Bridging the clinical gap: Confidence informed IDH prediction in brain gliomas using MRI and deep learning.

Background: The isocitrate dehydrogenase (IDH) mutation status is a key molecular marker in diagnosing and treating brain tumors. Currently, it is determined via invasive tissue biopsy. Recent advances in deep learning (DL) have offered promising non-invasive alternatives for determining IDH status.

Characteristics, Management, and Outcomes of Hospitalized Patients with Orthostatic Hypotension.

Orthostatic hypotension (OH) is a common inpatient condition associated with falls, syncope, and mortality. However, standardized approaches for inpatient management of OH are lacking and may vary across clinical specialties. In this retrospective observational cohort study, we reviewed the electronic medical records of patients admitted to Beth Israel Deaconess Medical Center between April 1, 2015 and June 1, 2021 with a diagnosis of OH or medication-related hypotension.

The Impact of Travel Distance on Patient Outcomes after Breast Reconstruction.

Background: Geographical barriers can impact access to healthcare, but their influence on complications and long-term patient-reported outcomes (PROs) after breast reconstruction is unclear. This study evaluates the impact of travel distance on postoperative complications and PROs using the BREAST-Q.

Patients And Methods: Patients who underwent postmastectomy breast reconstruction between 2017 and 2023 were categorized by travel distance into five groups (0-10, 11-25, 26-50, 51-100, 101+ miles).

Risk of Radiation-Induced Capsular Contracture Following Subpectoral or Prepectoral Implant-Based Breast Reconstruction.

Introduction: Radiation significantly increases the risk of capsular contracture after implant-based breast reconstruction. However, the relationship between anatomic plane placement (e.g.

Metformin Use and Risk of Breast Cancer-Related Lymphedema: A Retrospective Analysis.

Background: Over 30% of breast cancer patients develop lymphedema following axillary lymph node dissection (ALND), significantly impacting their quality of life. Comorbid conditions like diabetes mellitus (DM), which contribute to endothelial dysfunction and inflammation, may also affect lymphatic endothelium. Preclinical studies suggest that metformin, a common DM treatment, may reduce lymphedema risk.

Increased risk of recurrent stroke in patients with impaired kidney function: results of a pooled analysis of individual patient data from the MICON international collaboration.

Background: Patients with chronic kidney disease are at increased risk of stroke and frequently have cerebral microbleeds. Whether such patients also encounter an increased risk of recurrent stroke has not been firmly established. We aimed to determine whether impaired kidney function is associated with the risk of recurrent stroke, and microbleed presence, distribution and severity.

Forecasting deforestation and carbon loss across New Guinea using machine learning and cellular automata.

The island of New Guinea harbors some of the world's most biologically diverse and highly endemic tropical ecosystems. Nevertheless, progressing land-use change in the region threatens their integrity, which will adversely affect their biodiversity as well as carbon stocks and fluxes. Our objectives were to (1) compare deforestation drivers between Indonesian New Guinea and Papua New Guinea, (2) identify areas with a high risk of future deforestation under different development scenarios, and (3) evaluate the effects of potential deforestation scenarios on carbon pools.

Biodiversity impacts of the 2019-2020 Australian megafires.

With large wildfires becoming more frequent, we must rapidly learn how megafires impact biodiversity to prioritize mitigation and improve policy. A key challenge is to discover how interactions among fire-regime components, drought and land tenure shape wildfire impacts. The globally unprecedented 2019-2020 Australian megafires burnt more than 10 million hectares, prompting major investment in biodiversity monitoring.

Repeatability and Reproducibility of Pseudocontinuous Arterial Spin-Labeling-Measured Brain Perfusion in Healthy Volunteers and Patients with Glioblastoma.

Background And Purpose: Arterial spin-labeling (ASL) MRI has gained recognition as a quantitative perfusion imaging method for managing patients with brain tumors. Limited studies have so far investigated the reproducibility of ASL-derived perfusion in these patients. This study aimed to evaluate intrasession repeatability and intersession reproducibility of perfusion measurements using 3D pseudocontinuous ASL (pCASL) with TSE Cartesian acquisition with spiral profile reordering (TSE-CASPR) in healthy volunteers (HV) and patients with glioblastoma (GBM) at 3T and to compare them against 3D pCASL with gradient and spin echo (GRASE).

Large ischemic core defined by visually assessed ASPECTS predicts functional outcomes comparably accurate to automated CT perfusion in the 6-24 h window.

Introduction: Automated CT perfusion (aCTP) is commonly used to select patients with anterior circulation large vessel occlusion (aLVO) for endovascular treatment (EVT). The equivalence of visually assessed Non-contrast CT Alberta Stroke Program Early CT Scores (ASPECTS) and aCTP based selection in predicting favorable functional outcomes remains uncertain.

Patients And Methods: Retrospective multicenter study of adult aLVO patients from the Swiss Stroke Registry (2014-2021) treated with EVT or best medical treatment 6-24 h after stroke onset.

Concurrent Miller Fisher Syndrome and Immune Thrombocytopenic Purpura: A Case Report and Review of the Literature.

Guillain-Barre syndrome (and its subvariants) and immune thrombocytopenic purpura, while both autoimmune disorders provoked by viral infection, rarely coincide. We present the case of a young man who developed both conditions after URI, review prior cases of comorbidity in the literature, and describe their pathophysiology, diagnosis, and management.

Association between ischaemic stroke aetiology and leptomeningeal collateral status: a retrospective cohort study.

Introduction: There is limited understanding of the pathomechanistic relationship between leptomeningeal collateral formation and ischaemic stroke aetiology. We aimed to assess the association of leptomeningeal collateral status and ischaemic stroke aetiology, using the widely recognised "Trial of Org 10172 in Acute Stroke Treatment" (TOAST) classification categorising strokes into five distinct aetiologies.

Methods: Retrospective study of consecutively admitted adult ischaemic stroke patients at a Swiss stroke centre.

Two-Stage Training Framework Using Multicontrast MRI Radiomics for Mutation Status Prediction in Glioma.

Purpose To develop a radiomics framework for preoperative MRI-based prediction of isocitrate dehydrogenase () mutation status, a crucial glioma prognostic indicator. Materials and Methods Radiomics features (shape, first-order statistics, and texture) were extracted from the whole tumor or the combination of nonenhancing, necrosis, and edema regions. Segmentation masks were obtained via the federated tumor segmentation tool or the original data source.

Synthesizing 3D Multi-Contrast Brain Tumor MRIs Using Tumor Mask Conditioning.

Data scarcity and data imbalance are two major challenges in training deep learning models on medical images, such as brain tumor MRI data. The recent advancements in generative artificial intelligence have opened new possibilities for synthetically generating MRI data, including brain tumor MRI scans. This approach can be a potential solution to mitigate the data scarcity problem and enhance training data availability.

Sodium-glucose cotransporter 2 inhibitors: are they ready for prime time in the management of lupus nephritis?

Purpose Of Review: Lupus nephritis is a common complication of systemic lupus erythematosus and is associated with significant morbidity and mortality. The utility of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of lupus nephritis is currently uncertain. Here, we summarize the rationale for their use among patient with lupus nephritis.

Application of mask images of contrast-enhanced MR angiography to detect carotid intraplaque hemorrhage in patients with moderate to severe symptomatic and asymptomatic carotid stenosis.

Purpose: Carotid intraplaque hemorrhage (IPH) on MRI predicts stroke. Magnetization-prepared rapid acquisition gradient (MP-RAGE) is widely used to detect IPH. CE-MRA is used routinely to assess stenosis.

MRI-Based Deep Learning Method for Classification of IDH Mutation Status.

Isocitrate dehydrogenase (IDH) mutation status has emerged as an important prognostic marker in gliomas. This study sought to develop deep learning networks for non-invasive IDH classification using T2w MR images while comparing their performance to a multi-contrast network. Methods: Multi-contrast brain tumor MRI and genomic data were obtained from The Cancer Imaging Archive (TCIA) and The Erasmus Glioma Database (EGD).

Tranexamic Acid for Intracerebral Hemorrhage in Patients on Non-Vitamin K Antagonist Oral Anticoagulants (TICH-NOAC): A Multicenter, Randomized, Placebo-Controlled, Phase 2 Trial.

Background: Evidence-based hemostatic treatment for intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOACs) is lacking. Tranexamic acid (TXA) is an antifibrinolytic drug potentially limiting hematoma expansion. We aimed to assess the efficacy and safety of TXA in NOAC-ICH.

The impact of competing stroke etiologies in patients with atrial fibrillation.

Background: Data on the impact of competing stroke etiologies in stroke patients with atrial fibrillation (AF) are scarce.

Methods: We used prospectively obtained data from an observational registry (Novel-Oral-Anticoagulants-in-Ischemic-Stroke-Patients-(NOACISP)-LONGTERM) of consecutive AF-stroke patients treated with oral anticoagulants. We compared the frequency of (i) the composite outcome of recurrent ischemic stroke (IS), intracerebral hemorrhage (ICH) or all-cause death as well as (ii) recurrent IS alone among AF-stroke patients with versus without competing stroke etiologies according to the TOAST classification.

Mechanical Thrombectomy Versus Best Medical Treatment in the Late Time Window in Non-DEFUSE-Non-DAWN Patients: A Multicenter Cohort Study.

Background: We assessed the efficacy and safety of mechanical thrombectomy (MT) in adult stroke patients with anterior circulation large vessel occlusion presenting in the late time window not fulfilling the DEFUSE-3 (Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging trial) and DAWN (Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct trial) inclusion criteria.

Methods: Cohort study of adults with anterior circulation large vessel occlusion admitted between 6 and 24 hours after last-seen-well at 5 participating Swiss stroke centers between 2014 and 2021. Mismatch was assessed by computer tomography or magnetic resonance imaging perfusion with automated software (RAPID or OLEA).