Association of vascular brain injury, neurodegeneration, amyloid, and cognitive trajectory.

Objective: To determine whether vascular and neurodegenerative factors influence cognition before clinically relevant Alzheimer disease pathology, we analyzed MRI measures and amyloid imaging in an ethnoracially diverse cohort of cognitively normal individuals older than 60 years.

Methods: Participants (n = 154; mean age 74.15 ± 6.

Dihydroxyacetone phosphate signals glucose availability to mTORC1.

The mechanistic target of rapamycin complex 1 (mTORC1) kinase regulates cell growth by setting the balance between anabolic and catabolic processes. To be active, mTORC1 requires the environmental presence of amino acids and glucose. While a mechanistic understanding of amino acid sensing by mTORC1 is emerging, how glucose activates mTORC1 remains mysterious.

Current and future usefulness and potential of virtual simulation in improving outcomes and reducing complications in endovascular treatment of unruptured intracranial aneurysms.

Background: Simulation training has been used in the aviation industry and surgical specialties for many years, but integration into neurointerventional practice is lagging behind.

Objective: To investigate how neurointerventionalists perceive the usefulness and limitations of simulation tools for the treatment of unruptured intracranial aneurysms (UIAs), and to identify simulation applications that were perceived to be most valuable for endovascular UIA treatment.

Methods: A web-based international multidisciplinary survey was conducted among neurointerventionalists.

The Risk of Stroke and TIA in Nonstenotic Carotid Plaques: A Systematic Review and Meta-Analysis.

Background: Severe carotid stenosis carries a high risk of stroke. However, the risk of stroke with nonstenotic carotid plaques (<50%) is increasingly recognized.

Purpose: We aimed to summarize the risk of TIA or stroke in patients with nonstenotic carotid plaques.

MRI Head Coil Malfunction Producing Artifacts Mimicking Malformation of Cortical Development in Pediatric Epilepsy Work-Up.

We recently observed a type of MR imaging artifact that consistently mimics an abnormal appearance of the cerebral cortex, leading to initial misinterpretation and repeat scans. The artifact is caused by malfunction of part of the multichannel phased array head coil and is manifested by irregularity of cortical surface and gray-white matter junctions. The presence of such an artifact can be confirmed by assessing the background noise of the MR images and checking the coil element status on the MR imaging operator console.

Endovascular stroke treatment during the COVID-19 pandemic.

The COVID-19 pandemic has added an additional layer of complexity to endovascular treatment (EVT) for acute ischaemic stroke. Drawing on recently published guidelines, this article provides a conceptual framework for EVT in the COVID-19 era, outlining key principles for ensuring safe and timely EVT while minimizing the risk of infectious exposure for health-care workers and patients.

Reflux symptoms and oesophageal acidification in treated achalasia patients are often not reflux related.

Objective: After treatment, achalasia patients often develop reflux symptoms. Aim of this case-control study was to investigate mechanisms underlying reflux symptoms in treated achalasia patients by analysing oesophageal function, acidification patterns and symptom perception.

Design: Forty treated achalasia patients (mean age 52.

Improving Stroke Care in Times of the COVID-19 Pandemic Through Simulation: Practice Your Protocols!

During the coronavirus disease 2019 (COVID-19) pandemic, infectious disease control is of utmost importance in acute stroke treatment. This is a new situation for most stroke teams that often leads to uncertainty among physicians, nurses, and technicians who are in immediate contact with patients. The situation is made even more complicated by numerous new regulations and protocols that are released in rapid succession.

Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future.

In What Scenarios Does a Mobile Stroke Unit Predict Better Patient Outcomes?: A Modeling Study.

Background and Purpose- The mobile stroke unit (MSU) brings imaging and thrombolysis to patients in the field. The MSU has the potential to decrease time from onset to thrombolysis; however, this depends on the location of the patient, the MSU, and the hospital. The MSU will only be able to treat a small subset of patients it is dispatched to.

Prevalence of Ipsilateral Nonstenotic Carotid Plaques on Computed Tomography Angiography in Embolic Stroke of Undetermined Source.

Background and Purpose- Embolic stroke of undetermined source (ESUS) constitutes a large proportion of acute ischemic stroke. It is crucial to identify possible stroke etiologies in this patient subgroup to individually tailor secondary stroke prevention strategies. This study aimed to assess the prevalence of carotid plaques causing <50% stenosis in ESUS patients on computed tomography angiography and the association of these plaques with ipsilateral strokes.

Brief Cognitive Tests for Distinguishing Clinical Alzheimer-Type Dementia From Mild Cognitive Impairment or Normal Cognition in Older Adults With Suspected Cognitive Impairment.

Background: The accuracy and harms of brief cognitive tests for identifying clinical Alzheimer-type dementia (CATD) are uncertain.

Purpose: To summarize evidence on accuracy and harms of brief cognitive tests for CATD in older adults with suspected cognitive impairment.

Data Sources: Electronic bibliographic databases (from inception to November 2019) and systematic review bibliographies.

Accuracy of Biomarker Testing for Neuropathologically Defined Alzheimer Disease in Older Adults With Dementia.

Background: Biomarker accuracy for Alzheimer disease (AD) is uncertain.

Purpose: To summarize evidence on biomarker accuracy for classifying AD in older adults with dementia.

Data Sources: Electronic bibliographic databases (searched from January 2012 to November 2019 for brain imaging and cerebrospinal fluid [CSF] tests and from inception to November 2019 for blood tests), ClinicalTrials.

Benefits and Harms of Prescription Drugs and Supplements for Treatment of Clinical Alzheimer-Type Dementia.

Background: Effects of drug treatment of clinical Alzheimer-type dementia (CATD) are uncertain.

Purpose: To summarize evidence on the effects of prescription drugs and supplements for CATD treatment.

Data Sources: Electronic bibliographic databases (inception to November 2019), ClinicalTrials.

Spatial Resolution and the Magnitude of Infarct Volume Measurement Error in DWI in Acute Ischemic Stroke.

Background And Purpose: Infarct volume in acute ischemic stroke is an important prognostic marker and determines endovascular treatment decisions. This study evaluates the magnitude and potential clinical impact of the error related to partial volume effects in infarct volume measurement on diffusion-weighted MR imaging in acute stroke and explores how increasing spatial resolution could reduce this error.

Materials And Methods: Diffusion-weighted imaging of 393 patients with acute stroke, of whom 56 had anterior circulation large-vessel occlusion, was coregistered to standard space.

A TfR-Binding Cystine-Dense Peptide Promotes Blood-Brain Barrier Penetration of Bioactive Molecules.

The impenetrability of the blood-brain barrier (BBB) to most conventional drugs impedes the treatment of central nervous system (CNS) disorders. Interventions for diseases like brain cancer, neurodegeneration, or age-associated inflammatory processes require varied approaches to CNS drug delivery. Cystine-dense peptides (CDPs) have drawn recent interest as drugs or drug-delivery vehicles.

Workflow patterns and potential for optimization in endovascular stroke treatment across the world: results from a multinational survey.

Background: The benefit of endovascular treatment (EVT) is highly time-dependent, and treatment delays reduce patients' chances to achieve a good outcome. In this survey-based study, we aimed to evaluate current in-hospital EVT workflow characteristics across different countries and hospital settings, and to quantify the time-savings that could be achieved by optimizing particular workflow steps.

Methods: In a multinational survey, neurointerventionalists were asked to provide specific information about EVT workflows in their current working environment.

Effects of Chronic Nicotine Inhalation on Systemic and Pulmonary Blood Pressure and Right Ventricular Remodeling in Mice.

Cigarette smoking is the single most important risk factor for the development of cardiovascular and pulmonary diseases; however, the role of nicotine in the pathogenesis of these diseases is incompletely understood. The purpose of this study was to examine the effects of chronic nicotine inhalation on the development of cardiovascular and pulmonary disease with a focus on blood pressure and cardiac remodeling. Male C57BL6/J mice were exposed to air (control) or nicotine vapor (daily, 12 hour on/12 hour off) for 8 weeks.

Home medicines reviews and residential medication management reviews in Western Australia.

Background Australian government funding for Residential Medication Management Reviews and Home Medicines Reviews commenced in 1997 and 2001 respectively. Limited data are available on their provision in Australia. Objective To investigate the extent and characteristics of Home Medicines Review and Residential Medication Management Review services provided by accredited pharmacists practising in Western Australia.