Citations

ABSTRACT The recently published BLAST clinical risk model for chronic myelomonocytic leukemia (CMML) and its molecular version (BLAST‐Mol) differentiate low, intermediate, and high‐risk groups. The objective of the current retrospective study was to examine the survival impact of allogeneic stem cell transplant (ASCT) in a consecutive series of Mayo Clinic patients ( n = 775; 68% males, median age 71 years) with CMML, overall and adjusted for baseline BLAST/BLAST‐Mol risk categories. At a median follow‐up of 77 months, 151 (20%) patients underwent ASCT. Overall survival (OS) was longer in the ASCT compared to the non‐ASCT cohorts (median 77 vs. 28 months; p < 0.01). The significant difference in OS between the ASCT and non‐ASCT cohorts was retained after adjusting for BLAST clinical risk groups: high‐risk (median 50 vs. 14 months; p < 0.01), intermediate‐risk (81 vs. 28 months; p < 0.01), and low‐risk (111 vs. 65 months; p = 0.04), respectively. The same was mostly the case when OS comparison was adjusted for BLAST‐Mol with respective p values of < 0.01, < 0.01, and 0.08, respectively. Time‐dependent cox models confirmed the favorable survival impact of ASCT in the BLAST/BLAST‐Mol high‐ and intermediate‐risk groups. The current study highlights the benefit of ASCT for BLAST/BLAST‐Mol high‐ and intermediate‐risk groups in CMML and its potential to overcome the adverse impact of some high risk cytogenetic or molecular abnormalities. These observations support the early use of ASCT in CMML, ideally before BT and regardless of genetic characteristics.

Background Compassionate extubations (CEs) can be categorized as stressful clinical events that have potential to trigger a second victim response. The Second Victim Experience and Support Tool-Revised (SVEST-R) is a survey used by healthcare organizations to evaluate second victim experiences of their staff. The purpose of this study was to quantify the level of agreement among respiratory therapists (RTs) who participate in CEs resulting in the perception of being a second victim, as well as various desired forms of support. Methods The study employed a cross-sectional, non-experimental survey design. The SVEST-R was disseminated via an anonymous electronic survey posted to a private social media site for RTs. Data analysis included descriptive statistics for demographic variables, exploratory factor analysis, measures of reliability for the SVEST-R instrument, and comparison of responses across demographic variables. Results There were 146 survey responses. The majority of respondents were female (92%), between the ages of 25–40 (49%), had between 11 and 20 years of RT experience (27%), and practiced primarily in adult critical care (87%). Up to 51.4% of the sample reported that physical distress had occurred due to participation in CEs. The majority of respondents (80.8%) agree that colleague support is present. There was general agreement that supervisor (>60%) and organization (>50%) support are present. Perception of professional self-efficacy was preserved, and resilience remained high for the majority of RTs in this sample. There was general disagreement that involvement in CEs resulted in absenteeism from work or turnover intentions. The most frequently desired form of support was a peaceful location to recover and recompose after the event (85.8%). Conclusions RTs experience marginal yet meaningful distress as a result of participating in CEs. Respondents desire more opportunities to exist in terms of institutional support. Participating in CEs rarely impacts perceptions of self-efficacy. Respondents identify as resilient and feel the experiences with CEs have promoted professional growth.

Myelodysplastic syndromes (MDS), which are hematopoietic stem cell malignancies, are often accompanied by signs of chronic inflammation, that can in turn drive the pathogenetic process. The precise mechanisms dysregulating inflammatory and innate immune signaling in MDS hematopoietic stem and progenitor cells (HSPCs) remain under investigation. We report that mice lacking Tet2 developed a hyper-inflammatory state, which can be further fueled by LPS-induced inflammation. This chronic inflammation temporarily promotes the self-renewal and myeloid differentiation of Tet2-deficient HSPCs; however, it ultimately accelerates HSC exhaustion and triggers MDS development in chimeric mouse models. Driving this phenotype was the activation of the NLRC4 inflammasome pathway. Notably, Nlrc4 depletion in Tet2-deficient mice impaired MDS development and improved the survival of these mice. These findings uncover a novel mechanistic basis for the MDS-associated inflammation and provide new targeting opportunities in its management.

Abstract Black/African American populations, globally, bear the greatest prostate cancer (CaP) burden compared to other racial/ethnic groups. Addressing CaP disparities in Black men is complex, requiring a patient-centered, community-centric and comprehensive approach. This study integrates iCCaRE Consortium findings and broader literature to address unmet needs in survivorship care. The iCCaRE Consortium implemented five complementary pilot studies using mixed-methods designs, including feasibility trials, qualitative research, and observational analyses across the United States and sub-Saharan Africa. Descriptive statistics, subgroup analyses, and qualitative thematic analyses were performed across these studies. Collectively, projects addressed multilevel determinants including social, behavioral, and biological drivers of disparities. Project 1 implemented a Virtual Reality Assistant (ViRA) across clinical and community settings, with ongoing evaluation in pragmatic trials. Project 2 showed strong patient preference for home-based cancer care. Project 3 enrolled demonstrated trends toward improved health-related quality of life. Project 4 identified key themes influencing survivorship experiences. Project 5 identified biological mechanisms linking stress, immune modulation, and symptom burden. The iCCaRE pilot projects demonstrate the feasibility and early impact of a consortium-based, transdisciplinary approach to addressing CaP disparities in Black men. These findings highlight the importance of integrating patient-centered interventions, community engagement, and biological insights to inform scalable strategies aimed at improving survivorship outcomes and advancing health equity. The iCCaRE Consortium demonstrates that a transatlantic, patient-centered, and multidisciplinary approach integrating social, clinical, and biological factors can generate scalable strategies to improve survivorship outcomes and advance equity in CaP care for Black men.

Background Randomized trials have shown equivocal outcomes between a direct aspiration as first-pass technique (ADAPT) and stent retriever (SR) stroke thrombectomy, yet whether specific patient subgroups benefit differentially from one technique over the other remains unknown. Methods In this retrospective multicenter cohort study, patients with large vessel occlusion were included, and those who underwent ADAPT versus SR first-pass thrombectomy (either as standalone or combined with aspiration) were compared. The primary outcome was a composite of first-pass effect (FPE, modified Thrombolysis In Cerebral Infarction (mTICI) 2c or better with one attempt) with no symptomatic intracranial hemorrhage (sICH). A causal forest model was used to estimate the conditional average treatment effect (CATE) for each patient, with larger CATEs indicating that ADAPT is expected to be more advantageous. Patients were stratified by CATEs, and outcomes were compared between treatment groups. Results Among 6700 included patients, ADAPT (n=3695, 55%) was associated with a higher rate of FPE with no sICH (39.9% vs 26.9%; adjusted OR (aOR) 2.07, 95% CI 1.77 to 2.41, P<0.001). The causal forest identified significant treatment effect heterogeneity (interaction P<0.001), where ADAPT was more advantageous in more recent years and among patients with M1 occlusions presenting in earlier time windows. Low-CATE patients showed no statistically significant difference between techniques (aOR 0.91, 95% CI 0.57 to 1.45, P=0.70), while medium- and high-CATE patients demonstrated progressively larger ADAPT advantages (aOR 2.06, 95% CI 1.67 to 2.55, and aOR 2.99, 95% CI 2.24 to 3.98, respectively, both P<0.001). Conclusions ADAPT may be superior to SR for a majority of patients, particularly in recent years, and among patients with M1 occlusions presenting in earlier time windows.

ABSTRACT Purpose Despite 5‐year survival rates of over 90% among children and adolescents/young adults (CAYAs) with classic Hodgkin lymphoma (cHL), 15%–20% relapse after frontline therapy. Prior analysis of frontline Children's Oncology Group (COG) clinical trials demonstrated that, despite similar rates of relapse, non‐Hispanic Black (NHB) and Hispanic (vs. non‐Hispanic White [NHW]) patients experienced higher post‐relapse mortality. It is unknown whether post‐relapse disparities persist when second‐line treatment is delivered in a cooperative group trial setting. We examined overall survival (OS) by race and ethnicity in CAYAs enrolled in COG trials for relapsed/refractory (r/r) cHL. Methods A pooled analysis of individual‐level data from CAYAs (≤ 29 years) receiving therapy for r/r cHL on COG clinical trials (2001–2016) was conducted. The Kaplan–Meier method estimated 3‐year OS by racial and ethnic groups. Cox regression models examined associations of race and ethnicity and OS, adjusted for age, insurance, first versus ≥2 relapse, and time from initial diagnosis to relapse trial enrollment. Results Among 175 CAYAs treated on COG trials for r/r cHL (5.7% Asian or Pacific Islander, 14.9% Hispanic, 14.3% NHB, 61.7% NHW, 3.4% other), at median follow‐up of 4.9 years, 3‐year OS was 82.1% (95% confidence interval [CI], 75.3%–87.1%) and did not differ by race and ethnicity ( p = 0.36). In multivariable analyses, shorter time from diagnosis to relapse trial enrollment ( p = 0.01) and ≥2 relapses (vs. first, p = 0.004) conferred worse OS, with no significant effect of race and ethnicity ( p = 0.43). Conclusion Post‐relapse survival did not differ by race and ethnicity among CAYAs enrolled in COG trials for r/r cHL, suggesting access to clinical trials may mitigate OS disparities.

Objective To investigate sex differences in Alzheimer's disease (AD) related pathology among autopsy-confirmed Parkinson's disease (PD) cases. Background AD and PD frequently co-occur in older adults, yet the influence of sex on AD pathology in the context of PD remains unexplored. Methods All subjects were enrolled in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) and Brain and Body Donation Program (BBDP) and had annual standardized research clinical assessments by neuropsychologists, subspecialty behavioral and movement disorders neurologists, as well as comprehensive neuropathological examinations after death. Results Among 230 autopsy-confirmed PD cases, females exhibited greater amyloid plaque pathology burden than males, regardless of a co-occurring AD diagnosis. Specifically, females with PD had significantly higher mean cortical total plaque scores (mean 6.5/15 vs. 4.9/15, p = 0.045) and greater CERAD neuritic plaque density (mean 1.7/3 vs. 1.3/3, p = 0.035). Females were also more likely to have a higher cortical plaque burden (plaque total ≥ 5: 56.8% vs. 39.7%, p = 0.015). In multivariable logistic regression models, female subjects showed greater than twice the odds of having an amyloid plaque burden ≥5 compared to males (OR = 2.18; 95% CI = 1.17–4.06; p = 0.014), when controlling for ApoE ε4 status, Lewy body density score, and age at death. Conclusions Female sex is associated with increased amyloid plaque pathology in PD, independent of ApoE ε4 status. These findings highlight a sex-specific vulnerability to AD pathology in PD patients and support the need for sex-informed approaches to reseach in mixed neurodegenerative disease.

Abstract Purpose The female waist and torso remain fundamental aesthetic elements in body contouring, yet empirical data describing public preferences for waist-to-hip ratio (WHR) and abdominal muscle definition are limited. Misalignment between patient perceptions and actual aesthetic preferences may influence body dissatisfaction, drive unnecessary procedures, and shape unrealistic surgical goals. This study aimed to (1) evaluate how females perceive their own waist shape and ideal appearance using standardized manipulated images, (2) quantify male preferences for female WHR and abdominal definition, and (3) assess the discrepancy between what women believe men find attractive and men’s actual preferences. Methods An anonymous online survey was distributed internationally and collected 900 responses from adult participants. Two digitally manipulated, standardized female torso images were created: one varying waist-to-hip ratio across five levels (WHR 0.60 to 0.80) and one varying abdominal muscle definition. Male participants rated which WHR and abdominal definition they found most attractive. Female participants reported (1) which WHR and definition most resembled their current appearance, (2) which represented their ideal, and (3) which they believed men found most attractive. Additional demographic and body image variables were collected. Descriptive statistics were generated, and comparative analyses (chi-square tests) were conducted to evaluate differences in preference distributions and female perception versus male reality. Results A total of 900 respondents participated, including 41% men and 59% women. Male respondents showed a clear preference for smaller waist-to-hip ratios (WHR). The lowest WHR (0.60) was the most frequently selected option (38%), with steadily decreasing selections as WHR increased. Men also most preferred mild abdominal definition (Option B). Female responses revealed notable perception gaps: women most often perceived themselves as having midrange WHRs (0.70) but selected lower WHRs (0.65) as ideal, and they substantially overestimated men’s preference for the smallest WHR. Subgroup analyses showed that male WHR preferences varied significantly by continent (p &lt; 0.05), with Europe, North and South America favoring smaller WHRs, while Africa, Australia, and Asia preferred larger ones. Higher male physical activity was associated with selecting smaller WHRs (r = –0.220, p &lt; 0.05) and slightly greater abdominal definition (r = 0.169, p &lt; 0.05). Social media use did not influence male preferences. Among women, physical activity strongly predicted desired abdominal muscularity (r = 0.236, p &lt; 0.05) but not ideal WHR. Perceived social media influence significantly shaped ideal WHR (r = 0.202, p &lt; 0.05), such that women who reported more negative influence selected smaller, more exaggerated WHRs. Time spent on social media did not significantly affect female aesthetic preferences. Conclusion This study provides quantitative evidence describing public preferences for female waist and torso aesthetics, revealing important divergences between perception and reality. Men strongly prefer smaller waist-to-hip ratios and mild abdominal definition, but not to the extreme levels that women commonly assume. Women’s own ideal waist shape aligns directionally with male preferences, yet women significantly overestimate the degree to which men favor the smallest possible WHR. This misperception may contribute to body dissatisfaction, drive interest in unnecessary procedures, or set unrealistic surgical expectations. For aesthetic surgeons, these findings highlight the need for patient-centered counseling that addresses perception gaps, corrects inaccurate beliefs about male preferences, and reinforces natural, proportionate outcomes rather than extreme contouring. The data support a trend toward moderate enhancement rather than highly exaggerated WHR reduction or aggressive abdominal definition in female body contouring. Incorporating these insights may improve patient satisfaction, promote psychological well-being, and guide surgical planning grounded in evidence-based aesthetics.