Reappraisal of the Previously Described False Localizing Sign at C1-2 in Cases of Spontaneous Intracranial Hypotension.

Background And Objectives: We present an illustrative case of spontaneous intracranial hypotension (SIH) in the setting of a suspected C1-2 cerebrospinal fluid (CSF) leak that was successfully treated with muscle, collagen, and epidural blood patch. We examined the literature to identify similar cases reporting Cl-2 retrospinal fluid collections identified on imaging in the setting of SIH and quantified the success of targeted treatment to this area despite previous reports that caution about a "C1-2 false localizing sign."

Methods: A systematic search was performed identifying cases of SIH resulting from CSF leak with C1-2 fluid collection observed on imaging.

A toolbox of strategies to improve test-taking skills: a comparison of student perceptions.

Changes in the national examination structures have renewed interest in the development of test-taking strategies for professional students in the health sciences. It is often assumed that these high-achieving students have developed proficient test-taking skills and abilities before admittance. However, the assessments in these programs and for national licensure require an elevated level of reasoning and integration with clinical concepts.

Timing of diffusion tensor imaging in the management of a ruptured pediatric arteriovenous malformation: illustrative case.

Background: Diffusion tensor imaging (DTI) can characterize eloquent white matter tracts affected by brain arteriovenous malformations (AVMs). However, DTI interpretation can be difficult in ruptured cases due to the presence of blood products. The authors present the case of a ruptured pediatric AVM in the corticospinal tract (CST) and discuss how DTI at different time points informed the treatment.

SISMIK for brain MRI: Deep-learning-based motion estimation and model-based motion correction in k-space.

MRI, a widespread non-invasive medical imaging modality, is highly sensitive to patient motion. Despite many attempts over the years, motion correction remains a difficult problem and there is no general method applicable to all situations. We propose a retrospective method for motion estimation and correction to tackle the problem of in-plane rigid-body motion, apt for classical 2D Spin-Echo scans of the brain, which are regularly used in clinical practice.

Play your way to an "A": helping students engage during the social isolation of remote learning.

With the increased attention focused on active learning, educators strive to find better and more innovative ways to engage students in the classroom. One of the hurtles that educators are presented with is that the classroom is no longer limited to a physical location but rather students and professor can meet via the internet, Before COVID-19, distance or remote learning was something that students, by and large, had the option of choosing in which whether to engage. Students had the option to take "online courses," whether those be synchronous remote learning or asynchronous online courses.

Single-level laminoplasty approach to selective dorsal rhizotomy with conus localization by rapid spine MRI.

Introduction: While selective dorsal rhizotomy (SDR) was originally described as a multilevel approach, single-level approaches are now popularized. Conus localization is beneficial for operative planning in single-level selective dorsal rhizotomy. Our approach to SDR involves minimal exposure for a single-level laminoplasty, preserving one attached interspinous ligament.

Associations between social media, adolescent mental health, and diet: A systematic review.

Social media use is integral to many adolescents' lives. It brings benefits but can also have detrimental effects on both physical and mental health. We conducted a systematic review examining associations between social media use, adolescent mental health (including body image, self-esteem, stress, interpersonal relationships and loneliness, anxiety, and depressive symptoms), and dietary outcomes.

Equal but Separate: The Slow Assimilation of Osteopathic Surgery Residents Two Years After the Unified Match.

Objectives: The purpose of this study was to monitor the integration of general surgery residency programs before and after the 2020 unified match. We hypothesized that integration of osteopathic (DO) surgery residents would increase.

Design: We performed a retrospective cohort study of surgery residency programs between 2019 and 2021 utilizing data provided by the Association of American Medical Colleges.

The Syzygy, Reformulation and New Perspectives: Dreams, Anima-Animus and Gender.

The main objective of this qualitative and quantitative research paper is to explore the occurrences and relations of the anima, animus and androgynous in dreams, with particular emphasis on the consideration of the androgynous in the human psyche. The sample consists of 9 series of dreams (141 dreams in total), from 9 dreamers, 7 women (female sex/gender) and 2 men (male sex/gender), aged 25-57, heterosexual, undergoing Jungian psychotherapy, and presenting couple-related themes. Statistical results and qualitative analysis offer new input for the re-vision of the classical anima-animus model, and the addition of in-depth explorations into the androgynous, paving the way for a new model of psychopathology and psychotherapeutic clinical work, in transition.

Emergent patterns in global health diplomacy: a network analysis of the resolutions adopted by the World Health Assembly from 1948 to 2022.

From a complexity perspective on governance, multilateral diplomacy is based on interactions between people, ideas, norms, policies and institutions. This article uses a computer-assisted methodology to better understand governance systems as a network of norms. All World Health Assembly (WHA) resolutions that were available from 1948 to 2022 were collected from the WHO Institutional Repository for Information Sharing (IRIS) database.

Technical notes on the placement of cerebral microdialysis: A single center experience.

Background: Cerebral microdialysis enables monitoring of brain metabolism and can be an important part of multimodal monitoring strategies in a variety of brain injuries. Microdialysis catheters can be placed in brain parenchyma through a burr hole, a cranial bolt, or directly at the time of an open craniotomy or craniectomy. The location of catheters in relation to brain pathology is important to the interpretation of data and guidance of interventions.

Choreography Controlled (ChoCo) brain MRI artifact generation for labeled motion-corrupted datasets.

MRI is a non-invasive medical imaging modality that is sensitive to patient motion, which constitutes a major limitation in most clinical applications. Solutions may arise from the reduction of acquisition times or from motion-correction techniques, either prospective or retrospective. Benchmarking the latter methods requires labeled motion-corrupted datasets, which are uncommon.

Developing dietary interventions as therapy for cancer.

Cancer cells acquire distinct metabolic preferences based on their tissue of origin, genetic alterations and degree of interaction with systemic hormones and metabolites. These adaptations support the increased nutrient demand required for increased growth and proliferation. Diet is the major source of nutrients for tumours, yet dietary interventions lack robust evidence and are rarely prescribed by clinicians for the treatment of cancer.

Blood Pressure and Spot Sign in Spontaneous Supratentorial Subcortical Intracerebral Hemorrhage.

Background: Spontaneous intracerebral hemorrhage is a potentially devastating cause of brain injury, often occurring secondary to hypertension. Contrast extravasation on computed tomography angiography (CTA), known as the spot sign, has been shown to predict hematoma expansion and worse outcomes. Although hypertension has been associated with an increased rate of the spot sign being present, the relationship between spot sign and blood pressure has not been fully explored.

Early Minimally Invasive Parafascicular Surgery for Evacuation of Spontaneous Intracerebral Hemorrhage in the Setting of Computed Tomography Angiography Spot Sign: A Case Series.

Background: Spontaneous intracerebral hemorrhage (sICH) is associated with high morbidity and mortality, and the role of surgery is uncertain. Spot sign on computed tomography angiography (CTA) has previously been seen as a contraindication for minimally invasive techniques.

Objective: To demonstrate the use of minimally invasive parafascicular surgery (MIPS) for early evacuation of sICH in patients with spot sign on CTA.

On the Eve of Integration: Community and Affiliated Residency Programs Pave the Way Towards the Assimilation of Osteopathic Surgery Residents.

Objective: The 2020 match integrated former osteopathic and allopathic residency programs under single Graduate Medical Education accreditation. We describe the composition of general surgery residency programs prior to the 2020 integration and provide a baseline to monitor future progress.

Design: Retrospective, cross-sectional data provided by the Association of American Medical Colleges for the 2018 academic year were analyzed.

Broad Needs Assessment of Pain Education in Graduate Medical Education.

This article describes a survey-based study of graduate medical residents and fellows in an integrated health system. The study explores pain curricula, learner perspectives about pain education, and learner knowledge, attitudes, and confidence. Results indicate that pain education in the graduate medical setting is inadequate to meet learner needs.

Cohort profile: Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS).

Purpose: The Actionable Register of Geneva Outpatients and inpatients with SARS-CoV-2 (ARGOS) is an ongoing prospective cohort created by the Geneva Directorate of Health. It consists of an operational database compiling all SARS-CoV-2 test results recorded in the Geneva area since late February 2020. This article aims at presenting this comprehensive cohort, in light of some of the varying public health measures in Geneva, Switzerland, since March 2020.

Long-Term Mississippi River Trends Expose Shifts in the River Load Response to Watershed Nutrient Balances Between 1975 and 2017.

Excess nutrients transported by the Mississippi River (MR) contribute to hypoxia in the Gulf of Mexico. Nutrient balances are key drivers to river nutrient loads and represent inputs (fertilizer, manure, deposition, wastewater, N-fixation, and weathering) minus outputs (nutrient uptake and removal in harvest, and N emissions). Here, we quantified annual changes in nitrogen (N) and phosphorus (P) river loads and nutrient balances at the MR Outlet and documented that the river load response to watershed nutrient balances shifted between 1975 and 2017.

Treating Alpelisib-Induced Hyperglycemia with Very Low Carbohydrate Diets and Sodium-Glucose Co-Transporter 2 Inhibitors: A Case Series.

Alpelisib is a α-selective phosphatidylinositol 3-kinase (PI3K) inhibitor approved for treatment of postmenopausal women, and men, with hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-), PIK3CA-mutated, advanced breast cancer (ABC). Hyperglycemia is a common, on-target adverse effect that impairs treatment efficacy and increases the rate of treatment delays, dose reductions, and discontinuation. Currently, there are no clear guidelines on how to manage hyperglycemia due to alpelisib when metformin is not effective.

Targeting an anchored phosphatase-deacetylase unit restores renal ciliary homeostasis.

Pathophysiological defects in water homeostasis can lead to renal failure. Likewise, common genetic disorders associated with abnormal cytoskeletal dynamics in the kidney collecting ducts and perturbed calcium and cAMP signaling in the ciliary compartment contribute to chronic kidney failure. We show that collecting ducts in mice lacking the A-Kinase anchoring protein AKAP220 exhibit enhanced development of primary cilia.

Anti-EGFR VHH-armed death receptor ligand-engineered allogeneic stem cells have therapeutic efficacy in diverse brain metastatic breast cancers.

Basal-like breast cancer (BLBC) shows brain metastatic (BM) capability and overexpresses EGFR and death-receptors 4/5 (DR4/5); however, the anatomical location of BM prohibits efficient drug-delivery to these targetable markers. In this study, we developed BLBC-BM mouse models featuring different patterns of BMs and explored the versatility of estem cell (SC)-mediated bi-functional EGFR and DR4/5-targeted treatment in these models. Most BLBC lines demonstrated a high sensitivity to EGFR and DR4/5 bi-targeting therapeutic protein, EDR [anti-EGFR VHH (E) fused to DR ligand (DR)].

A Noninvasive Retrograde Flushing System for Shunted Hydrocephalus: Initial Case Series of 25 Patients.

Hydrocephalus is a common neurosurgical pathology associated with high patient morbidity and systemwide healthcare costs. A significant portion of these costs are related to the failure of ventricular shunting systems. Despite decades of research and technological development, the rate of shunt failure and revision has not significantly improved.