Rutgers Robert Wood Johnson Medical School is a medical school of Rutgers University. It is one of the two graduate medical schools of Rutgers Biomedical and Health Sciences, together with New Jersey Medical School, and is closely aligned with Robert Wood Johnson University Hospital, the medical school’s principal affiliate. Robert Wood Johnson Medical School operates campuses in Piscataway and New Brunswick in New Jersey. The medical school includes 20 basic science and clinical departments and a broad range of clinical programs conducted at its 34 hospital affiliates and numerous ambulatory care sites in the region. The school is named after Robert Wood Johnson II, the former president and chairman of the board of Johnson & Johnson. Prior to July 2013, Robert Wood Johnson Medical School was part of the University of Medicine and Dentistry of New Jersey (UMDNJ). In 2015-16 admissions cycle, the medical school has introduced the CASPer test, developed by McMaster University Medical School in Canada, as an admissions tool.
Background Pairing e-cigarettes with healthy lifestyle contexts in influencers’ promotional social media posts may increase e-cigarette use risk among young adults. This study examined the effects of e-cigarette and healthy lifestyle content on young adults’ perceptions of influencer credibility, harm perceptions of, and susceptibility to use, e-cigarettes. Methods In this survey-based online, repeated-measures experiment (2023), California young adults (N=1494, M age =23 (SD=1.8); 63% female, 51% Hispanic) were randomly shown 10 (total) Instagram and TikTok videos, featuring influencers promoting e-cigarettes alongside healthy lifestyle activities (experimental group), or a healthy lifestyle activity alone (control). After watching each video, participants rated perceived influencer credibility (eg, honesty). After watching all videos, harm perceptions of e-cigarettes were assessed among all participants and susceptibility to e-cigarette use was assessed among e-cigarette never-users. Harm perceptions and susceptibility outcomes were compared between groups (experimental vs control) and between participants who perceived influencers as credible versus non-credible, using binomial generalised linear mixed effects models. Results Participants in the experimental group were more likely to report lower harm perceptions (adjusted OR (AOR) 1.12; 95% CI 1.03; 1.21) and higher susceptibility to e-cigarette use (AOR 1.22, 95% CI 1.11; 1.34), than participants in the control condition. Similar results were found when influencers were perceived as credible, but not when they were perceived as non-credible. Conclusions Social media influencers’ posts promoting e-cigarette use along with healthy activities may contribute to young adult e-cigarette use. Decreasing perceived credibility of influencers could decrease the negative effects of their promotional posts. Trial registration number NCT06433466 .
BACKGROUND AND AIMS:The TRISCEND II trial demonstrated superior clinical benefits for patients with ≥severe tricuspid regurgitation (TR) treated with the EVOQUE transcatheter tricuspid valve replacement (TTVR) system plus medical therapy vs medical therapy alone. This work reports 1-year and 18-month outcomes in patients stratified by baseline TR severity. METHODS:The multicentre, prospective TRISCEND II trial enrolled 400 patients with symptomatic, ≥severe TR, and randomized 2:1 to TTVR (n = 267) or control (n = 133). In a post hoc analysis, patients were stratified into severe TR (n = 172) and massive/torrential TR (n = 220) cohorts. Clinical and quality-of-life outcomes were reported at 1 year, with Kaplan-Meier estimates for all-cause mortality and heart failure (HF) hospitalization assessed at 18 months. Study oversight included an independent echocardiographic core laboratory, clinical events committee, and data safety monitoring board. RESULTS:One year after TTVR, TR was ≤mild in 95.2% of severe TR and 95.3% of massive/torrential TR patients. The primary safety and effectiveness endpoint (win ratio) favoured TTVR over control regardless of baseline TR severity: severe {1.64 [95% confidence interval (CI): 1.11, 2.43]} and massive/torrential [2.20 (1.55, 3.14)]. At 18 months, TTVR patients had similar mortality to controls [rate difference: severe 0.2% (-11.6, 11.9), massive/torrential -5.8% (-17.6, 6.0)], whereas HF hospitalization rates favoured TTVR in the massive/torrential cohort [vs control, severe 9.8% (-3.0, 22.7), massive/torrential -15.2% (-28.9, -1.5)]. CONCLUSIONS:Patients with ≥severe TR benefit from TTVR, experiencing improvements in TR severity, functional capacity, and quality of life regardless of baseline TR severity, with a signal for greater benefit in patients with more advanced disease.
Most sudden cardiac deaths in young people arise from hypertrophic cardiomyopathy, a genetic heart muscle disease. Treatment has until recently been limited to symptomatic relief or invasive procedures. Small-molecule modulators of cardiac myosin are promising therapeutic options to target disease progression. Mavacamten, the first Food and Drug Administration-approved example, has an unclear mechanism. To address this, we solved cryo-electron microscopy (cryo-EM) structures of beta-cardiac heavy meromyosin in three adenosine 5'-diphosphate and inorganic phosphate (ADP.Pi)-bound states, the primed motor domain with and without mavacamten and the autoinhibited interacting-heads motif (IHM) with mavacamten, to 2.9, 3.4, and 3.7 Å global resolution, respectively. Together with quantitative cross-linking mass spectrometry analysis, these structures reveal how mavacamten inhibits myosin. Mavacamten stabilizes ADP.Pi binding, stalling the motor domain in a primed state, reducing motor dynamics required for actin-binding cleft closure, and slowing progression through the force generation cycle. These effects propagate within the two-headed molecule, stabilizing the IHM through increased motor-motor contacts. While this promotes diastolic relaxation, it also reduces systolic contractile output.
From genome sequencing to single-cell multi-omics profiling, bioinformatic data holds massive promise, calling for data interpretation to facilitate the development of precision medicine with artificial intelligence technologies. Moreover, clinical health records and real-time sensing data from wearable devices could provide deeper insights into construction of multidimensional personalized digital profiles. While precision medicine is an appealing concept, several core challenges still impede translation from bench to the bedside, including heterogeneity challenges across varied data sources, integration challenges facing privacy and permission concerns, and real-world challenges with a wider and more complicated disease range than training sets. In this Collection, we publish original research and contributions across all aspects of artificial intelligence, machine learning, and precision medicine.
BACKGROUND:Robot-assisted radical prostatectomy (RARP) is the most common surgical approach in the management of localized prostate cancer. Early evidence suggests that single-port (SP) RARP is a safe and feasible alternative to the conventional multiport (MP) RARP. We compared the perioperative and functional outcomes of SP vs MP RARP performed by a single high-volume robotic surgeon, assessing the efficacy of SP RARP in an academic setting. METHODS:We retrospectively analyzed data from 145 consecutive patients who had undergone SP RARP performed by a single surgeon after the initial adoption of this technique. Continence and potency were evaluated at 3 and 6 months postoperatively. After propensity score matching (PSM), outcomes were compared with a historical cohort of patients who had undergone MP RARP performed by the same surgeon. RESULTS:The median estimated blood loss (EBL) was 200 mL (100-300), and the median operative time (OT) was 210 minutes (180-240). Most patients showed intermediate Gleason risk (3 + 4, n = 99, 68.3%; 4 + 3, n = 30, 20.7%). When compared with the MP cohort after PSM, there were no differences in EBL and a positive surgical margin rate (p = 0.749 and 0.194, respectively). SP RARP patients showed longer OT (p = 0.007) and lower early continence rate after operation (3 months, 47.2% vs 65.9%, p = 0.003; 6 months, 55.3% vs 82.9%, p < 0.001) compared with patients who underwent MP RARP. The majority of the SP RARP patients were discharged on the day of operation. CONCLUSION:In this single-surgeon series, EBL and surgical margin positivity rate were similar between the SP and MP groups. However, OT was longer, and early continence rates were worse in the SP group. These findings suggest that SP RARP may yield suboptimal functional outcomes in the initial phase of the learning curve.
