Journals
2026 EN
Kim Ji Soo · Wallwork Rachel S. · Richardson Carrie L.
+9 more
Objective Cardiac involvement in systemic sclerosis (SSc) is a leading cause of death. We sought to investigate predictors of incident left ventricular systolic dysfunction (LVSD) and cardiac recovery in SSc. Methods In total, 2,303 patients in the Johns Hopkins Scleroderma Center Research Registry and 13,209 echocardiograms were analyzed. We identified predictors associated with incident LVSD defined by transitions in left ventricular ejection fraction (EF) states (EF ≥50% declining to <50% and EF >35% dropping to ≤35% [severe LVSD]) by fitting multivariate logistic regression models with time‐varying and invariant variables. Variables associated with cardiac recovery were identified by fitting multivariate logistic regression models using important variables identified from random forest analysis. Results Male sex, Black race, diffuse skin disease, higher modified Rodnan skin score (mRSS), echocardiographic evidence of pulmonary hypertension (PH), kidney disease, and atrial fibrillation (AFib) were associated with increased odds of incident LVSD (EF < 50%), whereas anticentromere and anti–topoisomerase‐1 were protective. Male sex, higher mRSS, PH, skeletal myopathy, kidney disease, AFib, and anti‐Ku antibodies were associated with higher odds of incident severe LVSD (EF ≤ 35%). For previous EF <50%, tendon friction rubs were associated with lower odds of cardiac recovery and anti‐RNA polymerase III (anti–RNAP III) was associated with higher odds. For previous EF ≤35%, diabetes was associated with lower odds of recovering to EF >35%. Conclusion Distinct demographic SSc‐specific and cardiac characteristics are associated with increased risk of incident LVSD in SSc, with skeletal myopathy and anti‐Ku antibodies being important risk factors for severe disease. Some patients improved, which was more likely in anti–RNAP III positive patients.
Journals
2026 EN
Ineson Sarah · Almond Chris · Davies Paul
+12 more
ABSTRACT UK winter 2023/24 had a particularly stormy start, similar to 2015/16, another strong El Niño winter. Successfully predicted by the Met Office seasonal forecast system, this increased early‐winter storminess was associated with lower‐than‐average surface pressure to the west of the UK. Although late winter during El Niño is often associated with the negative phase of the North Atlantic Oscillation (NAO), in 2023/24 the NAO was near‐neutral in observations and weakly positive in the ensemble mean forecast, the late‐winter Atlantic surface pressure pattern in the forecast resembling the response observed during the very strongest El Niño events. Both observations and the forecast showed relatively higher pressure west of the UK, but north‐west Europe and the southern North Atlantic were more cyclonic than forecast. The forecast ensemble mean stratospheric polar vortex (SPV) was relatively strong, and unusually, the mean of ensemble members which had a sudden stratospheric warming (SSW) did not project strongly onto the negative NAO, analysis suggesting tropospheric teleconnections masked the usual SSW impact. Conversely, the observed SPV was weak; however, a mid‐January SSW had little surface impact. Overall, our analysis suggests that, despite some differences in late winter, El Niño was the principal driver of observed conditions in the North Atlantic‐European sector.
Journals
2026 EN
Du Chris · Rac Goran · Lanzotti Nicholas
+9 more
Abstract Introduction Accurate, reliable means to obtain fresh viable clinically localised prostate cancer tissue do not exist. We developed a method in which bespoke 3D‐printed moulds can be created for any prostate and allow for ex vivo sampling of magnetic resonance imaging (MRI)‐visible, biopsy‐proven cancer lesions. We sought to demonstrate the ability of our platform to obtain fresh viable prostate cancer tissue after robot‐assisted radical prostatectomy (RARP). Methods Inclusion criteria were a patient that underwent MR‐fusion biopsy (UroNav, Philips) with a resulting biopsy proven Gleason Grade (GG) ≥ 2 target. STL files for prostate boundary and target regions of interest (ROI), created as part of fusion biopsy, were exported from the UroNav and imported into SolidWorks (Dassault), a solid modelling computer‐aided design and engineering application. A macro within SolidWorks was then applied to create a material‐optimised mould around the prostate with needle guides to allow for targeted sampling. The 3D mould was exported as an STL file and then 3D‐printed on a Stratasys Fortus 250 MC 3D Printer. During RARP, the specimen is extracted, the seminal vesicles detached and the prostate is placed in the mould for biopsy. The biopsy cores are sent to pathology for analysis and compared to specimens from the initial biopsy. Results Twelve patients with MRI‐visible lesions and biopsy proven GGG ≥ 2 cancer underwent RARP. In 12 out of 12 patients, ex vivo biopsies performed with the 3D‐printed mould yielded prostate tissue with cancer. Conclusions Our 3D‐printed mould platform allows for ex vivo sampling of MRI identified and previously biopsied prostate cancer at the time of RARP. The native, cancerous tissue may then be used to advance further research. The potential applications for a platform that can reliably sample living prostate cancer tissue are numerous, including the ability to advance future cancer research as well as other solid‐organ malignancies with targetable lesions.
Journals
2026 EN
Kazama Akira · MunozLopez Carlos · Attawettaya Worapat
+16 more
Abstract Objectives Our objective was to develop algorithms to predict adverse pathology (AP) and recurrence‐free survival (RFS) for patients with renal tumours primarily based on multifaceted analysis of preoperative CT imaging. Patients/Methods Seven hundred forty‐eight patients with non‐metastatic renal tumours managed with definitive surgery at Cleveland Clinic (2011–2014) were retrospectively evaluated (median follow‐up 9.1 years). All patients underwent contrast‐enhanced CT and parenchymal volume analysis using semi‐automated software. A variety of conventional radiological features were evaluated in addition to parenchymal volume replacement (PVR) due to invasive tumour growth, using the contralateral kidney as a control. Adverse pathology (AP) was defined as stage ≥pT3a, grade 3/4 or sarcomatoid/rhabdoid features. Multivariable logistic regression and Cox proportional hazards regression analyses were used to develop predictive models. Results Overall, 339/748 patients (45%) had AP, which significantly associated with reduced RFS. On univariable analysis, tumour‐size, degree of vascularity, heterogeneity, irregular contour, sinus margin irregularity, necrosis, non‐cystic tumour and increased PVR significantly associated with AP. On multivariable logistic regression, male sex, R.E.N.A.L. Nearness, heterogeneity, necrosis, sinus margin irregularity and PVR ≥ 25% independently associated with AP. Multivariable analysis indicated that tumour size, heterogeneity, necrosis, PVR ≥ 25% and tumour‐related symptoms significantly associated with reduced RFS. Models for AP and RFS at 3, 5 and 10 years showed area under the curve (AUC) values of 0.81 and 0.84–0.86, respectively. Conclusions These findings confirm that radiological features and PVR are associated with AP and reduced RFS after definitive renal cancer surgery. Our predictive models are entirely based on preoperative parameters and may improve patient counselling and occasionally preclude the need for renal mass biopsy.
Journals
2026 EN
Schneider Holm · Bunick Christopher G. · Hillmann Kathrin
+8 more
Abstract Congenital ichthyoses (CI) are rare, inherited skin disorders characterized by hyperkeratosis, scaling and fissuring that significantly impair patients' quality of life. Treatment options are limited, with systemic retinoids reserved for severe cases owing to their adverse effect profile. This open‐label, single‐arm, maximal‐use trial investigated the systemic exposure and safety of a topically administered isotretinoin ointment (TMB‐001 0.05%) in patients with moderate‐to‐severe CI. Thirty‐four patients aged ≥6 years applied TMB‐001 0.05% under maximal‐use conditions (twice daily to 75%–90% of the body surface area) for 14 days, with continued application for another 10 weeks. Exposure levels for TMB‐001 0.05% and its metabolites were < 1% of those observed after single oral administration of 80 mg isotretinoin to healthy adults. A majority of patients had local safety or tolerability issues, most of which were mild. Overall, the treatment was well tolerated with no evidence of systemic toxicity.
Journals
2026 EN
Mate OrsolyaAnna · Day Steven James · IbnMohammed Taofeeq
+1 more
ABSTRACT Logistics service providers (LSPs) can support the transition to a circular economy ( CE ) through their visibility over and facilitation of resource flows between supply chain (SC) actors. However, the proliferation of CE ‐related terms, compounded by a manufacturer‐centric focus on CE culminating in knowledge siloes that result in an overall reduction in conceptual clarity, constitutes a challenge. A further challenge is a lack of a unifying theoretical perspective, which currently impedes the consolidation of circular business models (CBMs) opportunities available to LSPs. Urgent interventions toward overcoming these two key challenges are therefore required. Accordingly, this paper systematically reviews existing academic literature ( N = 112), offering both descriptive and thematic analyses that synthesise CBMs and their applications, benefits and underlying capability requirements for LSPs. It also elucidates theoretical understanding through the novel application of a nested approach for examining the role of LSPs within the CE . Specifically, the adoption of the panarchy theory lens enabled the reinterpretation of insights garnered from the systematic review conducted. This yielded a new framework that incorporates three nested systems comprising the LSP, the SC and the broader logistics network, leading to propositions regarding the conditions that will enable LSPs to successfully adopt and implement CBMs. Wider practical implications and directions for future research are outlined.
Journals
2026 EN
Acharya Abhinav P. · Borrelli Matthew A. · Jurczak Michael J.
+2 more
Abstract Controlling the molecular transport of nutrients through the gut is an attractive strategy to modulate host metabolism. Herein, a technique of stress‐based evolution of an individual's own microbiota to enhance lipid metabolism is presented, which is based on sequential culture of these bacteria in higher concentrations of lipids. Using this technique, a probiotic formulation of bacterial colonies that exhibit increased lipid metabolism was generated from oral microbiota samples from mice, canine, and human sources. Mice fed a high‐fat diet (HFD) and administered lipid stress evolved (LSE) probiotics excreted increased lipids in stool and reduced triglyceride transport into the blood by three‐fold till 3 h post‐oral gavage of soybean oil, as compared to controls. In addition, these enhanced probiotics prevented weight gain in mice fed a HFD five‐fold better than controls and induced weight loss in mice with diet change three‐fold faster than diet change alone. In these mice, there was a marked change in appearance with a more healthy, less oily coat. Controlled metabolic cage experiments demonstrated that the total movement, food intake, and water intake were not significantly different between mice receiving LSE probiotic versus a control probiotic formulation, suggesting that important health measures are unchanged with LSE probiotic administration. Overall, this facile stress‐based culture technique can be utilized to modulate bacterial metabolism and applied to different industrial processes of probiotic generation and to affect different disease outcomes such as obesity.
Journals
2026 EN
Thida Aye Mon · Shah Ankita · (Steffens) Kelley Frederick
+5 more
ABSTRACT Background To evaluate trends in allogeneic hematopoietic cell transplant (HCT) referral perceptions and practices, we compared surveys of Hematology‐Oncology (Hem‐Onc) physicians conducted in 2015 ( N = 150), 2019 ( N = 302), and 2024 ( N = 183) and reported changes over time. Methods Eligible participants included Hem‐Onc physicians in the United States seeing at least 10 hematologic malignancy patients in the last year. Questions covered perceptions of HCT, referral practices, perceived barriers to referral, and endorsement of HCT education and patient support resources. Results There were positive trends in HCT perceptions, increased expected HCT benefit, and positive outcomes with older AML patients. Overall reported disease‐specific referral rates increased over the survey periods. Participants reported earlier HCT referral timing across the survey time periods for all diagnoses, as well as increased referral of AML in first complete remission (vs. later stages of disease). While reported barriers to HCT referral persist, 2024 responses (vs. 2019) had significant reduction in concern over finding a suitable HCT donor, adverse post‐HCT outcomes, patient age, and medical comorbidities or psychosocial barriers to HCT. Across all hematologic malignancies in 2024, the average maximum referral age was 73.5 years. Respondents indicated a strong desire for additional physician education and patient‐level support. Conclusions We identified positive trends in HCT perceptions and referral practices, and reduced barriers. Encouragingly, these trends suggest that evidence surrounding HCT benefit and broadened eligibility for HCT are reaching the larger Hem‐Onc community, and this may address historical barriers to access. Ongoing education and outreach are needed to facilitate additional progress.
Journals
2026 EN
Morse Lisa · Weiss Sandra · Ritchie Christine S.
+7 more
ABSTRACT Background Compared to younger patients, older patients report differences in the occurrence, severity, and distress of common symptoms associated with cancer and its treatment. Purpose Identify subgroups of younger and older patients with distinct symptom burden profiles and evaluate for risk factors associated with these profiles. Methods Oncology outpatients ( n = 1329) were dichotomized into younger (< 60 years) and older (≥ 60 years) groups. Data included demographic and clinical questionnaires and measures of global, cancer‐specific, and cumulative life stress, resilience, and coping. Memorial Symptom Assessment Scale evaluated the occurrence of 38 common symptoms. Separate latent class analyses were done within each age group to identify distinct symptom profiles. Differences among latent classes in demographic and clinical characteristics, stress, resilience, and coping were evaluated. Results In younger group ( n = 730), four profiles were identified (i.e., All Low (28.8%), Moderate Physical and Lower Psychological (21.9%), Moderate Physical and Higher Psychological (34.6%), All High (14.7%)). Compared to All Low class, All High class was younger, more likely to be female, had a higher comorbidity burden, and a lower functional status, as well as higher stress and lower resilience scores. In the older group ( n = 599), three profiles were identified (i.e., Low (34.4%), Moderate (47.9%), High (17.7%)). Compared to Low class, High class was more likely to be female, had a higher comorbidity burden and lower functional status, and received a more toxic chemotherapy regimen, as well as higher stress and lower resilience scores. Conclusion Study is the first to use latent class analysis to identify distinct symptom burden profiles in younger versus older oncology patients. In the younger group, differences in the occurrence of psychological symptoms differentiated among the symptom burden profiles. While some of the risk factors were similar, within the older group, patients in the High symptom burden class used a higher number of disengagement coping strategies.
Journals
2026 EN
Hammer Marilyn J. · Harris Carolyn · Pozzar Rachel
+10 more
ABSTRACT Context Limited information is available on the symptom burden and symptom clusters in cancer survivors. Objectives Describe the occurrence, severity, and distress of 44 symptoms; determine risk factors associated with a higher symptom burden; and evaluate for symptom clusters using symptom occurrence rates. Methods Survivors ( n = 1147) were recruited using an online survey. Symptom burden and symptom clusters were assessed using the Memorial Symptom Assessment Scale that included 44 symptoms and evaluated occurrence, severity, and distress. Simultaneous multivariable linear regression analysis was performed to determine risk factors associated with a higher symptom burden. Exploratory factor analysis was used to identify symptom clusters using ratings of symptom occurrence. Results Survivors reported an average ten concurrent symptoms. Survivors who are younger, female, with a higher comorbidity burden, evidence of metastatic disease, and a poorer functional status were at increased risk for a higher symptom burden. Six symptom clusters were identified (i.e., psychological cluster, cancer and treatment‐related cluster, respiratory cluster, pain cluster, weight loss cluster, epithelial cluster). Conclusion Additional research is warranted to confirm the prevalence rates for the various symptoms and symptom clusters; identify additional risk factors for a higher symptom burden; and determine the underlying mechanisms for the symptom clusters. Future studies need to develop and test targeted interventions for each of the symptom clusters within and across various types of cancer.