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Among left ventricular assist device patients, the most commonly infected component is the drive line, which can be managed with antibiotics and local debridement. Infection of intrathoracic device components is less common but more difficult to manage. Herein we describe the incidence of deep device infection (DDI) at our center as well as management and outcomes. We retrospectively reviewed 658 patients who underwent implantable left ventricular assist device insertion with HeartMate 2 (Abbott) or HeartMate 3 (Abbott) devices between January 2004 and June 2021. DDI was defined according to radiographic and clinical criteria. Cumulative incidence was calculated using a Fine-Gray subdistribution model; survival analysis was performed using the method of Kaplan and Meier. There were 32 (4.8%) DDIs during this study period. Drive line infection and re-exploration for bleeding were associated with development of DDI. Cumulative incidence of DDI increased over time, affecting 11% (7%-18%) at 5 years. The dominant microbes involved in DDI were Pseudomonas aeruginosa (19%) and methicillin-resistant Staphylococcus aureus (13%). Nineteen patients (59%) with device infection underwent device exchange, 6 (19%) underwent initial transplant, and 7 (22%) were treated solely with debridement and antibiotics. Of those who underwent device exchange, 12 (63%) developed reinfection of their new device and 6 underwent subsequent heart transplant. Patients who underwent transplantation for management of device infection had improved 5-year survival (80% vs 11%; P =.01) but 3 patients (25%) developed deep sternal wound infection after transplant. DDI is a rare but challenging complication in this destination era. Heart transplantation is the preferred management strategy for eligible patients but infectious complication is common. [Display omitted] [ABSTRACT FROM AUTHOR]

Urticaria is characterized by inappropriate mast cell degranulation leading to the development of wheals and/or angioedema. Twin and family studies indicate that there is a substantial heritable component to urticaria risk. Our aim was to identify genomic loci at which common genetic variation influences urticaria susceptibility. Genome-wide association studies of urticaria (including all subtypes) from 3 European cohorts (UK Biobank, FinnGen, and the Trøndelag Health Study [HUNT]) were combined through statistical meta-analysis (14,306 urticaria cases and 650,664 controls). Cases were identified via electronic health care records from primary and/or secondary care. To identify putative causal variants and genes, statistical fine-mapping, colocalization, and interrogation of publicly available single-cell transcriptome sequencing resources were performed. Genome-wide significant associations (P < 5 × 10–8) were identified at 6 independent loci. These included 2 previously reported association signals at 1q44 and the human leucocyte antigen region on chromosome 6. Genes with expected or established roles in mast cell biology were associated with the 4 other genome-wide association signals (GCSAML , FCER1A, TPSAB1, and CBLB). Colocalization of association signals consistent with the presence of shared causal variants was observed between urticaria susceptibility and increased expression of GCSAML (posterior probability of colocalization [PP coloc ] = 0.89) and FCER1A (PP coloc = 0.91) in skin. Common genetic variation influencing the risk of developing urticaria was identified at 6 genomic loci. The relationship between genes with roles in mast cell biology and several association signals implicates genetic variability of specific components of mast cell function in the development of urticaria. [ABSTRACT FROM AUTHOR]

• Frequently mutated genes in OSCC: TP53 (64%), FAT1 (27%), CDKN2A , CASP8 and DNAH7. • Tumor somatic mutations of OSCC can be detected in saliva DNA at high sensitivity. • The mutation detection is independent of primary site of the tumor or tumor stage. The incidence of head and neck squamous cell carcinoma (HNSCC) continues to increase and although advances have been made in treatment, it still has a poor overall survival with local relapse being common. Conventional imaging methods are not efficient at detecting recurrence at an early stage when still potentially curable. The aim of this study was to test the feasibility of using saliva to detect the presence of oral squamous cell carcinoma (OSCC) and to provide additional evidence for the potential of this approach. Fresh tumor, whole blood and saliva were collected from patients with OSCC before treatment. Whole exome sequencing (WES) or gene panel sequencing of tumor DNA was performed to identify somatic mutations in tumors and to select genes for performing gene panel sequencing on saliva samples. The most commonly mutated genes identified in primary tumors by DNA sequencing were TP53 and FAT1. Gene panel sequencing of paired saliva samples detected tumor derived mutations in 9 of 11 (82%) patients. The mean variant allele frequency for the mutations detected in saliva was 0.025 (range 0.004 – 0.061). Somatic tumor mutations can be detected in saliva with high frequency in OSCC irrespective of site or stage of disease using a limited panel of genes. This work provides additional evidence for the suitability of using saliva as liquid biopsy in OSCC and has the potential to improve early detection of recurrence in OSCC. Trials are currently underway comparing this approach to standard imaging techniques. [ABSTRACT FROM AUTHOR]

In order to meet the safeguard requirements for Nuclear Material Control and Accountability (MC&A) in liquid-fueled molten salt reactors, fuel salt transportation, and fuel cycle processes, it is important to develop effective methods for measuring and monitoring the mass of molten fuel salt or coolant salt. This paper seeks to validate the radioactive tracer dilution (RTD) method used for determining the mass of irradiated uranium-bearing molten salt. Small scale testing was conducted for this method by irradiating 6.065 g of MgCl–KCl–UCl 3 salt mixture with 1.21 mg of 235U at The Ohio State University, resulting in a neutron fluence of 4.0 × 1016 n/cm2. Gamma spectra were acquired over the course of a 42-day period starting in March 2023 to assess fission products and activity levels of the 22Na tracer that was added before irradiation. No additional interference peaks were observed to overlap with the 1274.54 keV energy peak from 22Na, aside from the known 154Eu peaks, which can be corrected based on prior studies. By placing a thin piece of lead between the source and detector, deadtime was effectively reduced while still allowing observation of the higher-energy peaks, most notably around the 154Eu peak at 1004.76 keV used for interference correction. Overall, the uranium salt irradiation techniques applied in this experiment demonstrate the potential of the RTD method to effectively measure small irradiated samples for large scale molten fuel salt applications. [ABSTRACT FROM AUTHOR]