Community hospitals grew from 23% to 45% of the US cell and gene therapy administering network between 2018 and 2025, while claims volume rose about 740%.
As CAR T expands to earlier cancer treatment and other diseases, care delivery is expected to become more decentralized and involve coordinated local and specialty providers.
Community hospitals can support diagnosis, referrals, collections, shared care, recovery monitoring, and long-term follow-up without duplicating specialized therapy-center infrastructure.
Community participation can progress from clinician education and referral pathways to toxicity readiness and, where appropriate, active support for therapy delivery.
Partnerships with established therapy programs, collection organizations, laboratories, and manufacturers can provide specialized expertise and infrastructure for community hospitals.
Objective: To assess new-onset flatfoot after ACL reconstruction using peroneus longus tendon autografts and examine associated factors. Approach: Design and pa
Among 130 patients undergoing primary ACL reconstruction with peroneus longus autografts, 2 developed new flatfoot by Arch Index criteria, an incidence of 1.5%.
Both cases occurred in the operated foot, and neither patient reported pain, instability, or limitations in daily activities or sports.
Flatfoot classification varied by measure: the Chippaux-Smirak Index identified 2 patients, the Staheli Index 24, and the Clarke angle 61.
Exploratory analyses found no significant associations with Beighton score, body mass index, weight, or height; the 2 cases were older than other participants.
The single-center study had no alternative-graft comparison group, and its small number of cases limited risk-factor analyses and generalizability.
Objective: To describe diagnostic challenges and clinical course in a patient with myxoid aortic intimal sarcoma. Approach: Case: A 69-year-old man with abdomin
A 69-year-old man had an aortic mass with renal and splenic infarctions and later developed popliteal artery occlusion despite anticoagulation.
Preoperative FDG-PET showed minimal uptake, with a maximum standardized uptake value of 3.1, favoring thrombus over malignancy.
The gelatinous, well-circumscribed mass resembled a benign myxoma during surgery, and frozen section supported that preliminary diagnosis.
Definitive pathology identified myxoid intimal sarcoma; MDM2 amplification was confirmed in the aortic tumor and an embolized fragment.
The patient declined recommended adjuvant anthracycline-based chemotherapy, developed progressive weight loss and ascites, and died 159 days after surgery.
Objective: The article examines the objective, findings, and clinical context described in Thyra Opens MSI to Multimodal Analysis. Approach: Data conversion: Th
Thyra is an open-source library that converts mass spectrometry imaging data into SpatialData objects for multimodal analysis.
The software supports raw vendor files and imzML, harmonizes mass-to-charge axes, and processes datasets larger than available computer memory.
Thyra stores ion images, spectra, and pixel coordinates in a shared physical coordinate system and writes outputs in cloud-compatible Zarr v3.
The authors demonstrated integration of MSI, hematoxylin and eosin histology, and Xenium spatial transcriptomics in a mouse brain dataset.
The authors noted that MSI pixel size, tissue deformation, and image-registration accuracy limit interpretation, and the current release does not preserve ion-mobility data.
A systematic review of 58 studies involving 2,076,289 patients found that nutritional disorders were associated with adverse outcomes after hip and knee arthroplasty.
Frailty was associated with higher mortality, more postoperative complications and infections, and longer hospital stays across arthroplasty populations.
ESPEN-defined malnutrition was associated with increased mortality, postoperative pain, and longer hospital stays.
Sarcopenia was associated with adverse outcomes, including prosthetic joint infection and poorer functional outcomes.
Associations varied by nutritional measure, and study heterogeneity and risk of bias prevented meta-analysis.
Objective: The article reports on Addenbrooke’s Hospital’s use of rapid whole-genome sequencing (WGS) for children suspected of having cancer and discusses how
In a study at Addenbrooke’s Hospital, rapid whole-genome sequencing reduced mean diagnostic turnaround time for children suspected of cancer from 42 days to 3 days.
The NHS currently offers whole-genome sequencing to people aged 0 to 25 years who are suspected of having cancer, with a mean end-to-end turnaround of 42 days.
Earlier genomic results can inform initial treatment decisions, potentially directing children to targeted treatments or clinical trials and helping avoid some harmful treatments.
In the study cohort, rapid whole-genome sequencing was associated with access to precision medicines, less invasive surgery, reduced chemotherapy use, and noncancer diagnoses in some cases.
NHS England plans to roll out rapid whole-genome sequencing across England over 2 years through the Pediatric Cancer Genomic Network of Excellence and NHS Genomic Medicine Service laboratories.
Objective: To describe disease stage, symptoms, tumor characteristics, recurrence, and outcomes among patients aged 21 or younger diagnosed with colorectal canc
Objective: Assess whether CAR T cell product characteristics are associated with outcomes in patients with non-Hodgkin lymphoma. Approach: Primary analysis: Res
In 580 patients with non-Hodgkin lymphoma treated with axi-cel, a higher proportion of CCR7- and CD45RA-positive naive-like T cells was associated with longer progression-free survival.
Patients in the highest naive-like T-cell group had a 54% lower relative hazard of progression or death and a higher ongoing response rate than those in the lowest group (59.3% vs 29.2%).
The association persisted after adjustment for prognostic factors and was validated in an independent cohort of 203 patients treated with axi-cel-based therapies or brexucabtagene autoleucel.
More prior lines of therapy were associated with fewer naive-like T cells in both starting material and final CAR T-cell products, but final-product proportions were more strongly associated with outc
The findings are associative, not causal, and may not generalize beyond the CD28-based CAR T products studied in patients with lymphoma.
Objective: Assess whether a fixed multimodal machine-learning model for delirium risk could be implemented at a second hospital without retraining, and describe
Objective: To examine whether current or former anabolic-androgenic steroid (AAS) use is associated with coronary microcirculation in women. Approach: Design an
This cross-sectional study included 54 resistance-training women: 20 current AAS users, 17 former users, and 17 never-users.
Mean myocardial flow reserve and the prevalence of clinically or subclinically impaired reserve did not differ among the three groups.
Among former AAS users, longer cumulative exposure was associated with lower myocardial flow reserve, including after adjustment for age and time since cessation.
Resting myocardial blood flow was lower in current AAS users than in control participants, while former users’ values did not differ significantly from controls.
The small sample and cross-sectional design limit causal inference; overall myocardial flow reserve did not differ by AAS-use history.
Objective: To compare telemedicine and in-person initial cardiology visits for subsequent health care utilization and time to cardiovascular diagnosis among adu
This retrospective cohort study included 5735 adults referred for cardiology care in Kaiser Permanente Northern California from June 2020 through May 2022.
Telemedicine was used for 4064 patients (70.9%), including 2403 with suspected atrial fibrillation, 1101 with suspected coronary artery disease, and 560 with suspected heart failure.
After covariate adjustment, telemedicine was associated with lower odds of a repeat cardiology visit within 90 days (OR, 0.77; 95% CI, 0.62-0.95).
For suspected coronary artery disease, telemedicine was associated with lower odds of an emergency department visit within 30 days (OR, 0.67; 95% CI, 0.46-0.98).
Telemedicine was not associated with 30-day hospitalization or time to cardiovascular diagnosis within 60 days; limitations included possible selection bias, residual confounding, and brief postpandem
Objective: The article examines the objective, findings, and clinical context described in The National Residency Matching Program Amid Uncertainty. Approach: P
Objective: To discuss how measurement practices affect the bedside interpretation of the Gastrointestinal Dysfunction Score (GIDS), evaluated in a prospective m
In 2679 ICU patients, higher Gastrointestinal Dysfunction Score values were associated with 28- and 90-day mortality, ICU-free days, and parenteral nutrition use.
Intra-abdominal pressure and gastric residual volume were often unmeasured, and unmeasured components were classified as normal.
Because measurement opportunities varied with illness severity and admission type, identical scores may reflect different clinical information.
Sensitivity analyses supported the mortality association, but did not establish that scores have equivalent bedside meaning across measurement contexts.
The score is a pragmatic, outcome-associated composite; whether GIDS-directed treatment changes improve outcomes remains unestablished.
Objective: The article examines the objective, findings, and clinical context described in Early Bone Marrow Transplantation Efforts: Honoring Jan Raszek-Rosenb
From 1938 to 1941, Jan Raszek-Rosenbusch and Franciszek Groër attempted intramedullary bone marrow administration at King John Casimir University in Lwow.
They aspirated several milliliters of marrow from an unrelated adult donor and immediately injected it into a child recipient, matching donors and recipients by ABO blood group.
No procedure-related immediate or delayed toxicity was observed, and some improvement in general condition was reported, but the diagnoses and outcomes are difficult to interpret by current standards.
Because there was no HLA matching, conditioning, or chimerism testing, the authors characterize these procedures as attempts to transplant rather than transplantation itself.
Later advances in conditioning, stem cell biology, and HLA matching led to successful allogeneic transplantation and the modern therapeutic era, established by Thomas and colleagues’ 1977 report.
Objective: Assess whether mobile medical units integrating HIV prevention and substance use disorder services, alongside peer navigation, improved outcomes for
In the 5-city HPTN 094 trial, 409 adults who injected drugs and had opioid use disorder were assigned to mobile-unit care or peer navigation to community services.
For 26 weeks, mobile units provided peer navigation, HIV preexposure prophylaxis, medication for opioid use disorder, and limited clinical and supportive services.
The mobile-unit group had 71% lower all-cause mortality than the group receiving peer navigation to community services alone.
Daily oral preexposure prophylaxis use and medication for opioid use disorder use did not differ between groups.
Researchers reported low oral preexposure prophylaxis use in both groups and called for evaluation of long-acting formulations among people who inject drugs.
The authors identified an error in their report on patient harms and vulnerable clinical groups during global hospital cyberattacks.
The file originally provided as Multimedia Appendix 4 duplicated Multimedia Appendix 5.
The corrected Multimedia Appendix 4 contains excerpts from the CIPHER database, with examples of patient-level harms from academic literature and social media.
The appendix organizes examples by clinical domain and identifies academic quotations by author and reference and social media quotations by subreddit.
The corrected article was resubmitted to PubMed, PubMed Central, and other full-text repositories, and the online version will include the correction notice.