The effect of TERT promoter mutation on predicting meningioma outcomes: a multi-institutional cohort analysis.

Background: Molecular aberrations have been incorporated into tumour classification guidelines of meningioma. TERT-promoter (TERTp) mutation is associated with worse prognosis and is designated a WHO grade 3 biomarker. However, it remains unclear whether TERTp mutation is context-dependent, with other co-occurring genetic alterations potentially driving its association with prognosis.

Ki-67 in meningioma: distribution and implications.

Objective: Ki-67 is a widely used marker of proliferation in meningiomas, influencing prognostic assessment and treatment decisions, including adjuvant radiation therapy. However, it is increasingly appreciated that some meningiomas are enriched with immune infiltration, which may confound Ki-67 interpretation as both immune and tumor cells exhibit proliferative potential. The authors aimed to dissect the cellular source and distribution of Ki-67 within the meningioma microenvironment and explore their clinical, genomic, and biological associations.

Distribution of copy number alterations and impact of chromosome arm call thresholds for meningioma.

Chromosome-arm copy number alterations (CNAs) are an important component of cancer molecular classifiers. CNAs are often translated into binary chromosome arm calls (arm gain/loss) using an arm call threshold before integration into classification schemes. However, substantial variability exists in thresholds used to define arm calls from CNA data.

Clinical, molecular and radiological predictors of prognosis in newly diagnosed astrocytoma, IDH-mutant, WHO grade 4.

Background: Astrocytoma, isocitrate dehydrogenase-mutant, WHO grade 4 (Astro4), is a new tumor type in the 2021 WHO classification of central nervous system tumors that has been poorly characterized in the literature. This study evaluates predictors of prognosis in a large cohort of newly diagnosed Astro4.

Methods: We retrospectively identified 128 consecutive adult patients who presented with an initial diagnosis of Astro4 at Dana-Farber Cancer Institute and Massachusetts General Hospital between 2010 and 2021.

Erratum: Daily oscillation of the excitation/inhibition ratio is disrupted in two mouse models of autism.

[This corrects the article DOI: 10.1016/j.isci.

Etiology and clinical outcomes in patients undergoing coronary artery bypass grafting in the second decade of life.

Introduction: The age of patients undergoing coronary artery bypass grafting (CABG) is progressively declining over time. Young adults are increasingly developing coronary artery disease (CAD), a condition that was once regarded as being more prevalent in the fifth or sixth decade of life.

Materials And Methods: To evaluate the etiology and clinical outcomes of CABG in this young population (10-19 years of age).

Impact of Adjacent Muscular Anatomic Preservation on Proximal Junctional Kyphosis and Failure.

Background: Surgical intervention is a cornerstone of adult spinal deformity (ASD) management. However, there remain burdens from complications, including proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Posterior anatomic preservation at the uppermost instrumented vertebra has emerged as an accessible approach to potentially reduce PJK/PJF risk.

Daily oscillation of the excitation/inhibition ratio is disrupted in two mouse models of autism.

Alterations to the excitation/inhibition (E/I) ratio are postulated to underlie behavioral phenotypes in autism spectrum disorder (ASD) patients and mouse models. However, in wild type mice the E/I ratio is not constant, but instead oscillates across the 24-h day. Therefore, we tested whether E/I regulation, rather than the overall E/I ratio, is disrupted in two ASD-related mouse lines: KO and BTBR, models of syndromic and idiopathic ASD, respectively.

Artificial Intelligence as a Discriminator of Competence in Urological Training: Are We There?

Purpose: Assessments in medical education play a central role in evaluating trainees' progress and eventual competence. Generative artificial intelligence is finding an increasing role in clinical care and medical education. The objective of this study was to evaluate the ability of the large language model ChatGPT to generate examination questions that are discriminating in the evaluation of graduating urology residents.

Neurosurgical Residency Training at Veterans Affairs Medical Centers, the Resident Perspective.

Background And Objective: Department of Veteran's Affairs (VA) Medical Centers play a crucial role in training neurosurgery residents. Although previous studies have examined the impact of VA rotations from the attending perspective, the resident experience remains unexplored. We present a national survey of neurosurgery residents to assess their perceptions of VA rotations, focusing on operative experience, call burden, longitudinal patient care experiences, and overall strengths and limitations.

Surgical outcomes of right atrial mass: 5 years of experience.

Cardiac masses are relatively rare, with a right atrial mass being even more rare. Right atrial masses pose a diagnostic dilemma owing to the diverse range of potential diagnoses, even when the clinical context and initial imaging modalities are thoroughly evaluated. A right atrial mass can have a varied etiology as it can be a physiological variant, or a neoplastic or a non-neoplastic mass with each having a separate line of management.

Strategies to improve surgical technical competency: a systematic review.

Background: A cornerstone of surgical residency training is an educational program that produces highly skilled and effective surgeons. Training structures are constantly being revised due to evolving program structures, shifting workforces, and variability in the clinical environment. This has resulted in significant heterogeneity in all surgical resident education, training tools utilized, and measures of training efficacy.

Double outlet left atrium: successful management of a rare entity.

Double-outlet left atrium is an extremely rare congenital ventriculo-atrial mal-alignment anomaly, wherein, the left atrium drains into both ventricles, through either a common atrioventricular valve or two separate atrioventricular valves. The only egress from the right atrium is through an inter-atrial communication. We present a 16-month-old male, diagnosed to have double outlet left atrium and describe its surgical management.