Keyhole Mini-Pterional Craniotomy for Clipping of Bilateral Middle Cerebral Artery Aneurysms.

Middle cerebral artery (MCA) aneurysms remain excellent candidates for microsurgical treatment, despite proliferation of new endovascular tools. Nonetheless, patients desire less invasive options for permanent, durable treatment of their aneurysms; this is particularly the case for those presenting without subarachnoid hemorrhage, and those with multiple aneurysms that may require several surgical approaches. Keyhole craniotomies, when properly utilized in well-selected patients, allow for minimally invasive treatment of both ruptured and unruptured cerebral aneurysms, including those harboring bilateral aneurysms which may be treated from a single approach.

Performance of Fluid Infusion Systems in the Changing Atmospheric Pressures Encountered in Aviation.

Introduction: With the increasing use of aeromedical transport for critically ill patients, it is essential to understand the impact of pressure changes on drug infusion delivery systems. As airplanes ascend and descend, gases/bubbles are released from solutions when ambient pressure decreases and dissolves when pressure increases. This may affect mechanical fluid delivery systems and cause clinically significant changes, especially within a critical care setting.

Ritlecitinib, a JAK3 /TEC inhibitor, modulates the markers of celiac autoimmunity in alopecia areata and vitiligo patients.

Background: Celiac disease (CeD) has shown an association with autoimmune disorders including vitiligo and alopecia areata (AA). Ritlecitinib, a JAK3 and TEC kinase family inhibitor, has been approved for treatment of patients with AA and is in late-stage development for vitiligo. Ritlecitinib inhibits cytotoxic T cells, NK cells, and B cells which play a role in the pathogenesis of CeD.

Consolidation in an Era of Population Health and Value-Based Care: Implications For Effectiveness, Costs, and Equity.

Consolidation of health care providers, and vertical integration of physicians with hospitals and/or payers has accelerated over the past 15 years. Although there is potential for consolidation to improve patient care, efficiencies and reduce overhead costs, participants in our conference identified that almost all research on consolidation has shown increased cost without improvement in outcomes or the experience of care. To provide a framework for considering the impact of consolidation, future research and analysis we offer 4 themes: (1) to move forward, we need to look back at historical drivers, value creation, and unintended consequences; (2) not all consolidation is created equally; (3) real-time, continuous evaluation is critical for improvement; and (4) a policy blueprint is desperately needed.

A Comparison of Glucose and Additional Signals for Three Different Exercise Types in Adolescents with Type 1 Diabetes Using a Hybrid Closed-Loop System.

To compare glycemic outcomes during and following moderate-intensity exercise (MIE), high-intensity interval exercise (HIE), and resistance exercise (RE) in adolescents with type 1 diabetes (T1D) using a hybrid closed-loop (HCL) insulin pump while measuring additional physiological signals associated with activity. Twenty-eight adolescents (average age 16.3 ± 2.

Impacts of EPA's finalized power plant greenhouse gas standards.

Emissions reductions may be met with relatively small costs.

Neuronal CD59 isoforms IRIS-1 and IRIS-2 as regulators of neurotransmitter release with implications for Alzheimer's disease.

We have previously demonstrated that the intracellular, non-GPI anchored CD59 isoforms IRIS-1 and IRIS-2 (Isoforms Rescuing Insulin Secretion 1 and 2) are necessary for insulin secretion from pancreatic β-cells. While investigating their expression across human tissues, we identified IRIS-1 and IRIS-2 mRNA in the human brain, though their protein expression and function remained unclear. This study shows the presence of both IRIS-1 and 2 proteins in the human brain, specifically in neurons and astrocytes.

0.5T MRI as a competitor to CT for sinus imaging.

The goal of this study was to determine how radiologists' rating of image quality when using 0.5T Magnetic Resonance Imaging (MRI) compares to Computed Tomography (CT) for visualization of pathology and evaluation of specific anatomic regions within the paranasal sinuses. 42 patients with clinical CT scans opted to have a 0.

Cutaneous sarcoidosis: clinical and pathologic features, molecular pathogenesis, and treatment.

Sarcoidosis is a multisystem inflammatory disorder that most commonly affects the lungs, lymphatic system, eyes, and skin. Cutaneous involvement is present in approximately 20-30% of patients. Prednisone and corticotropin repositories are the only FDA-approved therapies for sarcoidosis.

OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein: A cross-over, randomised controlled trial in adolescents and adults with type 1 diabetes using multiple daily injection therapy.

Aims: To (1) evaluate the efficacy of OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein in managing glycaemia compared with carbohydrate counting in adolescents and adults with type 1 diabetes using flexible multiple daily injection therapy (MDI, ≥4 injections/day) and (2) assess user acceptability of OptimAAPP.

Methods: In this free-living trial, participants aged 12-50 years were randomised to use carbohydrate counting or OptimAAPP for meal insulin dose calculation for 3 months, then use the alternate method for 3 months. The primary outcome, time-in-range (3.

Altered platelet phenotype in patients with type II endoleaks following abdominal aortic aneurysm repair.

Background: Endovascular abdominal aortic aneurysm repair (EVAR) is a preferred surgery to prevent aneurysm sac enlargement and minimize the risk of life-threatening rupture in patients with AAA. Serious complications of type II endoleaks following EVAR can cause sac expansion and increase rupture risk. This study focused on evaluating clinical and blood characteristics in patients with type II endoleaks to refine our understanding of systemic fluctuations associated with unsuccessful EVAR.

Osteopathic approach to injuries of the overhead thrower's shoulder.

Overhead sports place a significant amount of stress on the shoulder. There are a variety of activities and sports with overhead athletes including both throwing (baseball, softball, football, cricket) and nonthrowing (tennis, swimming, volleyball) sports. Although all of these overhead motions can lead to pathology, a large focus has been on the consequences of overhead throwing.

Elbow injuries in overhead throwing athletes: clinical evaluation, treatment, and osteopathic considerations.

Injury to the elbow is very common in the throwing athlete and can potentially lead to long absences from play and, in the most severe scenarios, medical retirement. The throwing motion is a highly complex series of movements through the entire kinetic chain that results in very high angular velocities and valgus forces at the elbow joint. The repetitive nature of overhead throwing in combination with the high levels of accumulated force at the elbow puts both pediatric and adult athletes at risk of both acute and chronic overuse injuries of the elbow.

Evaluating the use of systems thinking methods in healthcare: a RE-AIM analysis of AcciMap and Net-HARMS.

There are increasing calls for the application of systems ergonomics methods in healthcare, although evidence for their utility and uptake is limited. In this study, 67 Australian healthcare workers participated in a six-month longitudinal study where they were trained to apply the AcciMap adverse event analysis and Net-HARMS risk assessment methods. Data were gathered in line with the RE-AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) evaluation framework, including rates of organisational uptake and method validity, perceived workload, usability, and barriers and facilitators to use in practice.

Innovation in Alopecia Areata.

Advances in understanding of AA have led to the first approved therapies for this disease, and in the past two years, there have been three medicines approved for the treatment of severe alopecia areata. There are numerous clinical trials of novel therapeutics underway across the spectrum of AA.

CD59 double knockout mice express a CD59ba hybrid fusion protein that mediates insulin secretion.

CD59 is a cell-surface inhibitor of the terminal step in the complement cascade. However, in addition to its complement inhibitory function, a non-canonical role of CD59 in pancreatic beta cells has been identified. Two recently discovered intracellular alternative splice forms of CD59, IRIS-1 and IRIS-2, are involved in insulin exocytosis through interactions with SNARE-complex components.

Shedding of membrane complement inhibitors CD59 and CD46 into the circulation is associated with poor prognosis in acute coronary syndrome patients: a cohort study.

Introduction: The role of the complement inhibitory proteins CD46 and CD59 in the immune response to an acute coronary syndrome (ACS) is unknown. We investigated the relationships between the shedding of CD46 and CD59 into the circulation, reflected by plasma levels of soluble CD46 and CD59, and the risk for post-ACS complications.

Methods: We measured plasma sCD46 and sCD59 in a cohort of 546 ACS patients within 24 h after hospital admission, and after 6-weeks in a subgroup of 114 patients.

A Pumpless and Tubeless Microfluidic Device Enables Extended In Vitro Development of .

Background: The enteric parasite remains a treatment challenge for drinking water utilities globally due to its resistance to chlorine disinfection. However, the lack of an in vitro culture system for that is both cost-effective and reliable remains a key bottleneck in research.

Methods: Here we report that the microfluidic culture of human ileocecal colorectal adenocarcinoma (HCT-8) cells under fluid shear stress enables the extended development of .

Quantifying social media predictors of violence during the 6 January US Capitol insurrection using Granger causality.

Protests involving brute force are growing in number and are viewed as a likely source of increased collective violence in industrialized nations. Yet, our scientific understanding of how violent protests are related to a leader's social media communications during protests remains nascent. Here, we analyse new data from the 6 January 'march on the US Capitol' to quantify the links between leadership, social media and levels of violence.