Carotid plaques-the buildup of cholesterol, calcium, cellular debris, and fibrous tissues in carotid arteries-can rupture, release microemboli into the cerebral vasculature and cause strokes. The likelihood of a plaque rupturing is thought to be associated with its composition (i.e.
View Article and Find Full Text PDFBackground: Australians' use of e-cigarettes has increased dramatically in the last few years, following trends worldwide. The Australian Federal government introduced legislation on October 1st, 2021, which reclassified nicotine e-cigarettes as prescription only medicine in an attempt to curb their rapid uptake, especially amongst adolescents.
Methods: This is a retrospective analysis of e-cigarette exposure cases reported to the Victorian Poisons Information Centre between January 1st, 2017, and September 30th, 2023.
For proper reconstruction of scalp and forehead defects following Mohs micrographic surgery (MMS), knowledge of the unique anatomy and aesthetic importance of these structures is necessary to restore function and appearance. However, the inflexibility, convexity, and hair-bearing nature of the scalp and forehead can make reconstruction challenging. Detailed planning and precise management are essential to achieve adequate reconstructive results.
View Article and Find Full Text PDFGlobal Neurosurgery has been described as the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it. Global Neurosurgery activities in the form of mission trips, educational partnerships, and research collaborations have been in place for decades. Still, there have been no central organizing efforts to improve the harmonization of these endeavors until recently.
View Article and Find Full Text PDFPurpose: Survival of patients with metastatic sarcoma remains poor, and there is a pressing need for new therapies. Most sarcoma subtypes are not responsive to immune checkpoint inhibition alone. Lenvatinib, a multireceptor tyrosine kinase inhibitor targeting tumor vasculature, has an immunomodulatory activity that contributes to its antitumor effects.
View Article and Find Full Text PDFNeurosurgical education and training are the essential tenets for the development of a sustainable workforce. However, opportunities for training are limited in most parts of the world due to socioeconomic constraints and an inadequate workforce. This global deficit has triggered a huge drive to expand training opportunities.
View Article and Find Full Text PDFHealth care disparities between high-income countries (HICs) and low- and middle-income countries (LMICs) are well established. The focus of the surgical aspect of health was identified in the early twenty-first century, and efforts to provide safe surgical intervention require the shift of resources from HICs to LMICs with specialized surgeons, anesthesiologists, and equipment. This intervention may make a difference on the short run; however, to achieve a long-term self-sustaining surgical service in the region of need, education and training of local physicians is key.
View Article and Find Full Text PDFThis article provides a thorough analysis of the evolution and current state of global neurosurgery, emphasizing the transformative power of partnerships between various stakeholders to address the stark inequities in neurosurgical care, especially in LMICs. It discusses the transition from reliance on short-term medical missions to the development of sustainable, locally led neurosurgical programs through education, training, and infrastructure development. The article highlights the importance of long-term educational exchanges, innovative digital learning platforms, and strategic collaborations with foundations, philanthropic organizations, and academic institutions to build local capacities, enhance global neurosurgical competency, and promote self-sufficiency in neurosurgical care across different regions.
View Article and Find Full Text PDFMicroneurosurgical techniques remain crucial for managing neurosurgical diseases, especially in low- and middle-income countries (LMICs) where other advanced treatment modalities are not available. The global distribution of these techniques is uneven due to disparities in infrastructure, equipment, and training. Medical professionals from LMICs face barriers in reaching training centers in high-income countries, as well as in accessing microsurgical techniques.
View Article and Find Full Text PDFUntil recently, surgery had been passed over in the domain of global health, historically being described as "the neglected stepchild of global health." Knowledge of the existing global disparities in neurosurgical care has led to neurosurgery capacity-building efforts especially in low-income and middle-income countries. While many global collaborative projects are currently undertaken with philanthropic support, sustainability and scalability are not likely without governmental adoption of neurosurgery-inclusive national surgical plans.
View Article and Find Full Text PDFInternational bootcamps are important for providing access to advanced education and training to physicians around the world. In countries where resources are scarce, the opportunity to be exposed to advanced training and the latest technologies is limited. We set out to evaluate the educational value of integrating augmented reality (AR) into the curriculum of a global neurosurgery bootcamp.
View Article and Find Full Text PDFThe coronavirus disease 2019 (COVID-19) has caused immense devastation globally with many outcomes that are now extending to its long-term sequel called long COVID. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects not only lungs, but also the brain and heart in association with endothelial cell dysfunction, coagulation abnormalities, and thrombosis leading to cardio-cerebrovascular health issues. Fatigue, cognitive decline, and brain fog are common neurological symptoms in persisting long COVID.
View Article and Find Full Text PDFShared decision-making (SDM) is a collaborative approach to healthcare decision-making that involves patients and healthcare professionals working together to make decisions that are informed by the best available medical evidence, as well as the patient's values, preferences and goals. The importance of SDM and the intricate interplay among parents, children and young people (CYP), and healthcare professionals are increasingly acknowledged as the crucial aspects of delivering high-quality paediatric care. While there is a substantial evidence base for SDM improving knowledge and reducing decisional conflict, the evidence for long-term measures such as improved health outcomes is limited and mainly inconclusive.
View Article and Find Full Text PDFIn recent years, evidence has emerged that actinide (An) uptake at the enhanced actinide removal plant (EARP) at the UK's Sellafield nuclear site occurs An interactions with an α-Fe Keggin molecular cluster during ferrihydrite formation. We here study theoretically the substitution of aquo complexes of the actinides Th-Pu onto a Na-decorated α-Fe Keggin cluster using DFT at the PBE0 level. The optimised Pu-O and Pu-Fe distances are in good agreement with experiment and Na/An substitutions are significantly favourable energetically, becoming more so across the early 5f series, with the smallest and largest ° being for Th and Pu at -335.
View Article and Find Full Text PDFAbnormal microglial activation has been suggested as "driven force" promoting brain aging. Lipid droplets accumulating microglia (LDAM), identified as a novel inflammatory phenotype, elevate neuroinflammation and exaggerate neuronal injuries in aging and multiple neurodegenerative diseases. Since chronic HIV (human immunodeficiency virus) (+) individuals show an accelerated brain aging and higher incidence of neurological symptoms compared to age-matched HIV (-) population, we hypothesize that LDAM are also involved in such phenomenon.
View Article and Find Full Text PDFWe examine the phase structure of the two-flavor Schwinger model as a function of the θ angle and the two masses, m_{1} and m_{2}. In particular, we find interesting effects at θ=π: along the SU(2)-invariant line m_{1}=m_{2}=m, in the regime where m is much smaller than the charge g, the theory undergoes logarithmic renormalization group flow of the Berezinskii-Kosterlitz-Thouless type. As a result, dimensional transmutation takes place, leading to a nonperturbatively small mass gap ∼e^{-Ag^{2}/m^{2}}.
View Article and Find Full Text PDFDistraction osteogenesis (DO) of the craniofacial skeleton has become an effective technique for the treatment of both nonsyndromic and syndromic conditions. The advent of craniofacial DO has allowed for earlier intervention in pediatric patients with less complication risk and morbidity compared to traditional techniques. In this review, we will discuss current application and technique for craniofacial DO by anatomical region and explore future applications in craniofacial surgery.
View Article and Find Full Text PDFIn patients at high risk for ischemic stroke, clinical carotid ultrasound is often used to grade stenosis, determine plaque burden and assess stroke risk. Analysis currently requires a trained sonographer to manually identify vessel and plaque regions, which is time and labor intensive. We present a method for automatically determining bounding boxes and lumen segmentation using a Mask R-CNN network trained on sonographer assisted ground-truth carotid lumen segmentations.
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