A Complex, Convexity, Anterior Superior Sagittal Sinus Dural Arteriovenous Fistula Secondary to Venous Sinus Thrombosis.

We report the management of a convexity dural arteriovenous fistula (dAVF) in an uncommon anterior superior sagittal sinus (SSS) location. This was a high-risk Cognard IIa+b dAVF, which is notoriously complex to treat. Endoscopic management alone for complex SSS dAVFs is challenging due to the often bilateral arterial supply to the fistula, as demonstrated in this case.

Effectiveness of app-based cognitive behavioral therapy for insomnia on preventing major depressive disorder in youth with insomnia and subclinical depression: A randomized clinical trial.

Background: Increasing evidence suggests that insomnia plays an important role in the development of depression, supporting insomnia intervention as a promising approach to prevent depression in youth. This randomized controlled trial evaluated the effectiveness of app-based cognitive behavioral therapy for insomnia (CBT-I) in preventing future onset of major depressive disorder (MDD) in youth.

Methods And Findings: This was a randomized, assessor-blind, parallel group-controlled trial in Chinese youth (aged 15-25 years) with insomnia disorder and subclinical depressive symptoms.

Advancing adolescent bedtime by motivational interviewing and text message: a randomized controlled trial.

Background: Sleep deprivation is a prevalent problem among adolescents which is closely related to various adverse outcomes. The lack of efficacy of current sleep education programs among adolescents argues for the need to refine the content and format of the intervention. This study aimed to evaluate the effectiveness of a group-based sleep intervention using motivational interviewing plus text reminders in changing adolescent sleep habits.

Diastolic Dysfunction and Survival in Patients with Preserved or Mildly Reduced Left Ventricular Ejection Fraction following Myocardial Infarction.

Background: Left ventricular ejection fraction (LVEF) is relatively indiscriminate for prognosis in patients with preserved or mildly reduced LVEF (>40%) following myocardial infarction (MI). This study sought to determine the value of guideline-based assessment of diastolic dysfunction (DD) in predicting long-term all-cause and cardiac mortality in patients with a first-ever MI and LVEF>40%.

Methods: A retrospective single centre study involving 2234 patients with a first-ever MI (STEMI or NSTEMI) with LVEF>40% was performed.

Spatial tumor immune heterogeneity facilitates subtype co-existence and therapy response in pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) displays a high degree of spatial subtype heterogeneity and co-existence, linked to a diverse microenvironment and worse clinical outcome. However, the underlying mechanisms remain unclear. Here, by combining preclinical models, multi-center clinical, transcriptomic, proteomic, and patient bioimaging data, we identify an interplay between neoplastic intrinsic AP1 transcription factor dichotomy and extrinsic macrophages driving subtype co-existence and an immunosuppressive microenvironment.