Florida Memorial University

Treatment algorithms for hepatocellular carcinoma (HCC) account for tumor burden/stage and severity of liver disease. There are conflicting data on the differential benefit of curative versus non-curative treatments based on BCLC stage. Therefore, we sought to leverage a nationally representative sample of patients in the Veterans Health Administration (VHA) to address this question. We performed a retrospective cohort study of patients with cirrhosis and HCC in the VHA. We conducted a landmark analysis and fit survival models, censored at 3 years, to evaluate the association of treatment type based on the highest level (non-curative vs. curative vs. combination), stratified by BCLC stage, for patients with early-stage to intermediate-stage HCC. We evaluated 1191 patients with confirmed HCC (535 received only non-curative treatment, 227 only curative, and 429 received a combination of curative and non-curative). Among BCLC-0 patients, patients who received curative-intent therapy had significantly better survival at all time points compared with patients receiving non-curative treatment only (HR ranging from 0.53 at 6 months to 0.77 at 3 years). In contrast, for patients with BCLC-A stage disease, receiving either curative treatment alone or combination therapy was associated with significantly better survival compared with non-curative treatment (HR ranged from 0.41 to 0.76 over the study period). However, for BCLC-B stage disease, only combination therapy had significantly better survival (HR 0.44 at 6 months to 0.65 at 3 years). Our real-world data demonstrate that among patients with early-stage to intermediate-stage HCC, curative-intent treatment is associated with the best survival for patients with BCLC-0 and BCLC-A stage disease, while combination therapy yields the best outcomes in patients with BCLC-B stage disease.

“Inclusive” research has long been championed by scholars and activists in the fields of critical disability and critical gerontology. Despite this, there remain gaps in knowledge, with a notable paucity of research on the intersection of old age and neurodiversity. Debates persist regarding what counts as “inclusive” and how to assess the catalytic and transformative potential of “inclusive” research beyond the level of rhetoric, particularly in the context of interviewing people with experiences of intense social exclusion. Studies on aging with neurodiversity remain influenced by biomedical discourses insofar as the focus on “comorbidity” often overshadows the exploration of sociopolitical factors. The ways in which this research creates conditions of hyper/visibility (reduction of people to their “pathology” as patients or clients) and in/visibility (disregard for their voices, strengths, and agency) are cause for great concern. Our paper asks 3 related questions: (1) What counts as “inclusive” research on aging with neurodiversity? (2) Is it possible to move towards “transformation” in the operationalization of such research? (3) How do we do it? Using our research by way of illustrative example, we hope to create a dialogue with the reader about the possibilities and pitfalls of “inclusive” intersectional research praxis.

Abstract The formation of interpenetrating polymer networks (IPNs) in polysaccharide-based hydrogels is influenced by ion valency and coordination chemistry. In this work, hyaluronic acid (HA) and kappa-carrageenan ( κ -CG) were combined at low polymer concentrations suitable for injectable hydrogel applications and enriched with monovalent (K + ), divalent (Ca 2+ ), and trivalent (Al 3+ ) ions to investigate ion-specific contributions to network formation, structure and recovery. FTIR spectroscopy showed that K + did not produce detectable sulfate or carboxylate shifts, consistent with a predominantly physical mixture and the absence of IPN formation. Ca 2+ induced concentration-dependent shifts in both the amide/carboxylate region and the sulfate band (1232 → 1236 cm −1 ), absent at a low concentration but reemerging at higher concentrations, consistent with local chain compaction, complexation of HA carboxylates and bridging between κ -CG helices, indicating promotion of a semi-interpenetrated network structure above a thresh-old concentration. Al 3+ induced a distinct shoulder in the HA carboxylate region, confirming HA coordination and co-crosslinking with κ -CG, yielding a semi-IPN. Microrheology showed progressively stronger local confinement with increasing ion valency corroborating insights from spectroscopy, while recovery tests showed Ca 2+ attained the highest recovery potential possibly due to more robust network formation, Al 3+ systems displayed moderate recovery but overscreening at high concentrations resulted in network collapse, and K + systems displayed poor recovery.Importantly, these ion-specific outcomes must be interpreted in the context of combined electrostatic screening effects, which contribute to charge neutralization and polymer chain association independent of coordination chemistry. Collectively, these findings highlight ion charge as critical design levers which may be leveraged in tailoring mechanical properties of interpenetrating network hydrogels for injectable applications. Graphical Abstract Highlights Incorporation of κ -carrageenan ( κ CG) into a chemically unmodified hyaluronic-acid (HA) based hydrogel even at low concentrations is a potentially viable route for more efficient structuring. Interpenetrating network formation, structure and recovery of HA– κ CG networks can be tuned by charge density and coordination behavior of the crosslinking ion. Ca 2+ reinforces κ CG junction zones, yielding the highest elastic moduli and recovery capacity, with evidence of semi-IPN formation pointing to more robust network formation relative to Al 3+ and K + .

Mycobacterial spindle cell pseudotumors (MSCPs) are rare lesions characterized by the proliferation of spindle-shaped histiocytes caused by mycobacterial infections. MSCPs have been reported in the lung, lymphatic system, and skin of immunodeficient patients. We present the case of a spindle cell pseudotumor of the pancreas in a 30-year-old male with advanced human immunodeficiency virus (HIV) infection, which led to biliary stricture, splenomegaly, chronic pancreatitis, portal hypertension, compression of the hepatic artery and portal vein, and ascites. This was the patient’s third mycobacterial infection diagnosis. The MSCP was diagnosed via endoscopic biopsy after two prior non-diagnostic biopsies of the pancreatic lesion. Following 18 months of tailored antimycobacterial therapy, the pancreatic mass resolved radiographically with normalization of liver tests and sustained clinical improvement, and there has been no relapse more than 8 months after treatment completion. This case highlights the presentation of an MSCP in a unique anatomic location not previously documented and the challenges encountered with diagnosis and management.

ABSTRACTPredatory journals are a known hazard in modern academic research publishing, with research and anecdotal accounts indicating that they exploit inexperienced researchers. Most literature on the topic centres on specific disciplines and/or countries deemed ‘more vulnerable’ to publishing scams. At the time of publication, no studies have examined a full range of disciplines at institutions across the United States. Our research collected responses from 1098 faculty at 17 US doctoral universities using a multi‐disciplinary survey to assess self‐reported knowledge and awareness of predatory publishing. In this analysis, we investigated participants' reported knowledge levels of predatory journals in relation to four aspects: academic discipline, years employed in academic research, number of articles published, and early career researcher status. We conclude that the relationship between experience and knowledge of predatory publishing depends on the definition of experience employed, and that the number of recent articles published by a faculty member is a more reliable indicator of knowledge about predatory publishing than the other measures of experience investigated.

A esclerose múltipla (EM) é uma doença crônica do sistema nervoso central que provoca lesões desmielinizantes e afeta a condução dos impulsos nervosos, a doença afeta em maior número em adultos jovens do sexo feminino. O diagnóstico precoce e o acompanhamento da esclerose múltipla são essenciais para melhorar e acompanhar a evolução e tratamento da doença. É uma doença inflamatória autoimune com predisposição genética e ambiental ainda em estudo. A EM pode ser classificada em quatro tipos (EMRR), (EMPP), (EMPS), (EMPR). De acordo com a OMS, em 2024, estima-se que 28 milhões de pessoas são portadoras de EM globalmente e no Brasil aproximadamente 40 mil. A ressonância magnética (RM), especialmente com a técnica de Transferência de Magnetização (MTC), é um método primordial na detecção dessas lesões ao interagir especificamente com os tecidos afetados proporcionando informações detalhadas sobre a composição química e estrutural, auxiliando no diagnóstico. O presente trabalho relata o papel da técnica de Transferência de Magnetização (MTC) na Ressonância Magnética para uma detecção mais precisa da esclerose múltipla e discute o quanto essa técnica é importante no diagnóstico e no tratamento mais eficaz da doença. Ademais com o avanço tecnológico a Inteligência Artificial (IA) na RM tem demonstrado através de algoritmos subtipos baseados em RM que preveem o desenvolvimento da EM e a resposta ao tratamento podendo ser usado para conceituar grupos de pacientes em ensaios intervencionistas.

Vascular diseases, including peripheral arterial disease (PAD), pulmonary arterial hypertension, and atherosclerosis, significantly impact global health due to their intricate relationship with vascular remodeling. This process, characterized by structural alterations in resistance vessels, is a hallmark of heightened vascular resistance seen in these disorders. The influence of environmental estrogenic endocrine disruptors (EEDs) on the vasculature suggests a potential exacerbation of these alterations. Our study employs an integrative approach, combining data mining with bioinformatics, to unravel the interactions between EEDs and vascular remodeling genes in the context of PAD. We explore the molecular dynamics by which EED exposure may alter vascular function in PAD patients. The investigation highlights the profound effect of EEDs on pivotal genes such as ID3, LY6E, FOS, PTP4A1, NAMPT, GADD45A, PDGF-BB, and NFKB, all of which play significant roles in PAD pathophysiology. The insights gained from our study enhance the understanding of genomic alterations induced by EEDs in vascular remodeling processes. Such knowledge is invaluable for developing strategies to prevent and manage vascular diseases, potentially mitigating the impact of harmful environmental pollutants like EEDs on conditions such as PAD.