The Effect of Aneurysm Diameter on Perioperative Outcomes Following Complex Endovascular Repair.

Objectives: Endovascular aneurysm repair (EVAR) for large infrarenal abdominal aortic aneurysms (AAA) has been associated with worse outcomes compared to EVAR for smaller AAAs. Whether these findings apply to complex AAAs (cAAA) remains uncertain.

Methods: We identified all intact complex EVAR (cEVAR) from 2012-2024 in the Vascular Quality Initiative.

Potentiating the effect of immunotherapy in pancreatic cancer using gas-entrapping materials.

Immune checkpoint inhibitors (ICIs) show limited success in treating pancreatic ductal adenocarcinoma (PDAC), largely due to immune evasion mechanisms, including downregulating expression of major histocompatibility complex class I (MHC-I). Our retrospective analysis demonstrated that smoking - a state of elevated CO exposure - is correlated with increased MHC I expression in pancreatic tumors. Here we tested our hypothesis that introducing exogenous CO augments the anti-cancer effects of immunotherapy.

Preliminary Evidence for Perturbation-Based tACS-EEG Biomarkers of Gamma Activity in Alzheimer's Disease.

Background: Alzheimer's disease (AD) is characterized by impaired inhibitory circuitry and GABAergic dysfunction, which is associated with reduced fast brain oscillations in the gamma band (γ, 30-90 Hz) in several animal models. Investigating such activity in human patients could lead to the identification of novel biomarkers of diagnostic and prognostic value. The current study aimed to test a multimodal "Perturbation-based" transcranial Alternating Current Stimulation-Electroencephalography (tACS)-EEG protocol to detect how responses to tACS in AD patients correlate with patients' clinical phenotype.

Unsupervised deep learning of electrocardiograms enables scalable human disease profiling.

The 12-lead electrocardiogram (ECG) is inexpensive and widely available. Whether conditions across the human disease landscape can be detected using the ECG is unclear. We developed a deep learning denoising autoencoder and systematically evaluated associations between ECG encodings and ~1,600 Phecode-based diseases in three datasets separate from model development, and meta-analyzed the results.

Decision-making in women who considered planned oocyte cryopreservation: decision satisfaction or regret?

Research Question: Among women who considered planned oocyte cryopreservation, does decision regret differ between those who pursued planned oocyte cryopreservation and those who did not?

Design: A survey was e-mailed to all women who presented for an initial consultation for planned oocyte cryopreservation between January 2016 and December 2021 using a secure REDCap platform. The survey comprised questions on demographics, reproductive planning and the validated Decision Regret Scale (DRS). Univariable and multivariable models were fitted to compare decision regret in the group who had proceeded with planned oocyte cryopreservation with the group who had not.

Late-gadolinium enhancement predicts appropriate device therapies in non-ischemic recipients of primary prevention implantable cardioverter-defibrillators.

Background: Better risk stratification is needed to evaluate patients with non-ischemic cardiomyopathy (NICM) for prophylactic implantable cardioverter-defibrillators (ICD). Growing evidence suggests cardiac magnetic resonance imaging (CMR) may be useful in this regard.

Objective: We aimed to determine if late-gadolinium enhancement (LGE) seen on CMR (dichotomized as none/minimal <2% vs significant ≥2%) predicts appropriate ICD therapies (primary endpoint) and/or all-cause mortality/transplant/left-ventricular assist device (LVAD) implantation (secondary endpoint) in NICM patients.

Risk of SARS-CoV-2 infection and adverse outcomes among vaccinated patients with tuberculosis.

Objectives: Limited data are available to assess breakthrough SARS-CoV-2 infections, medical utilization, and mortality in patients with tuberculosis (TB). The aim of this study was to examine the risk of COVID-19 and severe outcomes in patients with TB between January 2020 and March 2022.

Study Design: US electronic medical records were used to identify TB and non-TB patients who completed the primary series of vaccination and had no prior COVID-19.

Sewing the SEAMs: Surgical Education in the Art Museum.

Objective: The field of surgery is highly visual and technical. Yet, there is a paucity of data evaluating how a mandatory visual arts-based workshop may benefit surgical trainees. We report upon the feasibility of and short-term outcomes of a novel, visual art-based curriculum for surgery residents.

Defining the Optimal Dose for 3-Dimensional Conformal Accelerated Partial Breast Irradiation: 15-Year Follow-Up of a Dose-Escalation Trial.

Purpose: Randomized trials have demonstrated similar local tumor control in patients treated with accelerated partial-breast irradiation (APBI) compared with whole-breast irradiation. However, the optimal APBI dose for maximizing tumor control and minimizing toxicity is uncertain.

Methods And Materials: We enrolled patients ≥18 years of age with grade 1 or 2 ductal carcinoma in situ or stage I invasive breast cancer and resection margins ≥2 mm between 2003 and 2011 to a sequential dose-escalation trial using 3-dimensional conformal external beam APBI giving twice daily 4 Gy fractions with total doses of 32 Gy, 36 Gy, and 40 Gy.

Variations in Revascularization Strategies for Chronic Limb-Threatening Ischemia: A Nationwide Analysis of Medicare Beneficiaries.

Background: Recent data support both surgical-first and endovascular-first revascularization approaches for chronic limb-threatening ischemia (CLTI), but hospital-based practices are poorly described.

Objectives: This aim of this study was to characterize contemporary variations and outcomes associated with each strategy among U.S.

Sex-Based Differences in Ruptured Abdominal Aortic Aneurysm Management and Outcomes: An Update.

Objectives: This study aimed to evaluate sex-based differences in outcomes following ruptured abdominal aortic aneurysm (AAA) repair, focusing on mortality, morbidity, and postoperative complications.

Design: Retrospective cohort study SETTING: Multi-institutional data from the Vascular Quality Initiative national database, covering a period from January 2003 to December 2022.

Participants: We included 7,548 patients undergoing open or endovascular repair for ruptured AAA: 5,829 men (77.

Calcium calmodulin kinase IV deficiency in podocytes prevents the development of lupus nephritis.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by widespread organ involvement including the kidney. Calcium/calmodulin-dependent protein kinase IV (CaMK4) has been shown to conrol immune cell nad podocyte function. To address the effect of genetic podocyte-specific CaMK4 deficiency on systemic autoimmunity and kidney pathology in lupus-prone mice we generated B6.

The Availability of Paternity Leave in US Surgical Residencies: A Study of Program Websites.

Introduction: As family dynamics evolve, an increasing number of male residents are embracing parenthood during their training. Consequently, paternity leave has emerged as a crucial consideration. The aim of this study was to determine the gap in public availability of paternity leave policies in surgical residency programs across the United States.

Tunneled Pleural Catheters: An Effective Nonsurgical Alternative for Nonexpandable Lung in Chronic Pleural Infection.

Background: Open window thoracostomy (OTW) is the standard of care for debilitated patients with chronic pleural infection and nonexpandable lungs (NEL) who are not candidates for major surgical intervention. Tunneled pleural catheters (TPC) offer tremendous treatment potential in this setting based on their efficacy in malignant pleural effusion and NEL. We aim to assess the efficacy, safety, and health care utilization of TPC in this setting.

Contemporary Administrative Codes to Identify Pulmonary Vein Isolation Procedures for Atrial Fibrillation.

Background: Use of pulmonary vein isolation (PVI) to treat atrial fibrillation continues to increase. Despite great interest in leveraging administrative data for real-world analyses, contemporary procedural codes for identifying PVI have not been evaluated.

Methods And Results: In this observational retrospective cohort study, inpatient PVIs were identified among US Medicare fee-for-service beneficiaries using Current Procedural Terminology (CPT) code 93656 in Carrier Line Files.

Adult Plastic Bronchitis: A Rare Cause for Chronic Productive Cough.

Plastic bronchitis is a rare disease with serious morbidity. We report a case of a 48-year-old male smoker with a past medical history of diabetes, emphysema, recurrent respiratory infections, a worsening productive cough, and increased oxygen requirement over the past 3 months. Often described in the pediatric population, it is important to maintain plastic bronchitis in the differential when considering unresolving pulmonary conditions with chronic sputum production.

The Population-Based Incidence and Prevalence of Catatonia.

Objective: Catatonia is a neuropsychiatric disorder that is associated with a range of medical and psychiatric illnesses. Although many single-center studies have been conducted, uncertainty over the population-based incidence and prevalence of the disorder remains. This study reports on the incidence and prevalence rates of catatonia extrapolated from two large epidemiologic studies in the United Kingdom and United States.

Impact of Sodium-Glucose Co-Transporter 2 Inhibitors on Atrial Fibrillation Recurrence Post-Catheter Ablation Among Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Atrial fibrillation (AF) is the most common cause of arrhythmia-induced cardiomyopathy. Effective management strategies include medical therapy for rate and rhythm control, catheter ablation (CA), and goal-directed medical therapy. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), a novel class of antidiabetic drugs, have shown a promising impact in reducing cardiovascular events in diabetic and nondiabetic heart failure (HF) patients.

Effect of daily alcohol intake on sex hormone levels among postmenopausal breast cancer survivors on aromatase inhibitor therapy: a randomized controlled crossover pilot study.

Background: Alcohol intake is associated with a higher risk of estrogen receptor-positive (ER+) breast cancer (BC), presumably through its confirmed ability to increase sex hormone levels. Whether consuming alcohol within the recommended limit of one serving per day increases sex hormone levels among postmenopausal women taking aromatase inhibitors (AI) to inhibit estrogen production remains unknown. Therefore, we compared sex hormone levels following white wine to levels following white grape juice among ER + BC survivors taking AIs.

Aneurysm dome and vessel pressure measurements with coiling, stent assisted coiling and flow diversion.

Background: Variability in long-term endovascular treatment outcomes for intracranial aneurysms has prompted questions regarding the effects of these treatments on aneurysm hemodynamics. Endovascular techniques disrupt aneurysmal blood flow and shear, but their influence on intra-aneurysmal pressure remains unclear. A better understanding of aneurysm pressure effects may aid in predicting outcomes and guiding treatment decisions.