Superior mesenteric artery syndrome patients with hypoglycaemic brain injury can Be treated with nutritional therapy. A case report.

Fibroblast Growth Factor 23 in CKD: Getting Closer to Prime Time?

Kidney Protection Options in 2025: Are Renin-Angiotensin System Inhibitors Still Needed?

Clinical diagnosis of sarcopenia: Is it finally ready for prime time?

Artificial intelligence in diagnostic, prognostic, and predictive genomic biomarkers for prostate cancer: Ready for prime time?

For over two decades, the mevalonate pathway has been in focus as an interesting therapeutic target in the Philadelphia-chromosome negative myeloproliferative neoplasms (MPNs). Initially explored for its potential in cytoreductive and antithrombotic therapy, the role of statins in MPNs is now experiencing a compelling renaissance. This renewed interest is fueled by the recognition of MPNs as "a human inflammation model," driven by chronic inflammation that fuels clonal expansion, premature atherosclerosis, fibrogenesis, and an increased risk of second cancers and comorbidities. Statins possess a wide spectrum of pleiotropic effects beyond lipid-lowering, including anti-inflammatory, antiproliferative, pro-apoptotic, anti-angiogenic, and antifibrotic properties. They dampen the activation of leukocytes, platelets, and endothelial cells. Recent epidemiological studies from Denmark demonstrate that statins protect against the development of MPNs in the general population. Furthermore, emerging clinical data suggest that statins enhance the efficacy of interferon-alpha (IFN-α), the only known therapy capable of directly targeting the malignant stem cell and inducing minimal residual disease (MRD) in a subset of patients. This review traces the 20-year journey of the statin-in-MPN concept, from its mechanistic rationale to the present, where a confluence of evidence from comorbid disease prevention and onco-immunology is supportive of their upfront use. I posit that we are at a watershed moment, where statins should be integrated into the upfront treatment of MPNs and in combination therapy strategies, particularly with IFN-α, and potentially with ruxolitinib and metformin, to extinguish the chronic inflammatory drive and fundamentally alter the natural history of these neoplasms.

Chronic obstructive pulmonary disease (COPD) is a major global health burden, affecting over 392 million individuals and causing approximately 3.3 million deaths annually. Although spirometry remains the cornerstone for diagnosing airflow limitation, it incompletely reflects the structural and biological heterogeneity of the disease, and many smokers with preserved spirometry exhibit substantial parenchymal and airway abnormalities. Advances in imaging-particularly quantitative CT (QCT), magnetic resonance imaging (MRI), and positron emission tomography (PET)-enable comprehensive assessment of structural, functional, and inflammatory processes in COPD. QCT-derived emphysema metrics, including the 15th percentile lung density, mean lung density, and low-attenuation area percentage, are reproducible, sensitive to progression, and widely used as outcome measures. Small airway disease can be characterized using parametric response mapping and complementary voxel-based indices that detect subclinical gas trapping and regional volume changes. The concept of mechanically affected lung highlights functionally impaired regions adjacent to emphysema that contribute to disease progression and mortality. Airway remodeling metrics, such as Pi10, PiSlope, tapering slope, and airway fractal dimension, further provide prognostic information. Mucus plug burden independently predicts mortality and represents a potential surrogate endpoint in therapeutic trials. Advanced MRI techniques and ^18F-FDG PET offer radiation-free or inflammatory insights, respectively. Current evidence supports that imaging is ready to evolve from an adjunct to a core element of COPD research and care.

Tumour infiltrating lymphocyte (TIL) therapy offers the potential for durable clinical benefit in select patients with advanced melanoma, especially after progression on treatment with immune checkpoint inhibitors and/or targeted therapies. The 2024 FDA approval of Lifileucel (Amtagvi), a commercially manufactured autologous TIL product, marks a key milestone in integrating advanced therapy medicinal products (ATMPs) into routine care for solid tumours. Health Canada has since approved Lifileucel, with regulatory and funding decisions across the UK and Europe still pending. In this Perspective, we review the evidence base and outline key considerations for national adoption of TIL therapy. Despite promising results from clinical trials, TIL therapy requires complex coordination, including patient selection, tumour procurement, manufacturing logistics, lymphodepletion, and IL-2 administration; all contingent on specialised infrastructure and well-considered integrated care pathways. While commercial centralisation may ease logistical barriers, the high cost of TIL therapy necessitates careful health economic evaluation. A nationally coordinated effort is required to harmonise clinical prioritisation strategies, maintain oversight by multidisciplinary specialist tumour boards, and consider investment in future-proof decentralised manufacturing capacity. Collaborations and peer support such as through theAdvanced Therapy Treatment Centre (ATTC) Network will facilitate phased, experience-led rollout with equity-focused service design.

Barrett's oesophagus (BE) continues to rise in prevalence alongside oesophageal adenocarcinoma; understanding and identifying early neoplastic changes is critical. Crypt dysplasia (CD) in BE is an emerging concept characterised by dysplasia confined to the crypt base without surface involvement. Recent studies suggest that CD shares molecular alterations with low-grade and high-grade dysplasia, such as TP53 mutations and chromosomal instability, and may represent an early phase of neoplasia. Grading of CD remains inconsistent, with limited correlation to clinical outcomes, although classifying CD into low-grade and high-grade categories provides a practical diagnostic framework. High-grade crypt atypia typically warrants a diagnosis of CD, whereas low-grade crypt atypia poses greater diagnostic challenges and requires careful differentiation from reactive changes. This framework also incorporates exclusionary criteria, such as inflammation, ulceration and erosion. This review encompasses key features of CD, the diagnostic pitfalls encountered in clinical practice and the underlying biology driving crypt dysplasia. Future studies focusing on the natural history of CD, its molecular underpinnings and interobserver reproducibility will be pivotal in refining diagnostic criteria and improving patient outcomes in BE.

Lipoprotein(a) (Lp(a)) has the reputation of being the most misunderstood metric in laboratory medicine. The unique apolipoprotein(a) (apo(a)) in Lp(a) is very heterogenous, the kringle IV domain of apo(a) being formed by 12-50 kringles due to 3 to ∼40 KIV2 repeats. The variable number of repeated identical KIV2 domains causes KIV2-dependent antibodies to form different amounts of immunocomplexes with apo(a), leading to higher recovery for larger and lower recovery for smaller apo(a) particles than the calibrator. Consequently, the required identity between the analyte in samples and in assay calibrator(s), which is at the basis of any immunoassay, cannot be accomplished in the case of Lp(a). Global Lp(a) standardization was first attempted in the nineties by anIFCC Working Group on Lp(a) Standardization using an ELISA-based reference measurement procedure (RMP) with monoclonal anti-apo(a) antibodies against unique epitopes. WHO-IFCC reference material (RM), named SRM2B, was established with apo(a) expressed in molar units. Currently, a 2nd generation, ISO 15193 compliant, IFCC-endorsed multiplex RMP based on quantitative Mass Spectrometry (MS) has been developed. Traceability to SRM2B is maintained using a value transfer protocol that assigned values to commutable serum-based secondary RMs. ISO 15194 compliant serum-based RMs are currently available. A network of three calibration laboratories runs the harmonized apo(a) RMP. Equipped with a state-of-the-art calibration hierarchy for Lp(a) and using a 2-step approach, it is prime time for global Lp(a) standardization to ensure effective implementation of Lp(a) clinical guidelines and refined cardiovascular precision diagnostics.

Fewer stents for STEMI. Are DCBs ready for prime time?

Chimeric antigen receptor T cell therapy in prostate cancer: racing to prime time

Children with developmental language disorder (DLD) exhibit linguistic difficulties that may stem from deficits in predictive processing. Several studies report impaired lexical priming in DLD groups compared to age-matched groups with typical language development (TLD). However, other studies report compensatory enhancement of lexical-semantic processing, leading to larger priming effects in DLD. We used Bayesian meta-analysis to examine lexical priming and overall reaction time (RT) differences in age-matched groups of children with DLD and TLD (k = 19, m = 56, N = 360 DLD, N = 369 TLD; Mage [DLD] = 9.1 years). Moderators were priming type (semantic, form based) and response type (button press, verbal). Results are reported with outliers removed. Both DLD and TLD groups exhibited lexical priming effects (faster RTs for primed targets; Hedges's g = 0.22 and 0.33, respectively), with similar between-study heterogeneity. There were trivial differences in the effects for semantic versus form-based (repetition/phonological) priming and for tasks requiring button press versus verbal responses. While group differences in priming effects were negligible (slightly larger priming effects in TLD groups, g = 0.11), group differences in overall RTs were of medium magnitude (shorter RTs in TLD groups, g = 0.56). Children with DLD exhibit slower processing than age-matched peers with TLD but do not show impaired lexical priming. Discrepancies with prior findings may result from small samples and longer RTs contributing to nonsignificant priming effects in DLD groups. By de-emphasizing significance testing, Bayesian meta-analysis offers a more robust framework than frequentist meta-analysis for clinical research with small samples.

Vesical Imaging Reporting and Data System: Ready for Prime Time, Although Education Will Be Key.

Long form troponins: a promising new diagnostic tool but not quite ready for prime time.

Objectives: This study examines the relationship between sporting events and crime near sports venues based on a sample of Major League Baseball (MLB) and National Football League (NFL) regular season games. Methods: Open crime data drawn from 21 U.S. cities were analyzed using a quasi-experimental design that compared differences in crime around venues hosting home games to venues whose teams play an away game, at the same time, from 2015 to 2023. Results: Within one kilometer of sports venues, larceny, assault, and robbery rose when stadiums hosted games. Larceny and auto theft peaked before and after games, while assaults tended to occur after games, suggesting different opportunity structures across crime types. Conclusions: The relationship between sporting events and crime is sensitive to some analytic considerations, which in turn have important implications for criminological theory and strategies to mitigate the criminogenic effects of games.

BackgroundPre-exposure prophylaxis (PrEP) has been a significant advancement in the prevention of HIV infection. However, knowledge and attitudes among physicians regarding PrEP options and lack of PrEP education in residency curricula may limit adoption of this preventive service. The primary aim of this project is to assess the impact of asynchronous education of internal medicine (IM) and medicine-pediatrics (Med-Peds) residents on HIV PrEP prescribing practices.Figure 1.Differences in perceived barriers to not prescribing HIV PrEP for pre- (blue) vs post-intervention (orange) participantsFigure 2.Differences in confidence levels in prescribing HIV PrEP for pre- (blue) vs post-intervention (orange) participantsMethodsAsynchronous education consisted of an in-person lecture, an online case-based module, and dissemination of a standardized clinical practice guideline to IM and Med-Peds residents and teaching attendings at three community health clinics within Baystate Health system. The impact was assessed through cross-sectional, anonymous online surveys via Research Electronic Data Capture, evaluating knowledge, attitudes, and beliefs about HIV PrEP before and four months after the educational campaign.Figure 3.Attitudes on incorporating HIV PrEP education into residency curriculum among post-intervention participantsResultsThere were 42 and 30 participants in pre-intervention and post-intervention surveys, respectively. 60% of post-intervention respondents completed at least one component of the educational campaign. Significant barriers to prescribing identified in the pre-intervention survey included lack of knowledge (64%) and lack of education (43%). In comparison, after the intervention, 33% and 20% of participants cited lack of knowledge and lack of education, respectively (Figure 1). 66% of residents reported they were “Not confident” or “Less confident” in their prescribing abilities before the intervention. After the intervention, only 30% were “Not confident” or “Less confident” (Figure 2). Lastly, 90% of participants indicated that they "Agreed" or "Strongly Agreed" that PrEP education should be a required component of the residency curriculum (Figure 3).ConclusionUnderstanding baseline knowledge and attitudes toward prescribing HIV PrEP and perceived barriers in the trainee setting has important implications for community health and graduate medical education. Our project highlights the critical need to incorporate HIV PrEP education into residency training. Key limitations included incomplete delivery of the educational intervention to all intended participants and a small sample size.DisclosuresArmando Paez, MD, AstraZeneca: Grant/Research Support|Nanobiosym: Grant/Research Support

In contemporary media-driven societies, the reporting of sexual offence cases has increasingly shifted from factual narration to narrative construction, often portraying the accused as presumptively guilty even before the commencement of trial. Prime-time television debates, digital news platforms, and social media trials frequently engage in sensationalism that undermines the foundational principles of criminal justice, particularly the presumption of innocence and the right to a fair trial. This research paper critically examines the phenomenon of media-constructed criminality in sexual offence reporting through the lens of due process jurisprudence. It analyses how media narratives influence public perception, judicial neutrality, and procedural fairness, thereby transforming the accused into a symbolic offender in the court of public opinion. The paper evaluates constitutional guarantees, criminal procedure safeguards, and judicial responses to trial by media, with special reference to sexual offence cases where emotions, morality, and public outrage dominate discourse. It argues that while media plays a vital role in exposing crime and empowering victims, unregulated and prejudicial reporting risks violating due process and compromising justice itself. The study concludes by proposing regulatory, judicial, and ethical reforms to balance freedom of expression with the imperatives of fair trial and dignity of all stakeholders.

Progress in reducing the burden of preterm birth: Are we ready for PRIME time?

Sex-Specific Coronary Artery Calcium Score Thresholds Predictive of Obstructive Coronary Artery Disease: Ready for Prime Time?