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PURPOSE Teclistamab is initiated with a step-up dosing (SUD) schedule to mitigate the risk of cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS). Early teclistamab users commonly received SUD in a hospital setting. This study aimed to evaluate safety and health care resource utilization (HRU) in real-world patients with multiple myeloma who initiated teclistamab SUD in an outpatient setting. METHODS This was a retrospective study using Mayo Clinic's electronic medical records from October 26, 2022, to October 31, 2023. Patient characteristics were summarized for all patients treated with teclistamab and separately for patients who started SUD outpatient. SUD pattern, safety, HRU, and post-SUD dosing schedule were described in patients with complete SUD. RESULTS At data cutoff, 65 patients received ≥1 teclistamab dose, including 58 patients who initiated SUD outpatient (median age, 69.2 years; male, 63.8%; White, 89.7%). Among 57 patients who completed SUD in an outpatient setting, all received premedications on the days of teclistamab administrations per label recommendation; 18 (31.6%) developed CRS (13 grade 1, four grade 2, and one grade 4) and two developed ICANS (one each with grade 2 and 4). All CRS and ICANS resolved with supportive care and all patients continued treatment. Eighteen patients were admitted to the hospital for CRS treatment, with a median CRS-related hospital stay of 2 days per admission. Most (60%) doses during SUD required <1 hour clinic time between administration and checkout. Post-SUD, clinic time for treatment doses decreased to <30 minutes for most doses (82%). CONCLUSION Outcomes of this study support outpatient administration as a safe and feasible option for teclistamab SUD to potentially reduce HRU and improve patient experiences.

Inconsistency in the calculation of time spent in moderate to vigorous physical activity (MVPA) limits interstudy comparability and interpretation of surveillance data. This study assesses whether combining multiple individual methods results in a more accurate estimate of MVPA, while considering the influence of device brand and wear location. Participants (n = 30, age = 49.2 ± 19.5 years) wore two accelerometers (GENEActiv, ActiGraph) on each wrist during two laboratory visits. Individual classification methods (11 for left wrist, eight for right wrist) estimated minutes of MVPA using three approaches (cut-point, two-regression, and machine learning), two types of input (count and raw), and five epoch lengths (1, 5, 15, 30, and 60 s). The consensus estimate was calculated as the mean or median (due to skew) across all individual estimates. No individual or consensus estimates were statistically equivalent to direct observation (mean 38.2 min), with 81%–95% of individual methods overestimating MVPA. The best-performing individual methods were raw acceleration cut-points, with a bias of −3.2 to 2.4 min across devices and wrists. Correlation coefficients between individual methods and the criterion were .35–.71 for the left and .12–.67 for the right wrist, compared to .65–.70 and .58–.66 for consensus methods, respectively. Correlations between device brands were .23–.99 for individual methods and .70–.86 for consensus methods, while correlations between locations were .55–.86 and .73–.87, respectively. Better methods are required for estimating MVPA from wrist-worn accelerometers given the consistent overestimation of MVPA observed. While a consensus method for wrist-worn data was not able to fully resolve these issues, it improves interwrist or interbrand comparability.

Background: Bucket-handle meniscal tears (BHMTs) are a common subtype of meniscal tears that represent a clinical challenge. Arthroscopic inside-out repair has been considered the gold standard in treatment; however, an all-inside approach has gained widespread popularity, with limited long-term evidence. Purpose/Hypothesis: The purpose of this study was to (1) compare long-term clinical outcomes and rates of failure after surgical repair of BHMTs using the all-inside versus inside-out technique, and 2) identify risk factors for failure at long-term follow-up. It was hypothesized that clinical outcomes and rates of failure would be similar between the 2 techniques. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who had undergone surgical repair of BHMTs between 2003 and 2013 at a single institution were identified. Patient-reported outcome measures (PROMs) were assessed preoperatively and at the latest follow-up using the Tegner scale, International Knee Documentation Committee questionnaire, and visual analog scale pain at rest and with activity. A univariate Cox proportional hazards model was used to identify predictors for repair failure, defined as revision meniscal surgery and/or documented meniscal retear. Results: In total, 63 patients were included (37 with inside-out repair, 26 with all-inside repair). At a mean follow-up of 11.2 years, the survival rate for BHMT repair was 63% overall, 70% for all-inside repairs, and 60% for inside-out repairs ( P = .37). The mean time to failure was 2.6 years for all-inside repairs and 2.5 years for inside-out repairs ( P = .98). PROM scores were not significantly different between the 2 repair groups ( P > .22). Univariate Cox proportional hazards model for failure demonstrated that increasing age at surgery was associated with lower failure rates (hazard ratio, 0.91 change per 1-year increase in age; 95% CI, 0.84-0.98) and medial meniscus repair was associated with higher failure rates (hazard ratio, 3.12; 95% CI, 1.14-8.77). Conclusion: Long-term follow-up of BHMT repair demonstrated satisfactory clinical outcomes and failure rates. In appropriately selected patients, the all-inside technique did not compromise outcome as compared with the inside-out repair techniques. For both methods, older age was associated with lower failure rates and medial meniscus repair was associated with increased failure.

Since the dawn of humanity, human beings have inherently sought a state of security, trying to make their existence as comfortable as possible. Accordingly, among the many factors affecting human health, comfort and well-being, the quality of the micro-environment and ecology, as well as the health care system and health-saving resources, are important. In this regard, environmental security, with its systemic nature, brings a significant contribution to the PPM model by optimizing the state of balance in the interrelationship of natural, anthropogenic, physiological and social processes. Accordingly, individualized nutrition and pharmacointervention for preventive and prophylactic purposes, being important tools for health preservation, represent an integrative approach aimed at understanding the interaction between nutrition and the environment within the formed or formed lifestyle. This review will consider the main components of human health protection, as well as their impact on the preservation of ecobiocenosis stability.

Everyone has the right to the highest attainable standard of health, and modern preventive, preventive and rehabilitative manipulations promote health and well-being. Thanks to a number of fundamental projects on the study of human health at various levels (genomic, proteomic, and metabolomic), and molecular mechanisms of the development of pathological conditions, there has been a great leap in the field of applied sectors of industrial biotechnology, including segments of the pharmaceutical and food industries, significantly replenished health-saving resources and improved the quality of life of the population. This article will review the advanced achievements of fundamental and applied research, as well as promising areas of the bioindustry.

The estimation of surgical blood loss is routinely performed during and after surgical procedures and has morbidity and mortality implications related to the risk of under- and over-resuscitation. The strategies for estimating surgical blood loss include visual estimation, the gravimetric method, the colorimetric method, formula-based methods, and other techniques (e.g., cell salvage). Currently, visual estimation continues to be the most widely used technique. In addition, unique considerations exist when these techniques are applied to various clinical settings such as massive transfusion, cardiac surgery, and obstetrics. Ultimately, when using estimated surgical blood loss to guide perioperative fluid management and transfusion thresholds, it is also important to mitigate the risks associated with resuscitation by targeting a goal-directed fluid therapy approach by utilizing markers of fluid-responsiveness to optimize stroke volume (cardiac output) and delivery of oxygen.

ObjectiveVagus 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.MethodsBaseline 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). Eight clinical measures assessed at baseline were also evaluated (treatment group, age, race, gender, paretic side, pre‐stroke dominant hand, time since stroke, and baseline Fugl‐Meyer upper extremity score). Bivariate analyses compared each measure with the primary trial end point (change in Fugl‐Meyer upper extremity score from baseline to end of 6 weeks of treatment) across all subjects, with secondary analyses examining trial groups separately.ResultsMRIs were available from 80 patients (age = 59.8 ± 9.5 years, 29 women). Across all patients, less white matter hyperintensities (r = −0.25, p = 0.028) at baseline was associated with larger Fugl‐Meyer score change. In the VNS group, less white matter hyperintensities (r = −0.37, p = 0.018) and larger ipsilesional thalamus volume (r = 0.33, p = 0.046) were each associated with larger Fugl‐Meyer score change. Analysis of covariance (ANCOVA) analyses tested the interaction that each baseline measure had with treatment group and found that the model examining white matter hyperintensities had a significant interaction term, indicating 2.3 less change in Fugl‐Meyer Upper Extremity (FM‐UE) points in the VNS group relative to the control group for each point increase in modified Fazekas scale.InterpretationNeuroimaging measures are associated with extent of gains on the primary endpoint of a phase III stroke recovery trial. Among the neuroimaging measures examined, a measure of global brain health (extent of white matter hyperintensities) was better at explaining the change in arm impairment as compared with measures of regional injury; this was true when examining all study subjects as well as only those in the VNS group and is consistent with the global mechanism of action that VNS has throughout the cerebrum. Future studies can evaluate additional measures that further predict response to VNS therapy. The current findings suggest that individual patient neuroimaging results may be useful for a personalized medicine approach to stroke recovery therapeutics. ANN NEUROL 2025;97:709–719