Reconstructing Covert Consciousness: Neural Decoding as a Novel Consciousness Assessment.

Determining the level of consciousness in patients with brain injury-and more fundamentally, establishing what they can experience-is ethically and clinically impactful. Patient behaviors may unreliably reflect their level of consciousness: a subset of unresponsive patients demonstrate covert consciousness by willfully modulating their brain activity to commands through fMRI or EEG. However, current paradigms for assessing covert consciousness remain fundamentally limited because they are insensitive, rely on imperfect assumptions of functional neuroanatomy, and do not reflect the spectrum of conscious experience.

Results From First-in-Human Phase I Study of a Novel CD19-1XX Chimeric Antigen Receptor With Calibrated Signaling in Large B-Cell Lymphoma.

Purpose: We designed a CD19-targeted chimeric antigen receptor (CAR) comprising a calibrated signaling module, termed 1XX, that differs from that of conventional CD28/CD3ζ and 4-1BB/CD3ζ CARs. Preclinical data demonstrated that 1XX CARs generated potent effector function without undermining T-cell persistence. We hypothesized that 1XX CAR T cells may be effective at low doses and elicit minimal toxicities.

Intraprocedural Three-Dimensional Imaging Registration Optimizes Magnetic Resonance Imaging-Guided Focused Ultrasound and Facilitates Novel Applications.

Background And Objective: Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) has revolutionized ablative treatment of essential tremor in recent years. However, limitations in precision targeting may account for suboptimal efficacy and significant side effects. We describe a simple intraprocedural three-dimensional image-guided lesion shaping technique that can improve overall outcomes of MRgFUS for essential tremor and facilitate expansion to novel indications.

T-Bar Angular Offset: A Novel Angle for Predicting Postoperative Coronal Balance Using Intraoperative Stitched Radiographs.

Background And Objectives: Accurate intraoperative assessment of coronal alignment is critical to achieving favorable clinical outcomes in adult spinal deformity surgery. However, surgical positioning creates challenges in predicting standing coronal alignment. Gravity-based plumblines require an upright posture and are not possible intraoperatively.

Review of Endosaccular Flow Disrupters for Wide-Neck Aneurysm Treatment.

Endosaccular flow disruption has emerged as a transformative approach for treating wide-neck intracranial aneurysms, which are characterized by neck diameters exceeding 4 millimeters or dome-to-neck ratios below 2. This review examines the technical specifications and clinical outcomes of major endosaccular devices, including the Woven EndoBridge (WEB) device, the Artisse embolization device, the Medina embolization device, the neck bridging device for bifurcation aneurysms, the polycarbonate urethane membrane-assisted device, the Galaxy saccular endovascular aneurysm lattice, and the Contour Neurovascular System. Analysis of pivotal trials reveals varying degrees of efficacy and safety across platforms.

Fibular-Sided Avulsion of Posterior Inferior Tibiofibular Ligament-Patel-Sharma Fragment: A Case Report.

Case: A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator.

Respiratory influence on cerebral blood flow and blood volume - A 4D flow MRI study.

Variations in cerebral blood flow and blood volume interact with intracranial pressure and cerebrospinal fluid dynamics, all of which play a crucial role in brain homeostasis. A key physiological modulator is respiration, but its impact on cerebral blood flow and volume has not been thoroughly investigated. Here we used 4D flow MRI in a population-based sample of 65 participants (mean age = 75 ± 1) to quantify these effects.

Intra-articular Median Nerve Entrapment of the Elbow After Medial Epicondyle Fracture: A Case Report.

Case: We describe a 13-year-old adolescent girl experiencing persistent pain and reduced grip strength following nonoperative treatment of a medial epicondyle fracture-dislocation with closed reduction over 5 years before her referral to our clinic. Neurological examination and magnetic resonance imaging of the elbow revealed damage to the median nerve due to an entrapment within the elbow. Surgical release of the nerve resulted in complete pain relief and improved neurological function with normalized nerve conduction.

Pre-exposure antibody prophylaxis protects macaques from severe influenza.

Influenza virus pandemics and seasonal epidemics have claimed countless lives. Recurrent zoonotic spillovers of influenza viruses with pandemic potential underscore the need for effective countermeasures. In this study, we show that pre-exposure prophylaxis with broadly neutralizing antibody (bnAb) MEDI8852 is highly effective in protecting cynomolgus macaques from severe disease caused by aerosolized highly pathogenic avian influenza H5N1 virus infection.

A feature-based approach for atlas selection in automatic pelvic segmentation.

Accurate and efficient automatic segmentation is essential for various clinical tasks such as radiotherapy treatment planning. However, atlas-based segmentation still faces challenges due to the lack of representative atlas dataset and the computational limitations of deformation algorithms. In this work, we have proposed an atlas selection procedure (subset atlas grouping approach, MAS-SAGA) which utilized both image similarity and volume features for selecting the best-fitting atlases for contour propagation.

Feasibility of rabbit auricular VX2 tumor model as an experimental model for intra-arterial embolization.

This study aimed to evaluate the feasibility of VX2 tumor in rabbit auricles as an experimental model for intra-arterial embolization. This study was approved by our Institutional Animal Care and Use Committee. VX2 tumors were implanted in both auricles of 12 New Zealand White Rabbits.

Cardiac MRI in Heart Transplantation: Approaches and Clinical Insights.

Orthotopic heart transplant (OHT) is a well-established therapy for end-stage heart failure that leads to improved long-term survival rates, with careful allograft surveillance essential for optimizing clinical outcomes after OHT. Unfortunately, complications can arise after OHT that can compromise the success of the OHT. Cardiac MRI is continually evolving, with a range of advanced techniques that can be applied to evaluate allograft structure and function.

Hypointense Findings on Hepatobiliary Phase MR Images.

Hepatobiliary (HB) contrast agents are increasingly valuable diagnostic tools in MRI, offering a wider range of applications as their clinical use expands. Normal hepatocytes take up HB contrast agents, which are subsequently excreted in bile. This property creates a distinct HB phase providing valuable insights into liver function and biliary anatomy.

Image-guided Interventions for Core Muscle Injury and Other Disorders in the Pubic Symphysis.

Formerly termed or , core muscle injury (CMI) encompasses abnormality of structures within the so-called core, which is essentially the hip, abdomen, and pubis. Compared with data on image-guided procedures of other joints, information regarding procedures performed to address CMI and other disorders of the pubic symphysis is lacking. These procedures can be daunting given the joint's small size, surrounding critical neurovascular structures, and three-dimensional anatomy.

Bone Health and Linear Growth in Children with Familial Hypoparathyroidism Treated with Human Parathyroid Hormone 1-34.

Context: Our study explores the impact of human PTH 1-34 injections (PTH therapy) on growth, areal bone mineral density (BMD), and bone quality (measured by trabecular bone score, TBS) in hypoparathyroidism due to autoimmune polyendocrine syndrome type 1 (APS-1) or an activating variant of the calcium sensing receptor (CaR).

Objective: To assess associations of 1) age and PTH therapy duration with age-standardized Z-scores for height (HAZ), BMD (BMD-Z), and TBS (TBS-Z) in CaR or APS-1, and 2) APS-1 disease severity with BMD-Z and TBS-Z.

Methods: This secondary analysis pooled linear growth and lumbar spine (LS) DXA data from studies of hypoparathyroidism with mean baseline age of 13.

Characterization of cognitive decline in long-duration type 1 diabetes by cognitive, neuroimaging and pathological examinations.

Background: We aimed to characterize factors associated with the under-studied complication of cognitive decline in aging people with long-duration type 1 diabetes (T1D).

Methods: Joslin "Medalists" (n = 222; T1D ≥ 50 years) underwent cognitive testing. Medalists (n = 52) and age-matched non-diabetic controls (n = 20) underwent neuro- and retinal imaging.

Interplay between Skeletal Muscle Catabolism and Remodeling of Arteriovenous Fistula via YAP1 Signaling.

Background: Arteriovenous (AV) fistulas are the preferred access for dialysis but have a high incidence of failure. This study aims to understand the crosstalk between skeletal muscle catabolism and AV fistula maturation failure.

Methods: Skeletal muscle metabolism and AV fistula maturation were evaluated in mice with chronic kidney disease (CKD).

The clinical meaning of the UIP pattern in fibrotic hypersensitivity pneumonitis on cryobiopsy: A multicentre retrospective study.

Fibrotic hypersensitivity pneumonitis (f-HP) is an interstitial lung disease in which various antigens in susceptible individuals may play a pathogenetic role. This study evaluates the role of transbronchial lung cryobiopsy (TBLC) and bronchoalveolar lavage (BAL) in identifying a UIP-like pattern and its association with fibrosis progression. We conducted a multicentre retrospective cohort study of patients diagnosed with f-HP who underwent BAL and TBLC between 2011 and 2023.

Ultrathin bronchoscopy-guided small airway biopsy for diagnosing sarcoidosis: A prospective study.

New ultrathin bronchoscopes (UTBs) enable the inspection and biopsy of small airways, potentially offering diagnostic advantages in sarcoidosis. In this prospective study, patients with suspected sarcoidosis underwent airway inspection with a UTB. Observed airway abnormalities were categorised into six predefined patterns.

Risk assessment of persistent incidental pulmonary subsolid nodules to guide appropriate surveillance interval and endpoints.

Guidelines for the follow-up of pulmonary subsolid nodule (SSN) vary in terms of frequency and criteria for discontinuation. We aimed to evaluate the growth risk of SSNs and define appropriate follow-up intervals and endpoints. The immediate risk (IR) and cumulative risk (CR) of SSN growth were assessed using the Kaplan-Meier method according to nodule consistency and size.

The diagnostic performance and optimal strategy of cone beam CT-assisted bronchoscopy for peripheral pulmonary lesions: A systematic review and meta-analysis.

Cone-beam computed tomography (CBCT) assisted bronchoscopy shows prospective advantages in diagnosing peripheral pulmonary lesions (PPLs), but its diagnostic value and potential influencing factors remain unclear. What is the clinical value and optimal strategy of CBCT-assisted bronchoscopy in diagnosing PPLs? The references were searched from PubMed, EmBase, and Web of Science. Studies reporting diagnostic yield and potential influencing factors of CBCT-assisted bronchoscopy were included.

Myocardial extracellular volume fraction estimations using late enhancement CT in patients with atrial fibrillation: a comparative study with cardiac MR.

Myocardial extracellular volume fraction (ECV) measured via MRI serves as a quantitative indicator of myocardial fibrosis. However, accurate measurement of ECV using MRI in the presence of AF is challenging. Meanwhile, CT could be a promising alternative tool for measuring ECV regardless of sinus rhythm or AF.

Spatial single-cell maps reveal ST6GAL1 promoting ovarian cancer metastasis.

In this study, spatial and single-cell transcriptome techniques were used to investigate the role of beta-galactoside alpha-2,6-sialyltransferase 1 (ST6GAL1) in promoting peritoneal metastasis in ovarian cancer epithelial cells. We collected single-cell transcriptomic (GSE130000) and spatial transcriptomic datasets (GSE211956) from the Gene Expression Omnibus and RNA-sequencing data from The Cancer Genome Atlas. The Robust Cell Type Decomposition (RCTD) approach was implemented to integrate spatial and single-cell transcriptomic data.

Anti-melanoma differentiation-associated gene 5 antibody-positive interstitial lung disease masquerading as rheumatoid arthritis-associated interstitial lung disease or overlapping with the same: a phenomenon driven by a probable genetic predisposition.

Rheumatoid arthritis (RA) is a systemic, progressive illness marked by persistent synovitis that causes substantial functional disability. Treatment delays frequently affect health-related quality of life. Extra-articular features are prevalent findings in RA, which leads to significant morbidity and mortality.