University of Iowa Health Care

Left ventricular noncompaction is characterized by excessive trabeculation and is variably associated with heart failure, arrhythmias, thromboembolism, and conduction disease. A 37-year-old man with palpitations and chest discomfort had intermittent high-grade (Mobitz II) atrioventricular block on event monitoring (3.7-second pause). Cardiac magnetic resonance revealed apicolateral hypertrabeculation with a diastolic noncompacted:compacted ratio of 3.5 without late gadolinium enhancement; transthoracic echocardiography showed preserved ejection fraction (60%). Electrophysiology recommended longitudinal rhythm surveillance with an implantable loop recorder; pacemaker was deferred. Genetic testing was advised but not authorized by insurance. Intermittent high-grade atrioventricular block can be an initial manifestation of left ventricular noncompaction with preserved systolic function. Recognition of this association supports advanced imaging in unexplained conduction disease in young adults and favors loop-recorder-guided surveillance with multidisciplinary follow-up, including genetics. Unexplained high-grade atrioventricular block in a young adult should prompt advanced structural evaluation-including cardiac magnetic resonance-to exclude left ventricular noncompaction and other cardiomyopathies. Preserved ejection fraction and absent late gadolinium enhancement can coexist with clinically relevant conduction disease in left ventricular noncompaction. Implantable loop recorder-guided surveillance enables individualized timing of device therapy and complements genetic evaluation and cascade family screening.

Abstract. Low-cost sensor networks offer an affordable option for long-term air quality and noise monitoring, but their performance can be limited by calibration drift. This study quantified drift in low-cost particulate matter (PM) and sound level sensors using measurements from three co-located units and reference instruments deployed in two contrasting indoor environments: a lower-concentration painting environment and a higher-concentration swine environment. Drift varied substantially by environment. In the painting environment, drift in both PM10 and sound sensors was small (PM10: 2.1 μg m-3 per year; sound: 0.78 dBA per year) and either within or near expected performance ranges based on manufacturer specifications and sound level tolerance criteria. In the swine environment, PM10 sensors exhibited rapid degradation (−46.2 μg m-3 per year), indicating substantial time-dependent drift under elevated particulate concentrations. Incorporating a drift term in the calibration model reduced RMSE and MAE by approximately 11 % in the swine environment, with negligible improvements in the painting environment. Sound sensors showed minimal drift and strong inter-sensor agreement across both deployments. These findings highlight the need for environment-specific recalibration strategies for low-cost PM sensors and demonstrate that drift-aware modelling can improve measurement reliability and support maintenance and lifecycle planning in high-concentration settings, with future work investigating how particulate characteristics and operating conditions influence drift.

To evaluate the effectiveness and safety of platelet-rich plasma (PRP) for acute hamstring injuries, with attention to return-to-play (RTP) time, reinjury rates and adverse events. Systematic review and meta-analysis of randomised controlled trials (RCTs). Risk of bias was assessed using the Cochrane tool; certainty of evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Databases included Embase, MEDLINE, Web of Science, Elsevier and Cochrane Central searched through March 2025. RCTs comparing PRP to control treatments for acute hamstring injuries were included. Non-randomised and chronic tendinopathy studies were excluded. Six RCTs (n=277) were included. PRP reduced RTP time versus control (mean difference -8.6 days; 21.4 vs 30.0 days; 95% CI -3.04 to -0.03; p=0.045), though heterogeneity was high (I²=94.1%). Reinjury (15% vs 16%; p=0.722) and adverse event rates (1% vs 0%; p=0.687) did not differ. Certainty of evidence was rated as low to moderate due to risk of bias and imprecision. PRP may shorten RTP in acute hamstring injuries, especially when image-guided. Reinjury risk appears unchanged. Further trials are needed to confirm these findings and standardise biological use in muscle injuries. CRD420251109346.

To compare characteristics of patients seeking comprehensive versus urgent care at a university dental school clinic, particularly regarding self-reported history of primary care provider (PCP) visits in the previous year. In this retrospective chart review, electronic data were collected from patients seen at the admissions clinic between 2016 and 2021. Patients were dichotomized based on their choice of comprehensive care (CC) versus urgent care (UC). Univariate, bivariate, and multivariable statistical analyses were conducted. Among approximately 28,000 patients, 57% sought CC while 43% sought UC. From 2016 to 2021, the proportion of patients seeking CC increased steadily from 52% to 63%. In multivariable analyses comparing patients who chose CC versus UC, the variables most strongly associated with being in the UC group were: not having seen a PCP in the year prior to the dental appointment (OR=1.67, 95% CI=1.52-1.83), being 25-44 years old (OR=1.21, 95% CI=1.08-1.36), being self-pay (OR=1.41, 95% CI=1.27-1.57), having blood pressure values in the prehypertensive, Hypertensive I, or Hypertensive II stage (OR=1.25, 1.47, 2.05 respectively; 95% CI=1.13-1.38, 1.28-1.68, 1.52-2.76, respectively), and being obese Class III (OR=1.46, 95% CI=1.25-1.70). Patients who sought urgent care were more likely to report not having seen a PCP in the previous year compared to patients who chose CC, after controlling for important confounding variables. Possible clinical and educational implications are discussed.

Enhanced myometrial vascularity (EMV) is a common postpregnancy (ie, postpartum, postpregnancy termination, and postpregnancy loss) sonographic finding that represents involuting myometrial hypervascularity of the placental bed in the early puerperium and may persist if retained products of conception (RPOC) are present. On color Doppler US images, EMV is characterized by tortuous and dilated myometrial vessels with high-velocity and turbulent flow. These features can be easily mistaken for an arteriovenous malformation (AVM). However, despite sharing overlapping flow patterns, AVM and EMV are fundamentally distinct. AVMs are vascular congenital malformations, whereas EMV is a dynamic finding in the postpregnancy state related to persistent or involuting uteroplacental circulation. Most EMVs that come to medical attention regress spontaneously after expulsion of the associated RPOC. AVMs, on the other hand, are not associated with pregnancy, do not regress spontaneously, and are difficult to treat, often requiring repeated embolization sessions with liquid embolic agents. By becoming familiar with EMV, radiologists may better serve patients and referring clinicians with guidance for further investigation or treatment (when appropriate), thereby preventing unnecessary interventions, hysterectomies, or potential complications associated with such treatments. The authors clarify the definitions of EMV, AVM, and other pertinent terms, discuss the physiology of the uteroplacental circulation and postpregnancy EMV, address the pathogenesis of persistent EMV associated with RPOC, and provide an overview of the imaging features and management of EMV. ©The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article. See the invited commentary by Kirsch and Ponder in this issue.

Introduction: Intracranial stenting during endovascular thrombectomy (EVT) is a common practice in the setting of failed reperfusion or severe stenosis. Immediate stent patency requires periprocedural antiplatelet therapy (APT). How APT intensity interacts with prior intravenous thrombolysis (IVT) to influence hemorrhagic risk remains uncertain. We aimed to assess whether the APT regimen modifies the association of IVT with early intracranial hemorrhage after intracranial stenting during EVT. Methods: This was a subanalysis of the RESISTANT registry, a multicenter, international, retrospective cohort (2016 to 2023) of adults with acute ischemic stroke who underwent intracranial stenting during EVT. APT regimens were categorized as conservative (intravenous or oral aspirin alone, or aspirin plus an oral P2Y12 inhibitor) and aggressive (any regimen including intravenous GPIIb/IIIa inhibitor or intravenous cangrelor). Four main groups were compared according to the APT regimen (conservative/aggressive) and the use of IVT (+/-). The primary outcome was a composite of sICH and parenchymal hematoma types 1 and 2 (sICH-PH2-PH1). Multivariable logistic regression models were used to evaluate the interaction between IVT and APT, adjusting for clinically relevant covariates. Results: Among the 823 included patients, 44 (5.3%) received conservative APT with IVT, 130 (15.8%) received conservative APT without IVT, 145 (17.6%) received aggressive APT with IVT, and 504 (61.2%) received aggressive APT without IVT. Among patients who received IVT, sICH-PH2-PH1 rates were 9.3% with conservative APT and 10.7% with aggressive APT; among those without IVT, rates were 3.2% and 9.9%, respectively. Administration of IVT (adjusted odds ratio [aOR] 5.84, 95%CI 1.07 to 43.92; p=0.05) and aggressive APT (aOR 4.81, 95% CI 1.41 to 30.22; p=0.03) were each associated with higher odds of hemorrhagic complications, with a significant IVT by APT interaction (P interaction =0.05; Figures 1 and 2 ). Within the aggressive APT plus IVT subgroup, sICH-PH2-PH1 occurred in 20% of patients treated with cangrelor and 6.1% treated with a glycoprotein IIb/IIIa inhibitor ( Figure 3 ). Conclusion: Among patients requiring intracranial stenting, aggressive periprocedural APT and prior IVT are each associated with higher hemorrhagic risk, with the combination showing the worst observed crude outcome. Prospective evaluation of protocolized APT pathways in the IVT setting is warranted.