Opportunities and Challenges of Chatbots in Ophthalmology: A Narrative Review.

Artificial intelligence (AI) is becoming increasingly influential in ophthalmology, particularly through advancements in machine learning, deep learning, robotics, neural networks, and natural language processing (NLP). Among these, NLP-based chatbots are the most readily accessible and are driven by AI-based large language models (LLMs). These chatbots have facilitated new research avenues and have gained traction in both clinical and surgical applications in ophthalmology.

Efficacy and safety of tofacitinib in an open-label, long-term extension study in patients with psoriatic arthritis who received adalimumab or tofacitinib in a Phase 3 randomized controlled study: a post hoc analysis.

Background: Data on treatment switching directly from tumor necrosis factor inhibitors to tofacitinib in psoriatic arthritis (PsA) are limited. This post hoc analysis assessed efficacy and safety outcomes in patients with PsA who directly switched to tofacitinib in a long-term extension (LTE) study after receiving adalimumab (ADA) in a Phase 3 study, compared with those who continued to receive tofacitinib.

Methods: Patients with active PsA received tofacitinib 5 mg twice daily (BID) or ADA 40 mg once every 2 weeks in a 12-month, randomized, double-blind study (OPAL Broaden) and then continued or switched to tofacitinib 5 mg BID and maintained this dose in an open-label LTE study (OPAL Balance).

Genetic Diversity and Expanded Phenotypes in Dystonia: Insights from Large-Scale Exome Sequencing.

Dystonia is one of the most prevalent movement disorders, characterized by significant clinical and etiological heterogeneity. Despite considerable heritability (~25%) and the identification of several disease-linked genes, the etiology in most patients remains elusive. Moreover, understanding the correlations between clinical manifestation and genetic variants has become increasingly complex.

repeat expansion creates the unstable folate-sensitive fragile site FRA9A.

The hyper-unstable Chr9p21 locus, harbouring the interferon gene cluster, oncogenes and , is linked to multiple diseases. (GGGGCC)n expansions (Exp) are associated with incompletely penetrant amyotrophic lateral sclerosis, frontotemporal dementia and autoimmune disorders. Exp patients display hyperactive cGAS-STING-linked interferon immune and DNA damage responses, but the source of immunostimulatory or damaged DNA is unknown.

The anesthetic and recovery profiles of low-dose hypobaric mepivacaine and bupivacaine for spinal anesthesia in total hip and knee arthroplasty: a prospective observational study.

Purpose: Same-day mobilization and early hospital discharge is increasingly emphasized following hip and knee arthroplasty. One challenge of spinal anesthesia in this setting is achieving adequate block height while avoiding excessively large local anesthetic doses and prolonged motor and sensory blockade. Using a hypobaric local anesthetic solution is one potential strategy, as its intrathecal distribution can be reliably manipulated by patient positioning to achieve adequate block height independent of dose.

Surgical Resection Followed by Stereotactic Radiosurgery (S+SRS) Versus SRS Alone for Large Posterior Fossa Brain Metastases: A Comparative Analysis of Outcomes and Factors Guiding Treatment Modality Selection.

Background/objectives: Around 20% of cancer patients will develop brain metastases (BrMs), with 15-25% occurring in the posterior fossa (PF). Although the effectiveness of systemic therapies is increasing, surgery followed by stereotactic radiosurgery (S+SRS) versus definitive SRS remains the mainstay of treatment. Given the space restrictions within the PF, patients with BrMs in this location are at higher risk of brainstem compression, hydrocephalus, herniation, coma, and death.

Obstacles in "Time to Spine": Challenges for the Timely Delivery of Acute Surgical Care for Patients with Traumatic and Non-Traumatic Spinal Cord Injury.

Over the past three decades, advancements in our understanding of the pathophysiology of spinal cord injury (SCI) have underscored the critical importance of early treatment for both traumatic and non-traumatic cases. Early surgical intervention significantly improves outcomes by limiting the extent of secondary damage. Despite numerous studies highlighting the superior outcomes associated with early decompression surgery for patients with SCIs, hospital reviews reveal that less than 60% of patients undergo surgical decompression within 24 h of injury.

Who is helping students? A qualitative analysis of task-shifting and on-campus mental health services in China's university settings.

The mental health of university students is a major concern worldwide. Current literature has highlighted workforce shortage as one of the main barriers for delivering mental health care in China and elsewhere. A common strategy to tackle this shortage involves engaging non-specialist health workers and professionals from non-medical backgrounds in mental health promotion within university settings.

The Impact of Revascularization Surgery on Headaches in Association with Cerebrovascular Reactivity in Patients with Moyamoya Angiopathy.

Background/objectives: Headaches in Moyamoya angiopathy are common but poorly understood. We aimed to investigate if headaches in Moyamoya angiopathy improve after revascularization surgery and whether this is associated with improvement in cerebrovascular reactivity on MRI (CVR-MRI).

Methods: We included consecutive adult patients with Moyamoya angiopathy who had chart data on headaches, CVR-MRI, and underwent extracranial-intracranial bypass surgery between January 2010 and September 2022 at a tertiary neurovascular referral center.

Who gets better after surgery for degenerative cervical myelopathy? A responder analysis from the multicenter Canadian spine outcomes and research network.

Background Context: Degenerative cervical myelopathy (DCM) is the most common cause of acquired nontraumatic spinal cord injury worldwide. Surgery is a common treatment for DCM; however, outcomes often vary across patients.

Purpose: To inform preoperative education and counseling, we performed a responder analysis to identify factors associated with treatment response.

Persistent activity during working memory maintenance predicts long-term memory formation in the human hippocampus.

Working memory (WM) and long-term memory (LTM) are often viewed as separate cognitive systems. Little is known about how these systems interact when forming memories. We recorded single neurons in the human medial temporal lobe while patients maintained novel items in WM and completed a subsequent recognition memory test for the same items.

Does ultrasound guidance decrease femoral access site complications in neurointerventional procedures? A retrospective cohort study.

Background: Ultrasound has been increasingly used to guide femoral arterial access for neuroendovascular procedures. Its effect on the safety outcomes has yet to be established.

Purpose: The purpose is to determine the effect of ultrasound-guided punctures on femoral access site complications (ASC), and to identify other potential predictors of ASC.

How Safe Are COVID-19 Vaccines in Individuals with Immune-Mediated Inflammatory Diseases? The SUCCEED Study.

We were tasked by Canada's COVID-19 Immunity Task Force to describe severe adverse events (SAEs) associated with emergency department (ED) visits and/or hospitalizations in individuals with immune-mediated inflammatory diseases (IMIDs). At eight Canadian centres, data were collected from adults with rheumatoid arthritis (RA), axial spondyloarthritis (AxS), systemic lupus (SLE), psoriatic arthritis (PsA), and inflammatory bowel disease (IBD). We administered questionnaires, analyzing SAEs experienced within 31 days following SARS-CoV-2 vaccination.

Clinical and Anatomical Characteristics of Perforator Aneurysms of the Posterior Cerebral Artery: A Single-Center Experience.

Introduction: Posterior cerebral artery (PCA) aneurysms represent up to 1% of all cerebral aneurysms. P1-P2 perforator aneurysms are thought to be even less prevalent and often require complex treatment strategies due to their anatomical and morphological characteristics, with risk of a perforator infarct. We studied the treatment of P1-P2 perforator aneurysms in a single-center cohort from a high-volume tertiary center, reporting clinical and anatomical characteristics, treatment strategies, and outcomes.

Multidevice spinal cord stimulation trials: shared decision making in the era of multiple neuromodulation paradigms.

There is a lack of evidence-based standards for matching spinal cord stimulation (SCS) paradigm to individual patients. We aim to determine the feasibility and safety of a new alternative trial strategy, a sequential multidevice trial. A retrospective analysis was performed on 116 patients who underwent SCS trials, single device or sequential multidevice (tonic and high-frequency), for chronic low back pain to assess feasibility and compare trial-to-implantation rate and explantation rate.

Methylation profiling in the contemporary management of meningioma.

Background: The last decade has seen major international research efforts focus on better understanding disease heterogeneity in meningioma. Multiple molecular platforms have generated significant biological and clinical utility, and there is a need to translate these findings into routine clinical practice. Here we review the role of DNA methylation profiling in meningioma and advocate for its widespread adoption.