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Objectives: To investigate the safety and efficacy of ANG-3777, a hepatocyte growth factor mimetic, in mitigating the risk of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass., Methods: In this double-blind placebo-controlled study (Guard Against Renal Damage [GUARD]), patients were randomized to receive intravenous ANG-3777 2 mg/kg or placebo once daily for 4 days. The primary end point was severity of AKI, measured by mean area under the concentration-time curve on percent increase in serum creatinine from days 2 to 6. Secondary end points included the proportions of patients who developed major adverse kidney events by day 30 or 90 and the percentage of patients diagnosed with AKI through day 5., Results: In total, 259 patients received study treatment (ANG-3777, n = 129; placebo, n = 130). Through day 6, there was no significant difference in least-squares mean change in serum creatinine between ANG-3777 and placebo (1.1%; 95% confidence interval, -6.2 to 8.4; P = .77), or in proportions of patients who developed major adverse kidney events by day 30 (18.6% vs 16.2%; P = .60) or day 90 (14.7% vs 21.5%; P = .16). Similar proportions of patients were diagnosed with AKI through day 5 (ANG-3777, 47.3%; placebo, 48.5%); however, exploratory analysis revealed more patients diagnosed with AKI postoperatively showed signs of recovery after treatment with ANG-3777 than placebo. Overall, ANG-3777 was well tolerated, with similar incidences of treatment-emergent adverse events between treatment arms., Conclusions: Findings from this study do not support the efficacy of ANG-3777 in preventing the development of AKI after cardiopulmonary bypass., Competing Interests: Conflict of Interest Statement T.B. has served as a consultant for AtriCure and as a speaker for Edwards Lifesciences. D.C. has served on a steering committee for, and as an advisor to, Alexion Pharmaceuticals. S.A. and J.N. were employees of Angion Biomedica at time of study. S.A.’s and M.S.’s institutions received research grants from Angion Biomedica. P.A.C. and G.A. are employees of CSL Vifor. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

To evaluate the in-hospital mortality and acute STEMI-related complications in a SMuRF-less STEMI population compared with a SMuRF STEMI population in the United States. The National Inpatient Sample (NIS) Database (2005-2014) was analyzed to identify patients with STEMI using ICD-9. Patients were grouped into SMuRF and SMuRF-less based on the presence of ≥1 SMuRF risk factor. The primary outcomes were the prevalence and in-hospital mortality of SMuRF-less patients. Secondary outcomes were rates of in-hospital complications in STEMI patients. A total of 434,111 STEMI patients were identified with 318,281 (73.4%) and 115,830 (26.6%) patients in the SMuRF and SMuRF-less categories, respectively. In multivariable logistic regression analysis, SMuRF-less patients had a higher in-hospital mortality rate (odds ratio [OR]: 1.670; 95% confidence interval [CI]: 1.620-1.722) and acute renal failure (OR: 1.724; 95% CI: 1.662-1.787). SMuRF-less STEMI patients have higher odds of in-hospital mortality and in-hospital STEMI-related complications compared with SMuRF STEMI patients., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Acute kidney injury (AKI) affects up to 30% of patients undergoing cardiac surgery, leading to increased in-hospital and long-term morbidity and mortality. Teprasiran is a novel small interfering RNA that temporarily inhibits p53-mediated cell death that underlies AKI., Methods: This prospective, multicenter, double-blind, randomized, controlled phase 2 trial evaluated the efficacy and safety of a single 10 mg/kg dose of teprasiran versus placebo (1:1), in reducing the incidence, severity, and duration of AKI after cardiac surgery in high-risk patients. The primary end point was the proportion of patients who developed AKI determined by serum creatinine by postoperative day 5. Other end points included AKI severity and duration using various prespecified criteria. To inform future clinical development, a composite end point of major adverse kidney events at day 90, including death, renal replacement therapy, and ≥25% reduction of estimated glomerular filtration rate was assessed. Both serum creatinine and serum cystatin-C were used for estimated glomerular filtration rate assessments., Results: A total of 360 patients were randomly assigned in 41 centers; 341 dosed patients were 73±7.5 years of age (mean±SD), 72% were men, and median European System for Cardiac Operative Risk Evaluation score was 2.6%. Demographics and surgical parameters were similar between groups. AKI incidence was 37% for teprasiran- versus 50% for placebo-treated patients, a 12.8% absolute risk reduction, P =0.02; odds ratio, 0.58 (95% CI, 0.37-0.92). AKI severity and duration were also improved with teprasiran: 2.5% of teprasiran- versus 6.7% of placebo-treated patients had grade 3 AKI; 7% teprasiran- versus 13% placebo-treated patients had AKI lasting for 5 days. No significant difference was observed for the major adverse kidney events at day 90 composite in the overall population. No safety issues were identified with teprasiran treatment., Conclusions: The incidence, severity, and duration of early AKI in high-risk patients undergoing cardiac surgery were significantly reduced after teprasiran administration. A phase 3 study with a major adverse kidney event at day 90 primary outcome that has recently completed enrollment was designed on the basis of these findings (NCT03510897). Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02610283.

MR imaging without the use of contrast agents has recently been used for creating perfusion and ventilation functional lung images. The technique incorporates frequency- or wavelet-domain filters to separate the MR signal components. This paper presents a new, subject-adaptive algorithm for perfusion and ventilation filters design. The proposed algorithm uses a lung signal model for separation of the signal components in the frequency domain. Non-stationary lung signals are handled by a short time Fourier transform. This method was applied to sets of 192 and 90 co-registered non-contrast MR lung images measured for five healthy subjects at the rate of 3,33 images per second, using different slice thicknesses. In each case, the resulted perfusion and ventilation images showed a smaller amount of mutual information, when compared to those obtained using the known lowpass/highpass filter approach., (Copyright © 2014. Published by Elsevier GmbH.)

Across the country, numerous perception studies have been conducted to gauge the public's opinion of America's health care system and the role local providers play in serving community health needs. The results consistently show that, in general, people are unaware of the myriad of benefits above and beyond the provision of general acute care services provided by not-for-profit community health care organizations.

Across the country, numerous perception studies have been conducted to gauge the public's opinion of America's health care system and the role local providers play in serving community health needs. The results consistently show that, in general, people are unaware of the myriad of benefits above and beyond the provision of general acute care services provided by not-for-profit community health care organizations.

More and more health care organizations are being approached to participate in efforts to report and financially quantify community services and charity care provided in their respective communities. It is apparent that a consistent format and more concise definitions are needed if data are to be useful in presenting a clear, industry-wide picture of the magnitude of contributions made to communities by health care organizations.