Outcomes of bypass surgery in asymptomatic moyamoya angiopathy: A multicenter study with propensity-score weighting.

Introduction: Asymptomatic moyamoya angiopathy (MMA) is increasingly detected through noninvasive imaging; however, its optimal management remains controversial. This multicenter retrospective cohort study compared outcomes in asymptomatic versus symptomatic MMA patients undergoing surgical revascularization.

Patients And Methods: A total of 475 patients treated with bypass surgery across multiple academic centers were included, with 56 (11.

Supporting Teacher Wellness: Administrator Insights on Protecting Teacher Vocal Health.

Studies show that significantly more teachers experience voice complaints than individuals in other professions. In order to better understand voice complaints, the researchers interviewed 30 administrators (elementary, middle, and high schools) from five school districts. Researchers analyzed the principals' responses through a series of coding, resulting in four emerging themes: (1) the impacts of teacher voice complaints, (2) administrators' responses to teacher voice complaints, (3) a lack of policy and infrastructure around teacher vocal health, and (4) voice enhancement systems as a type of policy.

Gene-by-Environment Interactions Involving Maternal Exposures with Orofacial Cleft Risk in Filipinos.

Background/objectives: Maternal exposures are known to influence the risk of isolated cleft lip with or without cleft palate (CL/P)-a common and highly heritable birth defect with a multifactorial etiology.

Methods: To identify new risk loci, we conducted a genome-wide gene-environment interaction (GEI) analysis of CL/P with maternal smoking and vitamin use in Filipinos ( = 540, = 260). Since GEI analyses are typically low in power and the results can be difficult to interpret, we applied multiple testing frameworks to evaluate potential GEI effects: a one degree-of-freedom (1df) GxE test, the 3df joint test, and the two-step EDGE approach.

The Use of Filled Pauses Across Multiple Discourse Contexts in Children Who Are Hard of Hearing and Children with Typical Hearing.

Filled pauses are thought to be reflections of linguistic processes (e.g., lexical retrieval, speech planning and execution).

Whole genome sequence-based association analysis of African American individuals with bipolar disorder and schizophrenia.

In studies of individuals of primarily European genetic ancestry, common and low- frequency variants and rare coding variants have been found to be associated with the risk of bipolar disorder (BD) and schizophrenia (SZ). However, less is known for individuals of other genetic ancestries or the role of rare non-coding variants in BD and SZ risk. We performed whole genome sequencing (∼27X) of African American individuals: 1,598 with BD, 3,295 with SZ, and 2,651 unaffected controls (InPSYght study).

Synthesis and evaluation of acyl-AMP phosphate isosteres as inhibitors of fungal acetyl CoA synthetase.

Acetyl-CoA synthetase (ACS) is a member of the adenylate-forming enzymes superfamily. This enzyme plays a crucial role in cellular metabolism. While ACS enzymes are non-essential in mammals, they are essential in some fungal species and parasites that are pathogenic to humans.

ACCELERATING QUANTITATIVE MRI USING SUBSPACE MULTISCALE ENERGY MODEL (SS-MUSE).

Multi-contrast MRI methods acquire multiple images with different contrast weightings, which are used for the differentiation of the tissue types or quantitative mapping. However, the scan time needed to acquire multiple contrasts is prohibitively long for 3D acquisition schemes, which can offer isotropic image resolution. While deep learning-based methods have been extensively used to accelerate 2D and 2D + time problems, the high memory demand, computation time, and need for large training data sets make them challenging for large-scale volumes.

Weakly Supervised Deep Learning for Monitoring Sleep Apnea Severity Using Coarse-grained Labels.

Sleep apnea, a prevalent sleep-related breathing disorder, often remains undiagnosed and untreated in a large patient population due to the need of extensive manual annotations on various physiological signals for clinical diagnosis. Despite the surge of interest in applying machine learning to automate apnea detection, the effectiveness of existing techniques highly relies on strongly supervised learning that requires massive finely labeled training data for sufficiently short time intervals - a requirement often unmet due to the prohibitively high cost of manual labeling in clinical practice. In this article, we incorporate clinical knowledge to establish a weakly supervised deep learning framework for automatically estimating the latent fine-grained apnea severity when only coarse-grained labels indicating apnea presence are available in the training data.

Growth inhibition of common neonatal pathogens differs between bovine lactoferrin products.

Infection is a leading cause of mortality during the first year of life, with the neonatal period being particularly high risk. It is critical to identify non-antibiotic approaches to improve neonatal infection outcomes due to the non-specific clinical signs of neonatal infection and negative consequences of early-life antibiotic exposure. Lactoferrin is a protein found in all mammalian milk that has a variety of antimicrobial properties.

Proto-Oncogene HRAS Transcript Level and Overall Survival in Stages II and III Colorectal Cancer.

Background: Mutational landscape is prognostic in colorectal cancer (CRC). Rat sarcoma (RAS) oncogenes, such as KRAS and NRAS, with driver mutations, portend poor survival outcomes, whereas pathologic mutations in HRAS are extremely rare, and their prognostic value remains uncertain.

Methods: This retrospective study analyzed the Oncology Research Information Exchange Network (ORIEN) alliance tumor RNA-Seq data in Stages II and III CRC to investigate the association between RAS gene expression and survival outcomes.

Deciphering SCN2A: A comprehensive review of rodent models of Scn2a dysfunction.

SCN2A encodes for the alpha subunit of the voltage-gated sodium channel Na1.2, which is involved in action potential initiation and backpropagation in excitatory neurons. Currently, it is one of the highest monogenetic risk factors for both epilepsy and autism spectrum disorder.

Personalized beta band HD-tACS over the left SMA improves speech and limb movement by modulating prefrontal delta oscillations in neurotypical young adults.

Objective: The supplementary motor area (SMA) demonstrates abnormal beta activity (13-30 Hz) during speech and limb movement tasks in neurological conditions such as Parkinson's disease (PD). Transcranial Alternating Current Stimulation (tACS) has demonstrated promising improvements in motor and non-motor functions by entraining endogenous neural oscillations. We conducted an exploratory study on the modulatory effects of personalized beta high-definition (HD)-tACS over the left SMA on speech production and limb movement.

Postural sway dynamics in adults across the autism spectrum: a multifactor approach.

Background: Motor challenges are highly prevalent within autism, and increased postural sway has been consistently demonstrated in autistic youth. However, the extent to which sway anomalies extend into adulthood remains understudied. This study aimed to investigate whether increased postural sway is altered in autistic adults compared to neurotypical controls using established sway metrics including sway area and path, as well as rambling-trembling decomposition—an approach that differentiates the postural sway signal into central and peripheral nervous system components.

Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes.

Introduction: Endovascular thrombectomy (EVT) is an effective treatment for basilar artery occlusion (BAO) stroke in select patients. While there is a growing body of literature suggesting that advanced imaging modalities such as computed tomography perfusion (CTP) and magnetic resonance (MR) may not be necessary for selecting anterior circulation large vessel occlusion stroke patients for EVT, whether advanced imaging may be superior to conventional imaging (non-contrast CT and CT angiography) in identifying good treatment candidates among BAO patients is less clear.

Patients And Methods: This was a multicenter retrospective cohort study of BAO EVT patients treated from 2013 to 2022 in the Stroke Thrombectomy and Aneurysm Registry.

Rural-Urban Disparities in COVID-19 Vaccine Uptake and Associated Mortality and Cardiovascular Disease Outcomes in the United States.

The COVID-19 pandemic magnified long-standing health disparities in the United States, particularly among rural, disadvantaged populations. These communities experience greater barriers to healthcare access, a higher prevalence of chronic illness, and increased vaccine hesitancy factors that collectively contribute to poorer health outcomes. This narrative review examines rural-urban disparities in COVID-19 vaccine uptake and their impact on mortality, with a focus on cardiovascular disease (CVD) outcomes.

Alloy Selection and Manufacturing Technologies for Total Ankle Arthroplasty: A Narrative Review.

Total ankle arthroplasty (TAA) has evolved significantly through advances in alloy selection and manufacturing technologies. This narrative review examines the metallurgical foundations of contemporary TAA implants, analyzing primary alloy systems and their mechanical properties. Cobalt-chromium alloys provide superior mechanical strength and durability but present metal ion release concerns, while titanium alloys (Ti6Al4V) optimize biocompatibility with elastic modulus values (101-113 GPa) closer to bone, despite tribological limitations.

COVID-19 Pandemic Experiences and Hazardous Alcohol Use: Findings of Higher and Lower Risk in a Heavy-Drinking Midwestern State.

This study assessed whether COVID-19 pandemic experiences were associated with excessive alcohol use during the first year of the pandemic in Iowa, a heavy-drinking midwestern US state. We analyzed survey data from 4047 adult residents of Iowa collected in August 2020, focusing on three pandemic-related stressors (e.g.

Barriers to Timely Referral of Children Born with Myelomeningocele in Zambia.

: Congenital anomalies impact 52 million infants worldwide with an estimated 94% living in low- and middle-income countries (LMICs). Approximately 200,000 children are born with a neural tube defect (NTD) in LMICs annually. Zambia is an LMIC with a high burden of myelomeningocele (MMC; a severe form of NTD).

Epigenetic Profiling of Cell-Free DNA in Cerebrospinal Fluid: A Novel Biomarker Approach for Metabolic Brain Diseases.

Due to their clinical heterogeneity, nonspecific symptoms, and the limitations of existing biomarkers and imaging modalities, metabolic brain diseases (MBDs), such as mitochondrial encephalopathies, lysosomal storage disorders, and glucose metabolism syndromes, pose significant diagnostic challenges. This review examines the growing potential of cell-free DNA (cfDNA) derived from cerebrospinal fluid (CSF) epigenetic profiling as a dynamic, cell-type-specific, minimally invasive biomarker approach for MBD diagnosis and monitoring. We review important technological platforms and their use in identifying CNS-specific DNA methylation patterns indicative of neuronal injury, neuroinflammation, and metabolic reprogramming, including cfMeDIP-seq, enzymatic methyl sequencing (EM-seq), and targeted bisulfite sequencing.

MR-Guided Radiation Therapy for Prostate and Pancreas Cancer Treatment: A Dosimetric Study Across Two Major MR-Linac Platforms.

MR-guided radiation therapy (MRgRT) has rapidly evolved into an important treatment modality, with the Elekta Unity and ViewRay MRIdian systems being two major MR-linac platforms. Despite the shared concept of MRgRT, the two platforms elected different system designs that could potentially impact the dosimetric characteristics and quality of a treatment. In this study, we aim to perform a comparative dosimetric investigation between these two MR-linac systems in prostate and pancreas cancers.

PET/CT and Paraneoplastic Syndromes: A Comprehensive Review.

Paraneoplastic syndromes (PNSs) are pathologic conditions produced by neoplasms not attributable to tumor invasion or metastasis. The clinical manifestations of PNSs can precede the diagnosis; these symptoms may serve as early indicators of underlying malignancy. Standard imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), have limited sensitivity in detecting small or early-stage PNS-associated tumors.

FAST MULTI-CONTRAST MRI USING JOINT MULTISCALE ENERGY MODEL.

The acquisition of 3D multicontrast MRI data with good isotropic spatial resolution is challenged by lengthy scan times. In this work, we introduce a CNN-based multiscale energy model to learn the joint probability distribution of the multi-contrast images. The joint recovery of the contrasts from undersampled data is posed as a maximum a posteriori estimation scheme, where the learned energy serves as the prior.

Practice Patterns in Pediatric Cardiothoracic Presurgical Conferences: A Multicenter Survey Study.

Pediatric cardiothoracic surgeries are high-stakes, complex procedures, typically undergoing prior review at multidisciplinary conferences. This study evaluates practice patterns of conferences throughout the United States (US). Surveys were distributed to fellowship program directors or division directors in 124 US pediatric cardiology centers seeking information on conference logistics, fellow roles, quality improvement (QI), and satisfaction.

Trends in Corticosteroid Use Among Males With Duchenne Muscular Dystrophy (DMD) During 2000-2015: Data From the MD STAR.

This study updates previous reports by the population-based Muscular Dystrophy Surveillance, Tracking and Research Network on associations between increased corticosteroid use over time, and delayed use of corticosteroids among non-Hispanic Black males and those having a positive family history of Duchenne muscular dystrophy. Data for 373 males from six sites born and followed during 2000-2015 were analyzed using Kaplan-Meier curve estimation and Cox proportional hazards modeling. Corticosteroids were offered to 75.