THE DIAGNOSIS AND TREATMENT OF ASYMPTOMATIC AND SYMPTOMATIC PATIENTS WITH CAROTID ARTERY STENOSIS.

Carotid artery atherosclerotic stenosis is an important annual cause of stroke in the United States. Moreover, the incidence of carotid artery stenosis is significantly increasing due to the widespread popularity of high fat and high salt diets, sedentary lifestyles, and the increasing age of the population. Of major importance to cardiovascular specialists is the fact that individuals with atherosclerotic carotid artery stenosis can have a prevalence of atherosclerotic coronary artery disease as high as 50 to 75%.

Changes in weight and physical function for older African American women in Take Off Pounds Sensibly (TOPS): Study protocol for a randomized clinical trial.

Background: Obesity and frailty are positively linked. Compared to other groups, older African American women have the highest rates of both obesity and frailty. Several academic weight loss interventions have shown that older adults can lose weight and improve physical function through diet and exercise.

N-Branched Tricyclic Guanidines as Novel Melanocortin-3 Receptor Agonists and Melanocortin-4 Receptor Antagonists.

The melanocortin receptors are a class of centrally and peripherally expressed G protein-coupled receptors, of which the MC3R and MC4R subtypes are implicated in the regulation of appetite and energy homeostasis and can serve as potential therapeutic targets for disorders such as obesity and cachexia. An unbiased high-throughput mixture-based library screen was implemented to identify novel ligands with an emphasis on the identification of nanomolar-potent agonists of the mouse melanocortin-3 receptor. This screen yielded the discovery of an N-branched tricyclic guanidine scaffold (TPI2408) that contained three nanomolar potent mMC3R agonists and additional compounds that possessed antagonism for the mMC4R.

Impact of Genomic Classifiers on Risk Stratification and Treatment Intensity in Patients With Localized Prostate Cancer : A Systematic Review.

Background: Tissue-based genomic classifiers (GCs) have been developed to improve prostate cancer (PCa) risk assessment and treatment recommendations.

Purpose: To summarize the impact of the Decipher, Oncotype DX Genomic Prostate Score (GPS), and Prolaris GCs on risk stratification and patient-clinician decisions on treatment choice among patients with localized PCa considering first-line treatment.

Data Sources: MEDLINE, EMBASE, and Web of Science published from January 2010 to August 2024.

Stroke Rehabilitation: Synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Description: In July 2024, the U.S. Department of Veterans Affairs (VA) and U.

Hemorrhagic astroblastoma: atypical presentation of a rare tumor. Illustrative case.

Background: Astroblastoma is an extremely rare tumor of the central nervous system, and its origin and validity as a different entity are still being debated. Because of its rarity and similarities to other glial neoplasms, it is often misdiagnosed, impacting treatment and outcomes.

Observations: Astroblastoma is very rare and mainly affects children and young adults.

Iatrogenic pseudoaneurysm formation of the anterior cerebral artery following placement of an external ventricular drain: illustrative case.

Background: External ventricular drains (EVDs) provide an invaluable diagnostic method for accessing cerebrospinal fluid and therapeutically treating elevated intracranial pressure. Although complications including hemorrhage and infection have been well documented, the formation of iatrogenic pseudoaneurysms following EVD placement has rarely been reported. The authors present a case of this exceedingly rare complication of iatrogenic pseudoaneurysm formation following EVD placement.

Connecting the dots: Low-grade appendiceal mucinous neoplasms and serrated polyps in the appendix.

Objective: This study aimed to examine the relationship between low-grade appendiceal mucinous neoplasms (LAMNs) and serrated polyps (SPs) of the appendix, both characterized by KRAS mutations and overlapping morphologic features.

Methods: We analyzed 27 cases of LAMN and 24 cases of SP from archival records, reviewed pathology, and performed molecular analysis on select cases. Four cases initially diagnosed as LAMN were excluded for not meeting diagnostic criteria, and 1 SP case was reclassified as LAMN.

Dry ice sublimation: A computational study with experimental validation for the effects of geometry.

Dry ice is one of the world's most in-demand commodities for cold-chain distribution of temperature-sensitive products. It offers an effective cooling solution without requiring mechanical refrigeration or specialized equipment. Dry ice is commonly produced as pellets and blocks.

How Weight Bias and Stigma Undermine Healthcare Access and Utilization.

Purpose Of Review: To highlight recent evidence of the impact of weight bias and stigma on healthcare access and utilization.

Recent Findings: Healthcare access for patients with obesity is limited by weight-discriminatory policies such as body mass index cutoffs and weight loss requirements. These policies are based on flawed justifications without demonstrated medical benefits.

Avian haemosporidian parasites affecting non-descript village chickens in Africa.

Smallholder farmers in most of the rural areas in African countries rear non-descript village chickens for petty cash, food provision and for performing rituals. Village chicken production systems are regarded as low input- low output because the chickens receive minimum care and produce average to less eggs and meat. The chickens receive minimal biosecurity and are often left to scavenge for feed and thus exposes them to potential vector parasites that can transmit parasites such as haemoparasites.

Identifying the greatest surgeon-perceived barriers and challenges in performing corneal transplantation in India.

Objective: There is currently no systematic method of assessing limitations in performing corneal transplantation. The purpose of the study was to identify the limitations of performing corneal transplantation in India.

Design: Cross-sectional survey study.

Depression in High-Risk Offspring: The Mediating Role of Sleep Problems.

Parental depression is associated with offspring depression and sleep problems are prospectively associated with the development of depression. However, little work has examined sleep problems in the offspring of depressed parents and whether these problems partially account for the association between parent and offspring depression. This longitudinal study examined the indirect effect of sleep problems on the association between parent psychopathology and offspring depression in a sample of 10,953 10 to 12-year-old children participating in the Adolescent Brain and Cognitive Development (ABCD) study.

Prospective Harmonization, Common Data Elements, and Sharing Strategies for Multicenter Pre-Clinical Traumatic Brain Injury Research in the Translational Outcomes Project in Neurotrauma Consortium.

Effective team science requires procedural harmonization for rigor and reproducibility. Multicenter studies across experimental modalities (domains) can help accelerate translation. The Translational Outcomes Project in NeuroTrauma (TOP-NT) is a pre-clinical traumatic brain injury (TBI) consortium charged with establishing and validating noninvasive TBI assessment tools through team science.

Impacts of Weather Anomalies and Climate on Plant Disease.

Predicting the effects of climate change on plant disease is critical for protecting ecosystems and food production. Here, we show how disease pressure responds to short-term weather, historical climate and weather anomalies by compiling a global database (4339 plant-disease populations) of disease prevalence in both agricultural and wild plant systems. We hypothesised that weather and climate would play a larger role in disease in wild versus agricultural plant populations, which the results supported.

Histopathologic Progression and Metastatic Relapse Outcomes in Small Cell Neuroendocrine Carcinomas of the Urinary Tract.

Introduction: Small cell neuroendocrine carcinoma of the urinary tract (SCNEC-URO) has an inferior prognosis compared to conventional urothelial carcinoma (UC). Here, we evaluate the predictors and patterns of relapse after surgery.

Materials And Methods: We identified a definitive-surgery cohort (n = 224) from an institutional database of patients with cT1-T4NxM0 SCNEC-URO treated in 1985-2021.

Implementing Early Kangaroo Mother Care: A Quality Improvement Initiative.

Background: Kangaroo Mother Care (KMC) has numerous maternal and neonatal benefits. KMC is often overlooked as a vital neonatal stabilization tool. Factors that influence the initiation of KMC by bedside staff include a lack of specific education on KMC, low confidence, and hesitancy due to the infant's clinical illness.

Conceptual and Evidence Update on Incidental Physical Activity: A Scoping Review of Experimental and Observational Studies.

Promoting incidental physical activity (IPA) can help reduce sedentary lifestyles and physical inactivity levels in the population. However, there is heterogeneity in the definition of IPA, and studies have yet to synthesize the empirical findings on this topic. This review aimed to (1) Synthesize the definitions of the IPA used in the scientific literature, (2) Identify the behaviors part of the IPA, and (3) Synthesize the main findings on IPA.

A novel approach to decannulation of a tracheostomy tube using a 1-way speaking valve after upper airway trauma in 2 dogs.

Objective: To describe a novel approach to tracheostomy management in dogs with upper airway trauma.

Case Series Summary: Two dogs with upper airway trauma presented to an emergency department and required immediate intubation. To minimize sedation time, tracheostomy tubes were placed in both dogs.

Retrospective evaluation of dexamethasone for treatment of suspected critical illness-related corticosteroid insufficiency in dogs with septic shock (2017-2022): 60 cases.

Objective: To retrospectively compare and report vasopressor duration and mortality of septic dogs with hypotension refractory to vasopressor administration (presumed critical illness-related corticosteroid insufficiency [CIRCI]) treated with or without dexamethasone sodium phosphate (DxSP).

Design: Retrospective study (2017-2022).

Setting: Tertiary referral and teaching hospitals.

Visual assessment for frontal sinus radiographic identifications: Documenting accuracy and exploring the effects of experience.

Decedent positive identification via visual comparisons of frontal sinus radiographs is commonly used in the medicolegal field; however, only a handful of studies have empirically tested this method. This study aimed to test the accuracy of visual assessment in frontal sinus identifications across a large and experientially diverse participant sample. A Qualtrics survey presented participants with 25 pairs of cropped frontal sinus radiographs, asking them to determine if they matched and their confidence level.

Latent Trajectories of Change in Dietary Restriction During Treatment in Avoidant/Restrictive Food Intake Disorder and Anorexia Nervosa.

Objective: Outcomes for low-weight restrictive eating disorders, including anorexia nervosa, restricting type (AN-R) and avoidant/restrictive food intake disorder (ARFID), are sub-optimal. Reducing dietary restriction is a key treatment target. Understanding heterogeneity in patterns of change in dietary restriction may aid in improving outcomes.

Self-Diffusion of Star and Linear Polyelectrolytes in Salt-Free and Salt Solutions.

This work explored solution properties of linear and star poly(methacrylic acids) with four, six, and eight arms (PMAA, 4PMAA, PMAA, and 8PMAA, respectively) of matched molecular weights in a wide range of pH, salt, and polymer concentrations. Experimental measurements of self-diffusion were performed by fluorescence correlation spectroscopy (FCS), and the results were interpreted using the scaling theory of polyelectrolyte solutions. While all PMAAs were pH sensitive and showed an increase in hydrodynamic radius ( ) with pH in the dilute regime, the of star polymers (measured at basic pH values) was significantly smaller for the star polyacids due to their more compact structure.

Associations between Driving Cessation and Mental Health among Rural and Urban Older Adults.

Driving cessation is robustly associated with poor mental health outcomes among older adults; however, the magnitude of this relationship may differ by rurality. This study examined cross-sectional and longitudinal associations between driving cessation and life satisfaction and depressive symptoms and assessed whether these relationships were moderated by rurality. Data is from participants in the 2014 and 2016 Health and Retirement Study (HRS) (mean age = 73; 58% female) with information on either depressive symptoms (n=5,650) or life satisfaction (n=1,931).

Vitiligo Exchange: An Expert Panel Discussion of Two Clinical Cases.

This article is based on a roundtable discussion in which three panelists review clinically relevant insights about vitiligo and discuss two cases that illustrate the multiple challenges faced by both patients and clinicians in managing this complex disease. The first is a 32-year-old White female patient with Fitzpatrick Skin Type III/IV with extensive depigmentation in the trunk area. The patient achieved 90-percent repigmentation with a combination therapy approach.