percutaneous coronary intervention (PCI) versus Coronary artery bypass grafting (CABG) among ACS patients with prior history of CABG remains understudied. PCI and CABG formed the 2 comparison cohorts. Nationwide Inpatient Sample (NIS) from 2015 to 2020 were analyzed using the ICD-10 coding system.

Incidence and outcomes of cardiogenic shock among women with spontaneous coronary artery dissection.

Background: There is a paucity of data on cardiogenic shock (CS) incidence and outcomes among patients with spontaneous coronary artery dissection (SCAD).

Methods: Women admitted to the hospital for acute myocardial infarction (AMI) with and without SCAD were identified from the United States National Readmission Database from October 1, 2015 to December 31, 2018. We calculated the incidence of CS among women with AMI with and without SCAD and odds for developing CS after adjusting for baseline characteristics.

Sixteen-Year National Trends in Use and Outcomes of VA-ECMO in Cardiogenic Shock.

There is a lack of data on contemporary trends in the use and outcomes of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) for cardiogenic shock (CS) at a national level. Patients with CS admitted during January 1st, 2002-December 31, 2018, were identified from the United States National Inpatient Sample. Among all patients admitted with CS, those who received VA-ECMO were identified.

Age stratified sex-related differences in incidence, management, and outcomes of cardiogenic shock.

Background: There is a lack of data on age-stratified sex differences in the incidence, treatment, and outcomes of cardiogenic shock (CS). We sought to study these differences from a contemporary database.

Methods: Patients admitted with CS (2004-2018) were identified from the United States National Inpatient Sample.

Sex-based outcomes of surgical myectomy for hypertrophic cardiomyopathy: An analysis from the National Readmission Database.

Background: There is a paucity of data on sex differences in outcomes after surgical myectomy (SM) for hypertrophic cardiomyopathy (HCM).

Methods: Patients who received SM for HCM during October 1, 2015, through December 31, 2018, were identified from the US National Readmission Database. The primary end point of this study was in-hospital mortality.

Catheter Ablation for Hospitalized Atrial Fibrillation Patients with Reduced Systolic Function: Analysis of Inpatient Mortality, Resource Utilization and Complications.

Background: Randomized trials have shown improvement in hard clinical end points when catheter ablation (CA) is employed as a management strategy for certain atrial fibrillation (AF) patients with heart failure and reduced ejection fraction (HFrEF). Limited data, however, exist in this realm outside the controlled clinical trial settings. We sought to determine real-world data on mortality and complications after utilization of CA in such patients.

Radiopaque drug-eluting embolisation beads as fiducial markers for stereotactic liver radiotherapy.

Objective: To determine the feasibility of using radiopaque (RO) beads as direct tumour surrogates for image-guided radiotherapy (IGRT) in patients with liver tumours after transarterial chemoembolisation (TACE).

Methods: A novel vandetanib-eluting RO bead was delivered via TACE as part of a first-in-human clinical trial in patients with either hepatocellular carcinoma or liver metastases from colorectal cancer. Following TACE, patients underwent simulated radiotherapy imaging with four-dimensional computed tomography (4D-CT) and cone-beam CT (CBCT) imaging.

Invasive Hemodynamic Monitoring in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality.

Background There is increasing utilization of cardiogenic shock treatment algorithms. The cornerstone of these algorithms is the use of invasive hemodynamic monitoring (IHM). We sought to compare the in-hospital outcomes in patients who received IHM versus no IHM in a real-world contemporary database.

A decision tool for radiographer-led abdominal image-guided stereotactic ablative body radiotherapy - Experience from a single institution.

A decision tool for radiographer-led image-guided radiotherapy (IGRT) using cone-beam CT (CBCT) for abdominal stereotactic radiotherapy was developed and successfully implemented in a single department. The confidence of 7 therapeutic radiographers when undertaking online CBCT review increased, and the pooled median online match time was reduced by 1 m 8 s. While this may be advantageous for abdominal SABR, further evaluation of this work in a larger cohort is required to validate these results.

Fifteen-Year Trends in Incidence of Cardiogenic Shock Hospitalization and In-Hospital Mortality in the United States.

Background There is a lack of contemporary data on cardiogenic shock (CS) in-hospital mortality trends. Methods and Results Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the overall population and selected subgroups.