Social and emotional well-being intervention to reduce stress, anxiety, and depression among Ukrainian refugees resettled in Massachusetts.

BACKGROUND: Mental health problems are high among refugees due to their traumatic experiences of fleeing war and witnessing disasters and deaths due to violence and conflict. Refugees are exposed to various socio-cultural stressors during their migration journey before, during, and after arriving at the host country, which may increase their risk of mental health problems. Strength-based interventions may be beneficial to address their socio-cultural and psychological stressors by strengthening individual's strengths to address their problems. AIMS: This study evaluated the effect of a Social and Emotional Wellbeing intervention on mental health (stress, anxiety, and depression) and emotional health outcomes (coping, self-efficacy, social support, and conflict resolution) among Ukrainian refugees in Massachusetts. METHODS: We implemented intervention (once-weekly/5-week) among 31 Ukrainian refugees with pre-and post-assessment of mental and emotional health outcomes (2022-2023). The intervention consisted 5-module: managing stress and mind-body exercise, strengthening communication and social networking, problem-solving, and creating a healthy family environment. Validated scales were used to measure mental and emotional health outcomes, such as the Hopkins-Symptom-Checklist-25 for anxiety and depression and the Cohen-Perceived-Stress scale for stress. Paired t-test was used for data analysis. RESULTS: The pre versus post-intervention proportion reduced for anxiety (61.29% vs. 22.58%) and depression (58.06% vs. 22.58%). The mean scores significantly decreased from pre- to post-intervention by 6.26 points for stress, by 7.07 points for anxiety, and by 6.29 points for depression (both p's < .01). The mean scores significantly increased for coping (by 15.71), emotion-focused engagement (4.48), problem-focused engagement (4.80), social support (8.77), problem-focused coping self-efficacy (14.93), stop unpleasant emotions and thoughts (12.74), and friends networking (3.48; all p's < .01). CONCLUSIONS: The stress, anxiety, and depression were reduced, and coping, self-efficacy, and social support networking skills were improved among Ukrainians after intervention. This program should be replicated in the larger community for a wider benefit.

Pharmacokinetics of nano- and microcrystal formulations of low solubility compounds after intramuscular injection to mice.

OBJECTIVES: The aim of this study was to investigate the pharmacokinetics (PK) of poorly soluble compounds when administered intramuscularly (i.m.) as crystalline particles of different sizes. METHODS: Three uncharged compounds (griseofulvin, AZ'72, and AZ'07) with varying aqueous solubility were dosed to mice at 10 and 50 mg/kg as nano- and microparticle formulations. The PK of the compounds was evaluated. KEY FINDINGS: The smaller particles of the drugs resulted in higher maximum plasma concentration (Cmax) and area under the plasma concentration-time profile (AUC) at 50 mg/kg. There was a dose-proportional increase in AUC but less than dose dose-proportional increase in Cmax. The evaluation at 10 mg/kg was more complex as increased exposure for nanoparticles was only observed for griseofulvin which has the highest solubility. In addition, there was an increase in half-life with an increase in dose. CONCLUSIONS: This study highlights that general expectations based on in vitro dissolution (i.e. that smaller particles dissolve faster than larger particles when surrounded by liquid) do not always translate to in vivo and demonstrates the importance of understanding the physicochemical properties of the drug, the characteristics of the formulations and the microphysiology at the delivery site.

Integrating knowledge graphs into machine learning models for survival prediction and biomarker discovery in patients with non-small-cell lung cancer.

Accurate survival prediction for Non-Small Cell Lung Cancer (NSCLC) patients remains a significant challenge for the scientific and clinical community despite decades of advanced analytics. Addressing this challenge not only helps inform the critical aspects of clinical study design and biomarker discovery but also ensures that the 'right patient' receives the 'right treatment'. However, survival prediction is a highly complex task, given the large number of 'omics; and clinical features, as well as the high degree of freedom that drive patient survival. Prior knowledge could play a critical role in uncovering the complexity of a disease and understanding the driving factors affecting a patient's survival. We introduce a methodology for incorporating prior knowledge into machine learning-based models for prediction of patient survival through Knowledge Graphs, demonstrating the advantage of such an approach for NSCLC patients. Using data from patients treated with immuno-oncologic therapies in the POPLAR (NCT01903993) and OAK (NCT02008227) clinical trials, we found that the use of knowledge graphs yielded significantly improved hazard ratios, including in the POPLAR cohort, for models based on biomarker tumor mutation burden compared with those based on knowledge graphs. Use of a model-defined mutational 10-gene signature led to significant overall survival differentiation for both trials. We provide parameterized code for incorporating knowledge graphs into survival analyses for use by the wider scientific community.

Toward Mass Production of Transition Metal Dichalcogenide Solar Cells: Scalable Growth of Photovoltaic-Grade Multilayer WSe2 by Tungsten Selenization.

Semiconducting transition metal dichalcogenides (TMDs) are promising for high-specific-power photovoltaics due to their desirable band gaps, high absorption coefficients, and ideally dangling-bond-free surfaces. Despite their potential, the majority of TMD solar cells to date are fabricated in a nonscalable fashion, with exfoliated materials, due to the lack of high-quality, large-area, multilayer TMDs. Here, we present the scalable, thickness-tunable synthesis of multilayer WSe2 films by selenizing prepatterned tungsten with either solid-source selenium at 900 °C or H2Se precursors at 650 °C. Both methods yield photovoltaic-grade, wafer-scale WSe2 films with a layered van der Waals structure and superior characteristics, including charge carrier lifetimes up to 144 ns, over 14× higher than those of any other large-area TMD films previously demonstrated. Simulations show that such carrier lifetimes correspond to ∼22% power conversion efficiency and ∼64 W g-1 specific power in a packaged solar cell, or ∼3 W g-1 in a fully packaged solar module. The results of this study could facilitate the mass production of high-efficiency multilayer WSe2 solar cells at low cost.

Treatment of Hand and Wrist Cartilage Defects in Athletes.

Cartilage injuries of the hand and wrist can be debilitating in the athlete. Diagnosis is difficult given the broad spectrum of presenting symptomatology. History and physical examination is crucial to achieve the correct diagnosis, and advanced imaging can offer helpful assistance to the clinician as well. TFCC injuries and ulnar impaction syndrome are among the most common conditions in athletes with hand and wrist pain. Treatment of these injuries is initially nonoperative, but elite athletes may elect to bypass nonoperative treatment in favor of earlier return to sport. Surgical treatment varies but can include open and arthroscopic methods. The clinician should tailor treatment plans to each athlete based on level of competition, type of sport, and individual preferences and goals.

Simultaneous Positron Emission Tomography and Molecular Magnetic Resonance Imaging of Cardiopulmonary Fibrosis in a Mouse Model of Left Ventricular Dysfunction.

BACKGROUND: Aging-associated left ventricular dysfunction promotes cardiopulmonary fibrogenic remodeling, Group 2 pulmonary hypertension (PH), and right ventricular failure. At the time of diagnosis, cardiac function has declined, and cardiopulmonary fibrosis has often developed. Here, we sought to develop a molecular positron emission tomography (PET)-magnetic resonance imaging (MRI) protocol to detect both cardiopulmonary fibrosis and fibrotic disease activity in a left ventricular dysfunction model. METHODS AND RESULTS: Left ventricular dysfunction was induced by transverse aortic constriction (TAC) in 6-month-old senescence-accelerated prone mice, a subset of mice that received sham surgery. Three weeks after surgery, mice underwent simultaneous PET-MRI at 4.7 T. Collagen-targeted PET and fibrogenesis magnetic resonance (MR) probes were intravenously administered. PET signal was computed as myocardium- or lung-to-muscle ratio. Percent signal intensity increase and Δ lung-to-muscle ratio were computed from the pre-/postinjection magnetic resonance images. Elevated allysine in the heart (P=0.02) and lungs (P=0.17) of TAC mice corresponded to an increase in myocardial magnetic resonance imaging percent signal intensity increase (P<0.0001) and Δlung-to-muscle ratio (P<0.0001). Hydroxyproline in the heart (P<0.0001) and lungs (P<0.01) were elevated in TAC mice, which corresponded to an increase in heart (myocardium-to-muscle ratio, P=0.02) and lung (lung-to-muscle ratio, P<0.001) PET measurements. Pressure-volume loop and echocardiography demonstrated adverse left ventricular remodeling, function, and increased right ventricular systolic pressure in TAC mice. CONCLUSIONS: Administration of collagen-targeted PET and allysine-targeted MR probes led to elevated PET-magnetic resonance imaging signals in the myocardium and lungs of TAC mice. The study demonstrates the potential to detect fibrosis and fibrogenesis in cardiopulmonary disease through a dual molecular PET-magnetic resonance imaging protocol.

Network-driven cancer cell avatars for combination discovery and biomarker identification for DNA damage response inhibitors.

Combination therapy is well established as a key intervention strategy for cancer treatment, with the potential to overcome monotherapy resistance and deliver a more durable efficacy. However, given the scale of unexplored potential target space and the resulting combinatorial explosion, identifying efficacious drug combinations is a critical unmet need that is still evolving. In this paper, we demonstrate a network biology-driven, simulation-based solution, the Simulated Cell™. Integration of omics data with a curated signaling network enables the accurate and interpretable prediction of 66,348 combination-cell line pairs obtained from a large-scale combinatorial drug sensitivity screen of 684 combinations across 97 cancer cell lines (BAC = 0.62, AUC = 0.7). We highlight drug combination pairs that interact with DNA Damage Response pathways and are predicted to be synergistic, and deep network insight to identify biomarkers driving combination synergy. We demonstrate that the cancer cell 'avatars' capture the biological complexity of their in vitro counterparts, enabling the identification of pathway-level mechanisms of combination benefit to guide clinical translatability.

Hemorrhagic and Ecthymatous Varicella in Immunosuppressed Adults: Report of Two Cases.

Varicella infection in immunosuppressed adults can be severe with atypical presentation of skin lesions. Hemorrhagic and ecthymatous varicella is a rare entity and can be misdiagnosed due to its atypical presentation. In its severe form, individuals with underlying cell-mediated immunodeficiency disorders have a high risk of developing multiple organ involvement associated with varicella-zoster virus infection. Here, we report two cases of primary varicella with hemorrhagic and ecthymatous skin lesions in adults receiving systemic immunosuppressive drugs for autoimmune disorders. There are only a few case reports on hemorrhagic and ecthymatous varicella. Hence, this case report highlights the atypical presentation of varicella in immunosuppressed adults, which necessitates an early diagnosis and prompt treatment as a lifesaving step.

Immunological defense mechanisms of ejaculates and the spread of viral infectious diseases through pig semen.

This review focuses on the mechanisms of immune tolerance and antimicrobial defense in the male genital tract of the pig. Sperm cells are foreign to the immune system and, therefore, they must be protected from the immune system. The blood-testis-barrier is mediated by a physical barrier between adjacent Sertoli cells, several cell types within the testis, and interactions between immunomodulatory molecules. The blood-epididymal-barrier is composed of a physical barrier that is lined with principal cells having a network of junctional complexes in their apical lateral membrane and completed by specific transporters. The seminal plasma (SP) contains many signaling agents involved in establishing a state of immune tolerance in the female genital tract, which is essential for successful fertilization. Specific SP-proteins, however, also have pro-inflammatory capacities contributing to transient uterine inflammation, supporting the removal of foreign cells, possible pathogens, and excessive spermatozoa. While many different proteins and other substances present in semen can damage sperm cells, they may also protect them against viral infections. A delicate balance of these substances, therefore, needs to be maintained. Related to this, recent studies have shown the importance of extracellular vesicles (EVs), as they contain these substances and convey immune signals. Yet, viruses may use EVs to interact with the male genital tract and circumvent immune responses. For this reason, further research needs to explore the role of EVs in the male reproductive tract, as it might contribute to elucidating the pathogenesis of viral infections that might be transmitted via semen and to developing better vaccines.

Organic/metallic component analysis of lignocellulosic biomass: A thermochemical-perspective-based study on rice and bamboo waste.

Thermochemical treatment is significantly impacted by the physiochemical properties of lignocellulosic biomass. Traditional characterization methods lack granularity, requiring advanced analytical techniques for comprehensive biomass characterization. This study analyzed elemental composition and their distribution in untreated rice husk, rice straw, and bamboo chips at micron and sub-micron scales. Results reveal significant variations in composition and spatial distribution of metallic components among agro-residues. Thermogravimetric analysis shows divergent decomposition patterns, while spectroscopic analysis indicates structural complexities and distinct silica content. Surface mapping illustrates prevalent silica and alkali metals on rice husk and rice straw. Atomic force microscopy depicts distinctive surface morphologies, with rice straw exhibiting heightened roughness due to silica bodies. Inductively coupled plasma-mass-spectrometry identified the abundance of alkali and alkaline earth metals in rice waste. Time-of-flight secondary ion mass spectrometry elucidates elemental spatial localization, affirming heterogeneous distribution across rice waste and homogenous distribution across bamboo waste. This study bridges the gap between biomass composition and optimized thermochemical conversion outcomes.

Vibrational spectroscopic detection of radiation-induced structural changes in Chironomus hemoglobin.

Purpose: Chironomus hemoglobin is known to exhibit higher gamma radiation resistance compared to human hemoglobin. In the present study, we have introduced a sensitive method to analyze radiation-induced alterations in Chironomus hemoglobin using Vibrational spectroscopy and further highlighting its potential for monitoring radiotoxicity in aquatic environments. Materials and methods: Vibrational spectroscopic methods such as Raman and FT-IR spectroscopy were used to capture the distinctive chemical signature of Chironomus hemoglobin (ChHb) under both in vitro and in vivo conditions. Any radiation dose-dependent shifts could be analyzed Human hemoglobin (HuHb) as standard reference. Results: Distinctive Raman peak detected at 930 cm-1 in (ChHb) was attributed to C-N stretching in the heterocyclic ring surrounding the iron atom, preventing heme degradation even after exposure to 2400 Gy dose. In contrast, for (HuHb), the transition from deoxy-hemoglobin to met-hemoglobin at 1210 cm-1 indicated a disruption in oxygen binding after exposure to 1200 Gy dose. Furthermore, while ChHb exhibited a consistent peak at 1652 cm-1 in FT-IR analysis, HuHb on the other hand, suffered damage after gamma irradiation. Conclusion: The findings suggest that vibrational spectroscopic methods hold significant potential as a sensitive tool for detecting radiation-induced molecular alterations and damages. Chironomus hemoglobin, with its robust interaction of the pyrrole ring with Fe, serves as a reliable bioindicator molecule to detect radiation damage using vibrational spectroscopic method.

Safety of first surveillance colonoscopy at 12 months after piecemeal EMR of large nonpedunculated colorectal lesions.

BACKGROUND AND AIMS: After piecemeal EMR (pEMR) of nonpedunculated colorectal lesions ≥20 mm, guidelines recommend first endoscopic surveillance at 6 months. However, initial surveillance at 12 months may be adequate for selected low-risk lesions and could save the cost, risk, and inconvenience of 1 surveillance examination. METHODS: This study retrospectively examined a prospectively collected database of all colorectal lesions referred to our center for endoscopic resection between August 2019 and April 2023. We report recurrence rates of patients with colorectal lesions ≥20 mm removed by pEMR who were assigned to 6-month first surveillance or to 12-month first surveillance (or assigned to a 6-month surveillance visit but did not return until after 10 months). RESULTS: There were 561 nonpedunculated lesions ≥20 mm that underwent first follow-up, including 490 lesions in 443 patients assigned to 6-month surveillance and 71 lesions in 65 patients assigned to 12-month surveillance. Lesions assigned to 12-month surveillance were smaller (mean size, 25.9 ± 6.1 mm vs 37.0 ± 17.4 mm), more likely serrated (63.4% vs 9.6%), and more often removed by cold pEMR (74.6% vs 20.4%). Twenty-nine lesions in 24 patients assigned to 6-month surveillance presented after 10 months, and their recurrence data were included in the group assigned to 12-month surveillance. Overall recurrence rates at 6 months and 12 months were 10.0% (46 of 461) and 10.0% (10 of 100), respectively. Mean recurrence sizes at 6 and 12 months were 10.9 ± 6.2 mm and 5.0 ± 3.1 mm, respectively. One patient in the 6-month surveillance group had cancer at the pEMR site, but no other recurrences at 6 or 12 months had either cancer or high-grade dysplasia. CONCLUSIONS: Twelve-month surveillance seems acceptable for selected colorectal lesions ≥20 mm removed by pEMR. A randomized trial comparing initial 6-month versus 12-month surveillance is warranted for selected lesions.

'Monkeypox 2.0': Case series on a reconditioned virus causing sexually transmissible disease in urban population.

BACKGROUND: MPOX (Monkeypox) viral infection, a zoonotic disease previously confined to the African sub-continent, has caught attention worldwide recently due to its resurgence in a new 'avatar' among urban communities. Dermatologists in the U. A. E. started to see patients with fever and a self-limiting pustular necrotic rash that was negative for all other infectious investigations. METHODS: We performed a prospective observational multicenter clinical study of the demographics, skin manifestations, and outcomes of patients presenting with necrotic pustular lesions and/or fever. RESULTS: 35 cases of PCR confirmed MPOX cases, mostly in the expatriate population, were followed up and found to have high-risk heterosexual contact on an average of 1 week prior to disease onset. We found that they have characteristic annular pustular lesions with necrotic center or "Smoke ring pustules' in all cases. Lesion tenderness and predilection for the lower abdomen, pubic area, and genitalia were observed. Most cases were systemically stable, with fever lasting for an average of 4 days and elevated CRP levels. Genital lesions were prone to secondary bacterial infections. The disease was severe, with larger annular plaques in one of our patients found to be living with HIV. CONCLUSIONS: The overall prognosis in healthy individuals is good, with lesions healing within an average of 2 weeks without scarring. 'New world MPOX' should be unclassified from zoonosis to a sexually transmitted infection (STI) capable of transmission in an urban population. Our findings can help in early clinical suspicion and differentiation from other STI's for primary and secondary health care physicians.

Lung-specific interleukin 6 mediated transglutaminase 2 activation and cardiopulmonary fibrogenesis.

Pulmonary hypertension (PH) pathogenesis is driven by inflammatory and metabolic derangements as well as glycolytic reprogramming. Induction of both interleukin 6 (IL6) and transglutaminase 2 (TG2) expression participates in human and experimental cardiovascular diseases. However, little is known about the role of TG2 in these pathologic processes. The current study aimed to investigate the molecular interactions between TG2 and IL6 in mediation of tissue remodeling in PH. A lung-specific IL6 over-expressing transgenic mouse strain showed elevated right ventricular (RV) systolic pressure as well as increased wet and dry tissue weights and tissue fibrosis in both lungs and RVs compared to age-matched wild-type littermates. In addition, IL6 over-expression induced the glycolytic and fibrogenic markers, hypoxia-inducible factor 1α, pyruvate kinase M2 (PKM2), and TG2. Consistent with these findings, IL6 induced the expression of both glycolytic and pro-fibrogenic markers in cultured lung fibroblasts. IL6 also induced TG2 activation and the accumulation of TG2 in the extracellular matrix. Pharmacologic inhibition of the glycolytic enzyme, PKM2 significantly attenuated IL6-induced TG2 activity and fibrogenesis. Thus, we conclude that IL6-induced TG2 activity and cardiopulmonary remodeling associated with tissue fibrosis are under regulatory control of the glycolytic enzyme, PKM2.

Audit of hemostatic clip use after colorectal polyp resection in an academic endoscopy unit.

Background and study aims Prophylactic closure of endoscopic resection defects reduces delayed hemorrhage after resection of non-pedunculated colorectal lesions ≥ 20 mm that are located proximal to the splenic flexure and removed by electrocautery. The risk of delayed hemorrhage after cold (without electrocautery) resection is much lower, and prophylactic clip closure after cold resection is generally unnecessary. The aim of this study was to audit clip use after colorectal polyp resection in routine outpatient colonoscopies at two outpatient centers within an academic medical center. Patients referred for resection of known lesions were excluded. Patients and methods Retrospective chart analysis was performed as part of a quality review of physician adherence to screening and post-polypectomy surveillance intervals. Results Among 3784 total lesions resected cold by 29 physicians, clips were placed after cold resection on 41.7% of 12 lesions ≥ 20 mm, 19.3% of 207 lesions 10 to 19 mm in size, and 2.8% of 3565 lesions 1 to 9 mm in size. Three physicians placed clips after cold resection of lesions 1 to 9 mm in 18.8%, 25.5%, and 45.0% of cases. These physicians accounted for 8.1% of 1- to 9-mm resections, but 69.7% of clips placed in this size range. Electrocautery was used for 3.1% of all resections. Clip placement overall after cold resection (3.9%) was much lower than after resection with electrocautery (71.1%), but 62.4% of all clips placed were after cold resection. Conclusions Audits of clip use in an endoscopy practice can reveal surprising findings, including high and variable rates of unnecessary use after cold resection. Audit can potentially reduce unnecessary costs, carbon emissions, and plastic waste.

Common operational issues and possible solutions for sustainable biosurfactant production from lignocellulosic feedstock.

Surfactants are compounds with high surface activity and emulsifying property. These compounds find application in food, medical, pharmaceutical, and petroleum industries, as well as in agriculture, bioremediation, cleaning, cosmetics, and personal care product formulations. Due to their widespread use and environmental persistence, ensuring biodegradability and sustainability is necessary so as not to harm the environment. Biosurfactants, i.e., surfactants of plant or microbial origin produced from lignocellulosic feedstock, perform better than their petrochemically derived counterparts on the scale of net-carbon-negativity. Although many biosurfactants are commercially available, their high cost of production justifies their application only in expensive pharmaceuticals and cosmetics. Besides, the annual number of new biosurfactant compounds reported is less, compared to that of chemical surfactants. Multiple operational issues persist in the biosurfactant value chain. In this review, we have categorized some of these issues based on their relative position in the value chain - hurdles occurring during planning, upstream processes, production stage, and downstream processes - alongside plausible solutions. Moreover, we have presented the available paths forward for this industry in terms of process development and integrated pretreatment, combining conventional tried-and-tested strategies, such as reactor designing and statistical optimization with cutting-edge technologies including metabolic modeling and artificial intelligence. The development of techno-economically feasible biosurfactant production processes would be instrumental in the complete substitution of petrochemical surfactants, rather than mere supplementation.

Quantitative evaluation of trastuzumab deruxtecan pharmacokinetics and pharmacodynamics in mouse models of varying degrees of HER2 expression.

Trastuzumab deruxtecan (T-DXd; DS-8201; ENHERTU®) is a human epithelial growth factor receptor 2 (HER2)-directed antibody drug conjugate (ADC) with demonstrated antitumor activity against a range of tumor types. Aiming to understand the relationship between antigen expression and downstream efficacy outcomes, T-DXd was administered in tumor-bearing mice carrying NCI-N87, Capan-1, JIMT-1, and MDA-MB-468 xenografts, characterized by varying HER2 levels. Plasma pharmacokinetics (PK) of total antibody, T-DXd, and released DXd and tumor concentrations of released DXd were evaluated, in addition to monitoring γΗ2AX and pRAD50 pharmacodynamic (PD) response. A positive relationship was observed between released DXd concentrations in tumor and HER2 expression, with NCI-N87 xenografts characterized by the highest exposures compared to the remaining cell lines. γΗ2AX and pRAD50 demonstrated a sustained increase over several days occurring with a time delay relative to tumoral-released DXd concentrations. In vitro investigations of cell-based DXd disposition facilitated the characterization of DXd kinetics across tumor cells. These outputs were incorporated into a mechanistic mathematical model, utilized to describe PK/PD trends. The model captured plasma PK across dosing arms as well as tumor PK in NCI-N87, Capan-1, and MDA-MB-468 models; tumor concentrations in JIMT-1 xenografts required additional parameter adjustments reflective of complex receptor dynamics. γΗ2AX longitudinal trends were well characterized via a unified PD model implemented across xenografts demonstrating the robustness of measured PD trends. This work supports the application of a mechanistic model as a quantitative tool, reliably projecting tumor payload concentrations upon T-DXd administration, as the first step towards preclinical-to-clinical translation.

Clinical relevance of intracranial hemorrhage after thrombectomy versus medical management for large core infarct: a secondary analysis of the SELECT2 randomized trial.

BACKGROUND: The incidence of intracerebral hemorrhage (ICH) and its effect on the outcomes after endovascular thrombectomy (EVT) for patients with large core infarcts have not been well-characterized. METHODS: SELECT2 trial follow-up imaging was evaluated using the Heidelberg Bleeding Classification (HBC) to define hemorrhage grade. The association of ICH with clinical outcomes and treatment effect was examined. RESULTS: Of 351 included patients, 194 (55%) and 189 (54%) demonstrated intracranial and intracerebral hemorrhage, respectively, with a higher incidence in EVT (134 (75%) and 130 (73%)) versus medical management (MM) (60 (35%) and 59 (34%), both P<0.001). Hemorrhagic infarction type 1 (HBC=1a) and type 2 (HBC=1b) accounted for 93% of all hemorrhages. Parenchymal hematoma (PH) type 1 (HBC=1c) and type 2 (HBC=2) were observed in 1 (0.6%) EVT-treated and 4 (2.2%) MM patients. Symptomatic ICH (sICH) (SITS-MOST definition) was seen in 0.6% EVT patients and 1.2% MM patients. No trend for ICH with core volumes (P=0.10) or Alberta Stroke Program Early CT Score (ASPECTS) (P=0.74) was observed. Among EVT patients, the presence of any ICH did not worsen clinical outcome (modified Rankin Scale (mRS) at 90 days: 4 (3-6) vs 4 (3-6); adjusted generalized OR 1.00, 95% CI 0.68 to 1.47, P>0.99) or modify EVT treatment effect (Pinteraction=0.77). CONCLUSIONS: ICH was present in 75% of the EVT population, but PH or sICH were infrequent. The presence of any ICH did not worsen functional outcomes or modify EVT treatment effect at 90-day follow-up. The high rate of hemorrhages overall still represents an opportunity for adjunctive therapies in EVT patients with a large ischemic core.

Aminobenzotriazole inhibits and induces several key drug metabolizing enzymes complicating its utility as a pan CYP inhibitor for reaction phenotyping.

Aminobenzotriazole (ABT) is commonly used as a non-selective inhibitor of cytochrome P450 (CYP) enzymes to assign contributions of CYP versus non-CYP pathways to the metabolism of new chemical entities. Despite widespread use, a systematic review of the drug-drug interaction (DDI) potential for ABT has not been published nor have the implications for using it in plated hepatocyte models for low clearance reaction phenotyping. The goal being to investigate the utility of ABT as a pan-CYP inhibitor for reaction phenotyping of low clearance compounds by evaluating stability over the incubation period, inhibition potential against UGT and sulfotransferase enzymes, and interaction with nuclear receptors involved in the regulation of drug metabolizing enzymes and transporters. Induction potential for additional inhibitors used to ascribe fraction metabolism (fm ), pathway including erythromycin, ketoconazole, azamulin, atipamezole, ZY12201, and quinidine was also investigated. ABT significantly inhibited the clearance of a non-selective UGT substrate 4-methylumbelliferone, with several UGTs shown to be inhibited using selective probe substrates in human hepatocytes and rUGTs. The inhibitors screened in the induction assay were shown to induce enzymes regulated through Aryl Hydrocarbon Receptor, Constitutive Androstane Receptor, and Pregnane X Receptor. Lastly, a case study identifying the mechanisms of a clinical DDI between Palbociclib and ARV-471 is provided as an example of the potential consequences of using ABT to derive fm . This work demonstrates that ABT is not an ideal pan-CYP inhibitor for reaction phenotyping of low clearance compounds and establishes a workflow that can be used to enable robust characterization of other prospective inhibitors.