Symptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention.

Symptomatic carotid disease, characterized by atherosclerotic or non-atherosclerotic internal carotid artery disease with ipsilateral stroke symptoms, represents a critical condition in stroke neurology. This "hot carotid" state carries a high risk of stroke recurrence, with almost one-fourth of the patients experiencing recurrent ischemic events within 2 weeks of initial presentation. The global prevalence of significant carotid stenosis (conventionally defined as ≥50% narrowing) is estimated at around 1.

Challenges in the Diagnosis and Management of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD).

Myelin oligodendrocyte glycoprotein antibody-associated disease has been recently identified to be a distinct autoimmune central nervous system disorder. There is significant clinical and radiological overlap with multiple sclerosis and aquaporin-4-IgG-associated neuromyelitis optica spectrum disorders. Clinical course is variable in that patients may have a monophasic or relapsing course, disease severity is unpredictable, and unlike other idiopathic autoimmune inflammatory disorders, there is no gender predilection and it is more likely to affect pediatric population.

Outcome Predictors of Generalized Myasthenia Gravis: A Prospective Observational Study.

Background And Objectives: There is paucity of studies on long-term remission of autoimmune generalized myasthenia gravis (MG) from Southeast Asia. We report the outcome predictors of generalized MG and also evaluate the influence of high- versus low-dose prednisolone and prednisolone with or without azathioprine (AZA).

Methods: Fifty-seven patients with generalized MG were included, who completed 2 years of follow-up.

Performance of an Electronic Health Record-Based Automated Pulmonary Embolism Severity Index Score Calculator: Cohort Study in the Emergency Department.

Background: Studies suggest that less than 4% of patients with pulmonary embolisms (PEs) are managed in the outpatient setting. Strong evidence and multiple guidelines support the use of the Pulmonary Embolism Severity Index (PESI) for the identification of acute PE patients appropriate for outpatient management. However, calculating the PESI score can be inconvenient in a busy emergency department (ED).

Optimizing autonomous artificial intelligence diagnostics for neuro-ocular health in space missions.

Spaceflight-Associated Neuro-Ocular Syndrome (SANS) presents a critical risk in long-duration missions, with microgravity-induced changes that threaten astronaut vision and mission outcomes. Current SANS monitoring, limited to pre- and post-flight exams, lacks in-flight diagnostics, highlighting an urgent need for autonomous tools capable of real-time assessment. Grok, an AI platform by xAI, offers promising potential as an advanced diagnostic tool for space-based health monitoring.

The hypercapnic environment on the International Space Station (ISS): A potential contributing factor to ocular surface symptoms in astronauts.

With increasing advancements and efforts towards space exploration, there is a pressing need to understand the impacts of spaceflight on astronauts' health. Astronauts have reported signs and symptoms of dry eye disease upon traveling to the International Space Station (ISS), thus necessitating an evaluation of the factors that contribute to the onset of spaceflight associated dry eye disease. Prior literature describes the hypercapnic environment of the ISS; however, the link between the high CO levels and astronauts' symptoms of dry eye disease remains unexplored.

Adaptive Intervention for School-Age, Minimally Verbal Children With Autism Spectrum Disorder in the Community: Primary Aim Results.

Objective: The goal of this study is to construct a 16-week, two-stage, adaptive intervention consisting of DTT ([discrete trials training], largely considered usual care for children with autism), JASP-EMT (a blended, naturalistic, developmental behavioral intervention involving JASPER [joint attention, symbolic play, engagement and regulation] and EMT [enhanced milieu teaching]), and parent training (P) for improving spontaneous, communicative utterances in school-aged, minimally verbal autistic children. Intervention was delivered both at school (DTT, JASP-EMT) and home (P). This manuscript reports results for the study's primary aim and a closely related secondary aim.

Assessing Lung Cancer Screening Eligibility of Lung Cancer Patients in the Boston Lung Cancer Study: An Analysis of 7,186 Lung Cancer Cases.

Background: To evaluate the proportion of lung cancer patients who would have qualified for lung cancer screening under different eligibility criteria in the Boston Lung Cancer Study (BLCS).

Methods: BLCS participants diagnosed with lung cancer from 1992-2024 were identified for analysis. The proportion of patients who would have qualified for screening under the 2021 U.

Volume-Outcome Relationship of Norwood Procedures: Insights from the National Pediatric Cardiology - Quality Improvement Collaborative Database.

Background: Prior investigations of the center-specific case volume on outcomes in hypoplastic left heart syndrome have conflicting results. This study utilized the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry to investigate the center volume-outcome relationship in patients following the Norwood procedure with consideration of pre-operative high-risk features.

Methods: Between 2016 and 2023, centers were categorized by Norwood procedure volume into low (≤ 5 cases/year), medium (6 to 10 cases/year), and high-volume centers (> 10 cases/year).

Redo Surgical Aortic Valve Replacement versus Valve-in-Valve Transcatheter Aortic Valve Replacement for Degenerated Bioprosthetic Valves.

Background: Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) is associated with improved perioperative safety compared to redo surgical aortic valve replacement (redo-SAVR), but long-term outcomes remain uncertain. We therefore compare long-term outcomes of ViV-TAVR and redo-SAVR.

Methods: The study included 1:1 propensity-matched Medicare beneficiaries with degenerated bioprosthetic valves admitted between 09/29/2011 and 12/30/2020 undergoing either redo-SAVR or ViV-TAVR.

Increased Risk of Surgical Aortic Valve Replacement After Prior Transcatheter Versus Surgical Aortic Valve Replacement with Concomitant Valve Disease.

Background: The etiology of increased risk for reoperation after transcatheter aortic valve replacement (TAVR) versus prior surgical aortic valve replacement (SAVR) is poorly understood. This study evaluated the impact of concomitant mitral and tricuspid valve disease on associated risk of TAVR explant.

Methods: Patients undergoing aortic valve replacement after prior SAVR or TAVR were extracted from the Society of Thoracic Surgeons Adult Cardiac Surgery Database (2011-2021).

Insurance-Based Disparities in Cardiac Allograft Vasculopathy Following Heart Transplantation Are Mediated by Care at High Volume Centers.

Background: Socioeconomic disadvantage and Medicaid insurance have been linked with inferior survival following heart transplantation, yet the contributing mechanisms remain to be elucidated. We evaluated the association of Medicaid with the development of cardiac allograft vasculopathy(CAV).

Methods: We considered heart transplant recipients ≥18years within the 2004-2022 Organ Procurement and Transplantation Network.

Lobectomy verses Sublobar Resection in The Society of Thoracic Surgeons Database: Importance of Patient Factors and Lymph Node Evaluation.

Background: Prospective randomized trials have demonstrated noninferior survival between sublobar resection and lobectomy in healthy non-small cell lung cancer (NSCLC) patients with tumors ≤2cm. However, some patient attributes are not well represented in randomized trials and uncertainty remains in the widespread applicability of randomized trial nodal dissection protocols.

Methods: Patients with ≤2cm, node-negative NSCLC (cT1N0) in the Society of Thoracic Surgeons prospective database were linked to Medicare survival data using a probabilistic matching algorithm.

Anastomotic Leak after Esophagectomy - Analysis of the STS General Thoracic Surgery Database.

Background: Anastomotic leak after esophagectomy is a major cause of morbidity and mortality. We sought to identify the prevalence of anastomotic leak, stratified by operative approach and disease etiology, as well as risk factors for leak.

Methods: A retrospective cohort analysis using the STS General Thoracic Surgery Database was conducted on patients who underwent esophagectomy with gastric reconstruction between 2009-2021.

The Society of Thoracic Surgeons National Intermacs Database Risk Model for Durable Left Ventricular Assist Device Implantation.

Background: Statistical risk models for durable left ventricular assist device (LVAD) implantation inform candidate selection, quality improvement, and evaluation of provider performance. We developed a 90-day mortality risk model utilizing The Society of Thoracic Surgeons National Intermacs Database (STS Intermacs).

Methods: STS Intermacs was queried for primary durable LVAD implants from 1/ 2019 - 9/2023.

Transcatheter vs Surgical Aortic Valve Replacement in Medicare Beneficiaries with Aortic Stenosis and Coronary Artery Disease.

Background: As percutaneous therapeutic options expand, the optimal management of severe aortic stenosis (AS) and concomitant coronary artery disease (CAD) is being questioned between coronary artery bypass grafting and surgical aortic valve replacement (CABG+SAVR) versus percutaneous coronary intervention and transcatheter aortic valve replacement (PCI+TAVR). We sought to compare perioperative and longitudinal risk-adjusted outcomes between patients undergoing CABG+SAVR versus PCI+TAVR.

Methods: Using the United States Centers for Medicare and Medicaid Services inpatient claims database, we evaluated all patient age 65 and older with AS and CAD undergoing CABG+SAVR or PCI+TAVR (2018-2022).

Light chain Split Luciferase assay implicates pathological NOTCH3 thiol reactivity in inherited cerebral small vessel disease.

Stereotyped mutations in NOTCH3 drive CADASIL, the leading inherited cause of stroke and vascular dementia. The vast majority of these mutations result in alterations in the number of cysteines in the gene product. However, non-cysteine altering pathogenic mutations have also been identified, making it challenging to discriminate pathogenic from benign NOTCH3 sequence variants.

Lung cancer screening program quality indicators - review & recommendations - An International Association for the Study of Lung Cancer Delphi process study.

Introduction: Lung cancer screening (LCS) using low-dose-computed tomography reduces lung cancer mortality in high-risk individuals. Evaluating and monitoring LCS programs are important to ensure and improve quality, efficiency and participant outcomes. There is no agreement on LCS quality indicators (QIs).

Covered Versus Bare Metal Stents in Chronic Mesenteric Ischaemia Treatment: A Systematic Review and Meta-analysis.

Introduction: The main treatment for Chronic Mesenteric Ischemia (CMI) is revascularization, typically achieved through stent angioplasty of the superior mesenteric artery, and in certain cases, the celiac trunk. However, long-term outcomes using bare-metal stents have been less than satisfactory. Therefore, we aimed to compare the performance of covered stents (CS) versus bare-metal stents (BMS) in patients treated for CMI.

Incidence and comparison of postoperative explained and unexplained fever in open aortic repair.

Objective: Fever is a classic symptom in postoperative period, but to our knowledge no study shows exclusively the occurrence of fever after open aortic repair (OAR) and explores the difference between explained and unexplained fever.

Methods: Patients who underwent an OAR between March 2018 to April 2023 in Reims University Hospital were enrolled retrospectively. The primary endpoint was the rate of fever after OAR, which was classed in explained fever group (eFG) or unexplained fever group (uFG).

Comparison of treatment outcomes between graft replacement and aneurysmorrhaphy with graft preservation for type 2 endoleaks after endovascular abdominal aortic aneurysm repair.

Objective: This study aimed to compare treatment outcomes between graft replacement and aneurysmorrhaphy with ligation of the aortic side branches for type 2 endoleaks after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms.

Methods: We retrospectively analyzed multicenter data of patients who underwent open surgical conversion, including graft replacement or aneurysmorrhaphy with ligation of the aortic side branches (graft preservation) for the treatment of type 2 endoleaks between 2007 and 2022. The endpoints were postoperative complications, 30-day mortality, overall survival, and reintervention or sac expansion after open surgical conversion.

Vascular research of pig knee from the perspective of comparative medicine.

Objective: Pigs have long been employed as an animal model for knee-related diseases. However, vascular anatomy around the pig knee is rare. The objective of this study was to explore the vascular anatomy around the pig knee from the perspective of comparative medicine.