Cleveland Clinic

Pooled Analysis of Valve‐in‐Valve and Valve‐in‐Ring Transcatheter Mitral Valve Replacement Using the SAPIEN Valve

Background Transcatheter mitral valve replacement (TMVR) using the Sapien (Edwards Lifesciences, Irvine, CA) transcatheter heart valve has become the preferred treatment for high‐risk patients with failed mitral bioprosthetic valves or prior surgical mitral valve repairs. Differe...

Persistent Challenges in Nuclear Grading of Clear Cell Renal Cell Carcinoma: A Survey of Pathologists

BackgroundGrading of clear cell renal cell carcinoma now focuses on the prominence of the nucleolus; however, there may be variability in how pathologists interpret this criterion.MethodsAn online survey was distributed via email and social media to pathologists.ResultsExcluding...

Establishment, Implementation, and Sustainability of Digital Dentistry in Dental Schools

ABSTRACT Digital dentistry technology and its workflows offer important benefits, including advancements in patient care and diagnostic capabilities. Dental schools have been adopting and integrating these advanced technologies into their educational and patient care practices. T...

Outer Retinal Volume on Macular OCT Predicts Two-Year Diabetic Retinopathy Progression

Purpose: To evaluate whether baseline retinal volume from macular optical coherence tomography (OCT) is associated with diabetic retinopathy (DR) progression over two years. Methods: In this longitudinal observational study, 190 eyes from 121 patients, across the DR severity spec...

The Evolution of Fitness Landscapes: From Visualizing Evolution to Controlling It

Fitness landscapes have long served as a conceptual tool in evolutionary biology. In recent years, however, they have shifted from being viewed primarily as theoretical constructs to being used to interpret experimental data and, increasingly, to guide evolutionary outcomes in bi...

High-grade astrocytoma with piloid features: a clinical and genomic analysis of prognostic factors using a large cohort

BACKGROUND: High-grade astrocytoma with piloid features (HGAP) is a recently defined tumor type that is not well-understood. Prognostic factors of clinical outcomes are not well-established. METHODS: Methylation profiling was performed on tumor samples, many at the National Cance...

Divergent Hypoxia-Inducible Factor 2-Alpha Signaling in Alcoholic Liver Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease

Abstract Fatty liver disease, including both metabolic dysfunction-associated steatotic liver disease (MASLD) and alcoholic liver disease (ALD) types, is an increasing global health issue, with escalating rates of illness and death. A key player in the progression of these liver...

Deep Brain Stimulation: A Window Into the Neural Mechanisms of Latent Nystagmus

Purpose: Latent nystagmus is a condition marked by a nasal-ward drift of the eye that reverses depending on the fixating eye. It is commonly associated with early-onset strabismus and amblyopia and is hypothesized to result from disrupted horizontal binocular connections in the p...

A comparative meta-analysis of amniotic membrane preservation methods: Balancing biological potency and clinical feasibility in ophthalmology

Objectives: The objective of the study is to systematically compare biological and structural properties of fresh, cryopreserved, lyophilized, and dehydrated human amniotic membrane (AM) and to quantify sufficiently comparable outcomes across preservation methods. Material and Me...

Prioritizing Global Health Education in Pulmonary and Critical Care Fellowships: An Applicant Survey

Abstract Background Global Health (GH) is expanding, offering an increasing number of opportunities for engagement to trainees in medical schools and residency programs. This expansion of opportunities has not yet reached those at the fellowship level, particularly in Critical Ca...

Age May Not be a Barrier: Cementless Total Knee Arthroplasty Yields Equivalent or Superior PROMs in Older Adults at One Year

Abstract Background Cementless total knee arthroplasty (TKA) is increasingly being used across the age spectrum, yet its impact on patient-reported outcomes (PROMs) in older adults remains understudied. As value-based care initiatives prioritize PROMs such as pain relief, functio...

Widespread Loss of Heterozygosity and Endoreduplication in Odontogenic Myxoma

Odontogenic myxoma (OM) is an uncommon, locally aggressive odontogenic neoplasm with characteristic histologic and clinico-radiographic features but with potential for histologic overlap with other odontogenic and non-odontogenic entities and a non-specific immunoprofile. Widespr...

Differential regulation of basal and interferon-induced APOL1 gene expression in podocytes

APOL1 genetic variants associated with kidney disease become pathogenic when APOL1 gene expression is induced to high levels, however, the mechanism of APOL1 gene regulation is not well characterized. Using human podocyte cell lines, the induction of APOL1 gene expression from va...

Short-term air pollution exposure and hospitalizations in idiopathic pulmonary fibrosis: data from the IPF-PRO Registry

Abstract Rationale While long-term exposure to ambient air pollution in patients with idiopathic pulmonary fibrosis (IPF) has been associated with an increased risk of disease progression and mortality, the risks associated with acute exposure are less clear. Objective To determi...

Alterations of endothelial cell bioenergetics in congenital diaphragmatic hernia

Abstract Background Pulmonary vascular development in congenital diaphragmatic hernia (CDH) is characterized by impaired angiogenesis and pathologic remodeling that contribute to pulmonary hypertension/hypoplasia. Mitochondria regulate endothelial energy, redox balance, and angio...

Management of Soft Tissue and Visceral Leiomyosarcomas

Importance Leiomyosarcoma is a rare and heterogeneous malignant mesenchymal neoplasm associated with substantial morbidity and mortality. Given recent advances in biologic understanding and the complexity of leiomyosarcoma, a consensus-driven approach is needed to harmonize manag...

Burden and Risk Factors for Severe Respiratory Syncytial Virus Infection Among Pediatric Hematopoietic Cell Transplant Recipients

BACKGROUND: Respiratory syncytial virus (RSV) causes substantial morbidity in pediatric hematopoietic cell transplant (HCT) recipients; however, risk factors for severe disease remain incompletely characterized. METHODS: We conducted a multicenter retrospective cohort study acros...

Hypoxia‐inducible factor‐1a (HIF1a) as a context‐dependent integrator of metabolic stress in skeletal muscle

Skeletal muscle experiences large fluctuations in ATP demand and redox state during contraction, ischaemia and chronic disease, requiring rapid adaptations in substrate selection, mitochondrial workload, vascular coupling, regeneration and protein homeostasis. Hypoxia-inducible f...

Low-pressure pneumoperitoneum in robot-assisted radical prostatectomy: a systematic review, meta-analysis and trial sequential analysis of randomized controlled trials

Abstract Purpose Low-pressure (LP) pneumoperitoneum (intra-abdominal pressure [IAP] <12 mmHg) has been proposed to reduce pain after robot-assisted radical prostatectomy (RARP), but earlier syntheses combined randomized with non-randomized data, pooled mixed urological procedures...

Instrumental activities of daily living in older adults with epilepsy: A cross‐sectional and longitudinal multicenter study

OBJECTIVE: Instrumental activities of daily living (IADLs) represent a critical but understudied measure of day-to-day function in people with epilepsy (PWE). In the multicenter Brain Aging and Cognition in Epilepsy (BrACE) study of PWE ≥55 years of age, we examined the proportio...