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Background The American Heart Association's Life's Essential 8 (LE8) are 8 risk factors for cardiovascular disease, with poor attainment across all racial, ethnic, and socioeconomic groups. Attainment is lowest among Americans of low socioeconomic status (SES). Evidence suggests the association of SES with LE8 may vary by race and ethnicity. Methods and Results The association of 4 SES categories (education, income‐to‐poverty line ratio, employment, insurance) with LE8 was computed in age‐adjusted linear regression models, with an interaction term for race and ethnicity, using National Health and Nutrition Examination Survey data, years 2011 to 2018. The sample (n=13 529) had a median age of 48 years (51% female) with weighting to be representative of the US population. The magnitude of positive association of college education (relative to ≤high school) with LE8 was greater among non‐Hispanic White Americans (NHWA) compared with non‐Hispanic Black Americans, Hispanic Americans, and non‐Hispanic Asian Americans (all interactions P <0.001). NHWA had a greater magnitude of positive association of income‐to‐poverty line ratio with LE8, compared with non‐Hispanic Black Americans, Hispanic Americans, and non‐Hispanic Asian Americans (all interactions P <0.001). NHWA with Medicaid compared with private insurance had a greater magnitude of negative association with LE8 compared with non‐Hispanic Black Americans, non‐Hispanic Asian Americans, or Hispanic Americans (all interactions P <0.01). NHWA unemployed due to disability or health condition (compared with employed) had a greater magnitude of negative association with LE8 than non‐Hispanic Black Americans, non‐Hispanic Asian Americans, or Hispanic Americans (all interactions P <0.05). Conclusions The magnitude of association of SES with LE8 is greatest among NHWA. More research is needed on SES's role in LE8 attainment in minority group populations.

BACKGROUND: Global collaboration in cardio-oncology is needed to understand the prevalence of cancer therapy-related cardiovascular toxicity in different risk groups, practice settings, and geographic locations. There are limited data on the socioeconomic and racial/ethnic disparities that may impact access to care and outcomes. To address these gaps, we established the Global Cardio-Oncology Registry, a multinational, multicenter prospective registry. METHODS: We assembled cardiologists and oncologists from academic and community settings to collaborate in the first Global Cardio-Oncology Registry. Subsequently, a survey for site resources, demographics, and intention to participate was conducted. We designed an online data platform to facilitate this global initiative. RESULTS: A total of 119 sites responded to an online questionnaire on their practices and main goals of the registry: 49 US sites from 23 states and 70 international sites from 5 continents indicated a willingness to participate in the Global Cardio-Oncology Registry. Sites were more commonly led by cardiologists (85/119; 72%) and were more often university/teaching (81/119; 68%) than community based (38/119; 32%). The average number of cardio-oncology patients treated per month was 80 per site. The top 3 Global Cardio-Oncology Registry priorities in cardio-oncology care were breast cancer, hematologic malignancies, and patients treated with immune checkpoint inhibitors. Executive and scientific committees and specific committees were established. A pilot phase for breast cancer using Research Electronic Data Capture Cloud platform recently started patient enrollment. CONCLUSIONS: We present the structure for a global collaboration. Information derived from the Global Cardio-Oncology Registry will help understand the risk factors impacting cancer therapy-related cardiovascular toxicity in different geographic locations and therefore contribute to reduce access gaps in cardio-oncology care. Risk calculators will be prospectively derived and validated.

AbstractThe Alzheimer's Disease Neuroimaging Initiative (ADNI) aims to improve Alzheimer's disease (AD) clinical trials. Since 2006, ADNI has shared clinical, neuroimaging, and cognitive data, and biofluid samples. We used conventional search methods to identify 1459 publications from 2021 to 2022 using ADNI data/samples and reviewed 291 impactful studies. This review details how ADNI studies improved disease progression understanding and clinical trial efficiency. Advances in subject selection, detection of treatment effects, harmonization, and modeling improved clinical trials and plasma biomarkers like phosphorylated tau showed promise for clinical use. Biomarkers of amyloid beta, tau, neurodegeneration, inflammation, and others were prognostic with individualized prediction algorithms available online. Studies supported the amyloid cascade, emphasized the importance of neuroinflammation, and detailed widespread heterogeneity in disease, linked to genetic and vascular risk, co‐pathologies, sex, and resilience. Biological subtypes were consistently observed. Generalizability of ADNI results is limited by lack of cohort diversity, an issue ADNI‐4 aims to address by enrolling a diverse cohort.

AbstractLiver transplant patients require a multidisciplinary and personalized approach to optimize outcomes. Posttransplant complications can be devastating for the patient and can jeopardize graft survival. Therefore, a careful evaluation and stepwise decision-making process is necessary to determine the best strategy, whether it is surgical, interventional, or a combination of both. While access to liver transplant interventions in Latin America can be more limited compared with other parts of the world, many countries in the region have made significant progress in developing their liver transplant programs and improving the management of posttransplant complications. For example, in Brazil, specialized transplant centers and multidisciplinary teams have been established to reduce morbidity and improve graft survival rates. The article also explores the latest advancements in interventional radiology techniques, such as angioplasty, stent placement, and embolization, and how they can be used to successfully treat these complications. Overall, this article highlights the importance of a comprehensive approach to managing complications in liver transplant patients and emphasizes how individualized treatment plans can lead to improved outcomes, even in settings with limited resources.

Abstract Askow, AT, Jennings, W, Jagim, AR, Fields, JB, Beaudoin, RG, Sanchez, GM, Weeks, JE, Oliver, JM, and Jones, MT. Athlete external load measures across a competitive season in high school basketball. J Strength Cond Res 37(11): 2206–2212, 2023—The purpose of this retrospective analysis was to quantify in-season external load and to determine if relationships existed between load metrics and basketball performance. Eleven male high school varsity basketball athletes (n = 11; mass 80.5 ± 9.6 kg, height 190.2 ± 9.4 cm, age 17.6 ± 0.7 years) were monitored across a season. PlayerLoad (PL), PL per minute (PL·min −1 ), total jumps, and explosive movements (EMs) were quantified using a commercially available local positioning unit. Basketball-specific performance metrics, including points scored, points allowed, point differentials, and shooting percentages for each quarter and game, were compiled. Data were analyzed using repeated-measure analysis of variance to evaluate differences in load by starting status, session type, game outcome, and game type. Pearson's correlation coefficients were used to assess relationships between load metrics and basketball performance. Statistical significance was set at p < 0.05. The mean values across 23 games for PL, PL·min −1 , total jumps, and EMs were 457 ± 104 AU, 10.9 ± 1.6 AU, 42.6 ± 9.6, and 46.7 ± 7.2, respectively. Relationships were observed ( p < 0.05) between PL and points scored ( r = 0.38) and free throw percentage ( r = 0.21). Further relationships were observed between PL·min −1 and free throw shooting percentage ( r = −0.27), and between points scored and total jumps ( r = 0.28), and EMs ( r = 0.26). Notable differences in game demands were observed for playing status. Meaningful differences in measures of external load were observed between each quarter of play, with the highest measures evident in quarters 1 and 3. Guards and forwards experienced minimal differences in external load during gameplay, and game outcome did not result in differences. Higher point totals corresponded with higher PL, total jumps, and EM.

Purpose To establish consensus statements on platelet‐rich plasma (PRP) for the treatment of musculoskeletal pathologies. Methods A consensus process on the treatment of PRP using a modified Delphi technique was conducted. Thirty‐five orthopaedic surgeons and sports medicine physicians participated in these consensus statements on PRP. The participants were composed of representatives of the Biologic Association, representing 9 international orthopaedic and musculoskeletal professional societies invited due to their active interest in the study of orthobiologics. Consensus was defined as achieving 80% to 89% agreement, strong consensus was defined as 90% to 99% agreement, and unanimous consensus was indicated by 100% agreement with a proposed statement. Results There was consensus on 62% of statements about PRP. Conclusions (1) PRP should be classified based on platelet count, leukocyte count, red blood count, activation method, and pure‐plasma versus fibrin matrix; (2) PRP characteristics for reporting in research studies are platelet count, leukocyte count, neutrophil count, red blood cell count, total volume, the volume of injection, delivery method, and the number of injections; (3) the prognostic factors for those undergoing PRP injections are age, body mass index, severity/grade of pathology, chronicity of pathology, prior injections and response, primary diagnosis (primary vs postsurgery vs post‐trauma vs psoriatic), comorbidities, and smoking; (4) regarding age and body mass index, there is no minimum or maximum, but clinical judgment should be used at extremes of either; (5) the ideal dose of PRP is undetermined; and (6) the minimal volume required is unclear and may depend on the pathology. Level of Evidence Level V, expert opinion.

AbstractCystic fibrosis (CF) is widely known as a disease of the lung, even though it is in truth a systemic disease, whose symptoms typically manifest in gastrointestinal dysfunction first. CF ultimately impairs not only the pancreas and intestine but also the lungs, gonads, liver, kidneys, bones, and the cardiovascular system. It is caused by one of several mutations in the gene of the epithelial ion channel protein CFTR. Intense research and improved antimicrobial treatments during the past eight decades have steadily increased the predicted life expectancy of a person with CF (pwCF) from a few weeks to over 50 years. Moreover, several drugs ameliorating the sequelae of the disease have become available in recent years, and notable treatments of the root cause of the disease have recently generated substantial improvements in health for some but not all pwCF. Yet, numerous fundamental questions remain unanswered. Complicating CF, for instance in the lung, is the fact that the associated insufficient chloride secretion typically perturbs the electrochemical balance across epithelia and, in the airways, leads to the accumulation of thick, viscous mucus and mucus plaques that cannot be cleared effectively and provide a rich breeding ground for a spectrum of bacterial and fungal communities. The subsequent infections often become chronic and respond poorly to antibiotic treatments, with outcomes sometimes only weakly correlated with the drug susceptibility of the target pathogen. Furthermore, in contrast to rapidly resolved acute infections with a single target pathogen, chronic infections commonly involve multi‐species bacterial communities, called “infection microbiomes,” that develop their own ecological and evolutionary dynamics. It is presently impossible to devise mathematical models of CF in its entirety, but it is feasible to design models for many of the distinct drivers of the disease. Building upon these growing yet isolated modeling efforts, we discuss in the following the feasibility of a multi‐scale modeling framework, known as template‐and‐anchor modeling, that allows the gradual integration of refined sub‐models with different granularity. The article first reviews the most important biomedical aspects of CF and subsequently describes mathematical modeling approaches that already exist or have the potential to deepen our understanding of the multitude aspects of the disease and their interrelationships. The conceptual ideas behind the approaches proposed here do not only pertain to CF but are translatable to other systemic diseases.This article is categorized under: Congenital Diseases > Computational Models

Abstract The role of measurable residual disease (MRD) in multiple myeloma patients treated with chimeric antigen receptor (CAR) T cells is uncertain. We analyzed MRD kinetics during the first year after idecabtagene vicleucel (ide-cel) infusion in 125 relapsed/refractory multiple myeloma patients enrolled in KarMMa. At month 1 after ide-cel, there were no differences in progression-free survival (PFS) between patients in less than complete response (CR) versus those in CR; only MRD status was predictive of significantly different PFS at this landmark. In patients with undetectable MRD at 3 months and beyond, PFS was longer in those achieving CR versus &lt;CR. Persistent MRD in the 10−6 logarithmic range and reappearance of normal plasma cells in MRD-negative patients were associated with inferior PFS. This study unveils different prognostic implications of serological and MRD response dynamics after ide-cel and suggests the potential value of studying the reappearance of normal plasma cells as a surrogate of loss of CAR T-cell functionality. Significance: This is one of the first studies evaluating the impact of CR and MRD dynamics after CAR T therapy in relapsed/refractory multiple myeloma. These data help interpret the prognostic significance of serological and MRD responses at early and late time points after CAR T-cell infusion. See related commentary by Landgren and Kazandjian, p. 346 . This article is featured in Selected Articles from This Issue, p. 337