Digital Commons Network^™

Robotic Single-Incision Laparoscopic Surgery For The Management Of Endometriosis: First Experience Via The Da Vinci Sp Platform, Qiannan Yang, Daniel Y Lovell, Xiaoming Guan

Faculty, Staff and Students Publications

Objective: To demonstrate the feasibility and mid-term outcomes of Robotic single-port single-incision laparoscopic surgery (RSP-SILS) for endometriosis management.

Methods: A retrospective analysis was conducted on 50 adult women with endometriosis who underwent RSP-SILS via the da Vinci SP platform between November 2023 and July 2025.

Results: Median total operative time was 142 min, robot dock time was 3 min, and robot console time was 99 min. Median estimated blood loss was 25 mL. No conversion occurred. Reported mid-term outcomes included 1 case each of pelvic haematoma, Clostridioides difficile colitis, and umbilical surgical site infection, as well as 3 cases of …

Comprehensive Profiling Of The Human Tear Fluid Mirnome Using Small Rna Sequencing, Garrett Jones, Drew Mayernik, Saleh Ahmed, Eliza Williams, Jeremy Altman, Tae Jin Lee, Amy Estes, Cintia S De Paiva, Pamela Martin, Shruti Sharma, Ashok Sharma

Faculty, Staff and Students Publications

Purpose: To generate a comprehensive profile of microRNAs (miRNAs) present in human tear fluid using next-generation sequencing (NGS), establish a reference miRNome for healthy human tear fluid, and investigate whether miRNA expression varies by sex, race, or age.

Methods: Tear samples were collected from 32 adults using Schirmer strips. RNA was isolated using the miRNeasy Serum/Plasma Kit, and cDNA libraries were prepared using the QIAseq miRNA Library Kit. Barcoded libraries were sequenced on the NovaSeq 6000 platform. Bioinformatic analyses included adapter trimming, alignment to miRBase, normalization with DESeq2, and functional annotation using multiMiR and clusterProfiler. Differential expression analysis was performed …

Rexinoid Net-3ib Promotes Resident Macrophage Gene Expression And Mitigates Desiccation-Induced Ocular Surface Disease, Jehan Alam, Yangluowa Qu, Jianming Shao, Ebru Yaman, Karen Zheng, Hiroki Kakuta, Stephen C Pflugfelder

Faculty, Staff and Students Publications

Purpose: To evaluate the effects of rexinoid NEt-3IB on desiccating stress-induced dry eye, as well as monocyte/macrophage gene expression and cellular trajectory.

Methods: Eyes were topically treated with rexinoid NEt-3IB (5 µM) or vehicle three times a day for 5 days of desiccating stress-induced dry eye. Single-cell RNA sequencing (RNA-seq) profiled gene expression in conjunctival immune cells. RNA-seq was also used to evaluate gene expression in lipopolysaccharide (LPS)-stimulated, dexamethasone-treated (Dex, 1 µM), or NEt-3IB-treated (1-1000 nM) cultured monocytes. Cellular state trajectory and latent time were inferred with scVelo, and latent-time-associated genes were identified using Monocle 3. Permeability to Oregon Green-labeled …

Results Of A Randomized, Double-Masked, Placebo-Controlled Phase 1/2 Study Of A Trpv1 Antagonist Sjp-0132 In Participants With Dry Eye Disease, Tomoyuki Wada, Kazunori Omatsu, Stephen C Pflugfelder

Faculty, Staff and Students Publications

Purpose: To investigate the safety, tolerability, pharmacokinetic profile, and efficacy of SJP-0132 in participants with dry eye disease (DED).

Design: Phase 1/2, randomized, double-masked, single-center, placebo-controlled single and multiple ascending dose study.

Participants: Generally healthy adults aged ≥18 years with a patient-reported history of DED for ≥6 months, eye dryness visual analog scale (VAS: 0-100) ≥40 mm, 5-item dry eye questionnaire (DEQ-5) ≥6, and central corneal fluorescein staining (CFS) of 2 to 4 (Baylor scale: 0-5 for each of five zones).

Methods: This study consisted of Part A and Part B, containing four single- and two multiple-ascending dose cohorts, respectively. …

Avacincaptad Pegol For Geographic Atrophy Secondary To Age-Related Macular Degeneration: Two-Year Efficacy And Safety Results From The Gather2 Phase 3 Trial, Arshad M Khanani, Carl J Danzig, Jeffrey S Heier, Glenn J Jaffe, Peter K Kaiser, David R Lally, Sunil S Patel, Lejla Vajzovic, Christina Y Weng, Hersh Patel, Julie Clark, Dhaval Desai, Don Luo, Erin Henry, Frank G Holz

Faculty, Staff and Students Publications

Purpose: Avacincaptad pegol (ACP) is a pegylated RNA aptamer that inhibits complement C5. The efficacy and safety of ACP 2 mg was investigated in GATHER2, with positive year 1 results published. Herein, 2-year results are reported.

Design: Phase 3, randomized, sham-controlled study (ClinicalTrials.gov identifier, NCT04435366).

Participants: Patients with non-center point-involving geographic atrophy (GA).

Methods: Eligible patients were randomized 1:1 to receive monthly ACP 2 mg (n = 225) or sham (n = 222) for 1 year. At month 12, patients who received ACP 2 mg were randomized again 1:1 to dosing every month (EM; n = 96) or every …

Utility Of Diagnostic Arthroscopy Before Medial Patellofemoral Ligament Reconstruction In Pediatric And Adolescent Patients Without Articular Findings On Magnetic Resonance Imaging, Holden Archer, Kaleb Patterson, Jonathan D Schwartzman, Scott D Mckay, Indranil Kushare

Faculty, Staff and Students Publications

BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is frequently used to manage recurrent patellar instability. Diagnostic arthroscopy is commonly performed before MPFL reconstruction to identify, confirm, and address intra-articular pathology. However, when preoperative magnetic resonance imaging (MRI) does not demonstrate intra-articular lesions, it is unclear how often diagnostic arthroscopy in pediatric patients alters surgical management.

PURPOSE: To determine the utility of diagnostic arthroscopy in young patients undergoing MPFL reconstruction who had no intra-articular chondral or osteochondral pathology, meniscal tears, or loose bodies identified on preoperative MRI, and to characterize intra-articular pathology detected on arthroscopy but not identified on MRI.

STUDY DESIGN: …

Body Mass Index And Survival In Children Receiving Extracorporeal Membrane Oxygenation, Pilar Anton-Martin, Keith Baxelbaum, Shilpa Vellore, Erika O'Neil, Vinai Modem, Sameer Thadani

Faculty, Staff and Students Publications

Importance: Underweight and obesity represent opposite ends of the nutritional risk spectrum that negatively affect children's health worldwide. Both conditions have been associated with increased mortality in pediatric patients receiving extracorporeal membrane oxygenation (ECMO) support.

Objective: To investigate the association of underweight and obesity status with pediatric ECMO outcomes using body mass index (BMI) z scores.

Design, setting, and participants: This retrospective cohort analysis used data from the Extracorporeal Life Support Organization (ELSO) database from January 1, 2019, to December 31, 2023. Participants included all pediatric patients from international ECMO centers aged 29 days to 18 years who received ECMO …

(Giga)Time For The Era Of Ai: Virtual Multiplex Immunofluorescence From Routine H&E For Large Populations, Shao-Ping Yang, Dihua Yu

Faculty, Staff and Student Publications

No abstract provided.

Weekly Fluctuations Of Plasma Amyloid-Beta In Alzheimer’S Disease: Implications For Biomarker Reliability, Andy Delgado, Kanisa Davidson, Danitra Parker, Jaleesa Bryant, Vicki Winstead, Mustafa Yildiz, Carolyn E Z Pickering, Andrew M Pickering

Faculty, Staff and Student Publications

No abstract provided.

Helminth Coinfections Mitigate Clinical, Parasitological, And Immune Outcomes In Mozambican Children With Malaria, Inocência Cuamba, Rebeca Santano, Berta Grau-Pujol, Marta Vidal, Ruth Aguilar, Anélsio Cossa, Chenjerai Jairoce, Rojelio Mejia, Augusto Nhabomba, Jose Muñoz, Gemma Moncunill, Carlota Dobaño

Faculty, Staff and Students Publications

Background: Clearance of Plasmodium falciparum infection requires a TH1 immune response with production of pro-inflammatory cytokines, IgG1, and IgG3 responses. In contrast, infections with helminths are dominated by TH2/Treg immune responses characterized by production of anti-inflammatory cytokines, IgE, and IgG4, which could potentially interfere with malaria outcomes and immune responses.

Methods: We recruited 441 malaria-symptomatic children aged 2-10 years attending two hospitals in the Manhiça District (Mozambique) and assessed infection by rapid antigen diagnostic test, microscopy, and/or quantitative PCR. Using Luminex, we measured concentrations of 30 cytokines and IgA, IgM, IgE, IgG, and IgG1-4 levels against 12 P. falciparum antigens …

High-Power Dual-Channel Chamber For High-Frequency Magnetic Neuromodulation, Xiaoyang Tian, Hui Wang, Boshuo Wang, Jinshui Zhang, Dong Yan, Jeannette Ingabire, Samantha Coffler, Guillaume Duret, Quoc-Khanh Pham, Gang Bao, Junzhe Wang, Ashok Veeraraghavan, Jacob T Robinson, Stefan M Goetz, Angel V Peterchev

Faculty, Staff and Students Publications

Objective. Several novel methods, including magnetogenetics and magnetoelectric stimulation, use high frequency alternating magnetic fields to precisely manipulate neural activity. To quantify the behavioral effects of such interventions in a freely moving mouse, we developed a dual-channel magnetic chamber, specifically designed for rate-sensitive magnetothermal-genetic stimulation, and adaptable for other uses of alternating magnetic fields.

Approach. Through an optimized coil design, the system allows independent control of two spatially orthogonal uniform magnetic fields delivered at different frequencies within a 10 × 10 × 6 cm3 chamber suitable for mouse studies. The two channels have nominal frequencies of 50 and 550 kHz …

Prescribed Aerobic Exercise And Sport-Related Concussion Recovery: A Validation Case Series, Lacy L. Chapel, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Active rehabilitation, including prescribed sub-symptom threshold aerobic exercise implemented during the acute phase of recovery after sport-related concussion, has been shown to facilitate recovery and reduce the risk of persisting postconcussion symptoms. The purpose of this validation case series was to evaluate currently available external evidence regarding the effects of prescribed aerobic exercise interventions on recovery after sport-related concussion. For this study, the patient population included college athletes diagnosed with a sport-related concussion who participated in at least 5 days per week of supervised, prescribed aerobic exercise, based on graded aerobic exercise testing and heart rate threshold. Our study findings …

Suture Augmentation With Ucl Repairs In Baseball Pitchers As An Alternate To Reconstructions: An Evidence-To-Practice Review, Kayleigh A. De Koker, Kenneth E. Games

Clinical Practice in Athletic Training

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the …

Sulfatase Modifying Factors Control The Timing Of Zebrafish Convergence And Extension Morphogenesis, Ailen Soledad Cervino, Amrita Basu, Ryan J Weiss, Gursimran Kaur Bajwa, Rubén Marín-Juez, Sandra L Grimm, Cristian Coarfa, Margot Kossmann Williams

Faculty, Staff and Students Publications

Convergence and extension (C&E) cell movements that elongate the primary embryonic axis are precisely timed during vertebrate gastrulation, but mechanisms controlling their onset remain unknown. Using zebrafish embryonic explants that recapitulate C&E and its timing, we identified sulfatase modifying factor 2 (sumf2) as a candidate trigger gene for C&E onset. sumf2 and its paralog sumf1 encode negative and positive sulfatase regulators, respectively, whose expression levels invert and increase heparan sulfate sulfation during gastrulation. Overexpressing sumf1 or sumf2 causes delayed or precocious C&E, respectively, whereas their loss shifts C&E timing in the opposite direction. We identified Sulf1, a modifier of heparan …

The Relationship Between Smartphone Screen Time Duration And Individual Chronotype: A Systematic Literature Review, Diego Sergio Giasia Lumbantobing, Thalia Altamilano Pramudya

Jurnal Epidemiologi Kesehatan Indonesia

The rapid increase in smartphone use over the past decade led to prolonged screen time across age groups, particularly during nighttime hours. Exposure to artificial light and pre-sleep digital activities was associated with circadian rhythm disruption and alterations in individual chronotype. This systematic literature review aimed to synthesize empirical evidence on the relationship between smartphone screen time duration and individual chronotype across all age groups and to identify key moderating factors influencing this association. The review was conducted in accordance with PRISMA 2020 guidelines. Literature searches were performed in PubMed, Scopus, and ScienceDirect for studies published between 2015 and 2025. …

Gene-Agnostic Therapeutic Strategies For Inherited Retinal Diseases: Neuroprotection And Immunomodulation, Lucas W. Rowe, S. Patricia Becerra, Robert E. Maclaren, Robert L. Avery, Charles C. Wykoff, Allen C. Ho, Carl D. Regillo, Dean Eliott, Andrew Osborne, Katie M. Binley, Thomas A. Ciulla

Wills Eye Hospital Papers

Background/Objectives: Inherited retinal diseases (IRDs) represent a genetically heterogeneous group of disorders caused by mutations in over 280 genes with more than 3100 identified variants. While gene-specific replacement therapies have achieved landmark success with voretigene neparvovec (Luxturna) for biallelic RPE65-associated retinal dystrophy, developing individual therapies for each genetic subtype remains impractical. This review examines gene-agnostic therapeutic approaches utilizing neuroprotection and immunomodulation that target common pathophysiological mechanisms shared across multiple IRD genotypes. Methods: We reviewed the literature on neuroprotective and immunomodulatory gene therapy strategies for IRDs, focusing on neurotrophic factors and complement system modulation. Results: Neuroprotective approaches delivering neurotrophic factors—including pigment …

Oral Pcsk9 Inhibitor Enlicitide Versus Oral Nonstatin Therapies: A Phase 3 Randomized Clinical Trial, Alberico L Catapano, Elina Mikhailova, Ann Marie Navar, Puja Banka, Pablo Corral, Manish Saxena, P Gabriel Steg, Subodh Verma, Andrew Yacoub Kordahi, Geraldine Mendizabal, Pengfei Zhu, Christie M Ballantyne, Coralreef Addon Investigators

Faculty, Staff and Students Publications

Background: Many adults fail to achieve guideline-directed low-density lipoprotein cholesterol (LDL-C) goals on statin monotherapy, requiring additional nonstatin lipid-lowering medication. Enlicitide, an oral proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitor, lowered LDL-C by 60% compared with placebo; its efficacy compared with other oral nonstatin therapies has yet to be examined.

Objectives: This study assessed the efficacy of enlicitide, a novel oral PCSK9 inhibitor, vs other oral nonstatin therapies.

Methods: In this phase 3, randomized, double-blind, active-comparator trial, statin-treated adults aged ≥18 years with LDL-C ≥55 mg/dL and a previous major atherosclerotic cardiovascular disease (ASCVD) event, or LDL-C ≥70 mg/dL if at …

Cilia Dynamics In Primary Ciliary Dyskinesia: A Biophysical Characterization Of The Rsph4a Founder Variant, Gabriel Rosario-Ortiz, José Muñiz-Hernández, Natalia M Ortiz-Pérez, Marcos J Ramos-Benitez, Ricardo A Mosquera, Wilfredo De Jesús-Rojas

Faculty, Staff and Student Publications

Primary ciliary dyskinesia (PCD) is a rare ciliopathy resulting in chronic oto-sino-pulmonary disease. PCD diagnosis can be achieved by a combination of different diagnostic and adjuvant tools, including high-speed video-microscopy analysis (HSVA). A founder variant has been described in Puerto Rico as the most common cause of PCD in the island. Background/Objectives: In HSVA, objective parameters such as ciliary beat frequency (CBF) and subjective parameters such as ciliary beat pattern (CBP) shed light on the biophysical properties of cilia. However, the subjective nature of CBP creates a gap in knowledge; characteristics such as the length, angle, and bending index of …

Response To Letter: Assessment Of Postoperative Range Of Motion In Pediatric Patients Undergoing Surgical Reduction And Fixation Of Lateral Condyle Fractures, Gabrielle Rogie, Timothy Borden, Lindsay Crawford, Surya Mundluru, Brennan Roper, Rohini Mahajan Vanodia, Shiraz Younas

Faculty, Staff and Student Publications

No abstract provided.

An Atlas Of Genetic Effects On The Monocyte Methylome Across European And African Populations, Wanheng Zhang, Chuan Qiu, Xiao Zhang, Zichen Zhang, Kuan-Jui Su, Zhe Luo, Minghui Liu, Bingxin Zhao, Lang Wu, Qing Tian, Hui Shen, Chong Wu, Hong-Wen Deng

Faculty, Staff and Student Publications

No abstract provided.

Letter To The Editor: Evidence For A Two-Step Species-Level Pulmonary Nocardiosis Diagnostic Approach, John Halphen, Mohadese Ahmadzade, Babith Mankidy, Ashkan Berenji, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Pulmonary nocardiosis, a rare and diagnostically challenging infection, usually presents with heterogeneous radiographic findings, compounded by the low sensitivity of traditional confirmatory cultures. In their most recent work, Wang et al analyzed 102 patients with pulmonary nocardiosis to address these concerns, investigating species-characteristic imaging patterns, pathological associations, and the role of metagenomic next-generation sequencing (mNGS) in the diagnostic approach. High-resolution computed tomography (CT) in adult patients with pulmonary infections caused by Nocardia wallacei was demonstrated to have a sensitive (85.71%) and specific (83.34%) presentation of bronchopneumonia in relation to the five Nocardia species in the sample with CT data. The …

The Hexosamine Biosynthetic Pathway Alters The Cytoskeleton To Modulate Cell Proliferation And Migration In Aggressive Prostate Cancer, Rajina Shakya, Praveen Suraneni, Amit Rahi, Michael Y Young, Emily Cousino, Christine B Magdongon, Raju Gajjela, Basil B Mattamana, Alexander Zaslavsky, Ganesh S Palapattu, Arun Sreekumar, Dileep Varma

Faculty, Staff and Students Publications

Castration-resistant prostate cancer (CRPC) progresses despite androgen deprivation therapy, as cancer cells adapt to grow without testosterone, becoming more aggressive and prone to metastasis. CRPC biology complicates the development of effective therapies, posing challenges for patient care. Recent gene-expression and metabolomics studies highlight the Hexosamine Biosynthetic Pathway (HBP) as a critical player, with key components like GNPNAT1 (Glucosamine-phosphate N-acetyltransferase 1) being downregulated in CRPC. GNPNAT1 knockdown in pre-clinical models has been shown to increase growth and metastasis in CRPC tumors, though the mechanisms remain unclear.To investigate the cellular basis of these CRPC phenotypes, we generated a CRISPR-Cas9 knockout model of …

Perinatal Obsessive-Compulsive Symptoms And Maternal-Infant Bonding: A Longitudinal Examination Of Depression And Relationship Quality, Journa Njoh, Jonathan S Abramowitz, Rashelle Musci, Mary C Kimmel, Lauren M Osborne, Jack Samuels, Paul Nestadt, Gerald Nestadt, Eric A Storch

Faculty, Staff and Students Publications

Background

Perinatal obsessive–compulsive (OC) symptoms are common and distressing, yet their impact on early parenting outcomes such as maternal-infant bonding remains poorly understood. Although prior research links maternal depression and anxiety to bonding difficulties, less is known about how perinatal OC symptoms relate to maternal-infant bonding over time, or the extent to which maternal-partner relationship quality is associated with these outcomes, and whether depressive symptoms explain observed associations.

Methods

Data were drawn from a longitudinal study of 256 pregnant women recruited from two U.S. sites between 2020 and 2023. Participants completed self-report and clinician-administered assessments at 20 weeks (PGWK20), 34 …

Influenza Infection Has Higher Risk Of Postoperative Complications Than Covid-19 In Shoulder Arthroplasty Patients, Jad J Lawand, Umar Ghilzai, Caleb Witsken, Dion Birhiray, Abdullah Ghali, Youssef M Khalafallah, Rohan G Reddy, Sameer R Khawaja, Adil Shahzad Ahmed

Faculty, Staff and Students Publications

INTRODUCTION: The COVID-19 pandemic has captured the attention of healthcare systems worldwide, and testing remains a mainstay of preoperative testing before all surgical procedures, including shoulder arthroplasty. Other viral illnesses, specifically influenza, while still having severe complications, are either overshadowed by testing for COVID-19 or not tested at all.

METHODS: A multi-institutional cohort study using the TriNetX network examined patients undergoing total or hemi shoulder arthroplasty from January 2020 to March 2024. Matched cohorts were created: one with influenza and one with COVID-19 infection, 14 days before surgery.

RESULTS: A total of 3233 and 18,209 patients were included in the …

Assessment Of Routine, On-Demand Electroencephalograms For Seizure Detection In The Intensive Care Unit Of A Major Saudi Tertiary Center, Abdulrahman Yousef Aldayel, Homoud Alsahli, Rawabi Alhathlool, Afag Osman, Sonia Khan, Mohammed T. Alshahrani

Neurosciences

Objectives: To investigate the occurrence and characteristics of seizures using routine electroencephalograms (EEGs) in intensive care unit (ICU) patients.

Methods: We conducted a retrospective analysis on routine, portable EEGs of 188 adult ICU patients (53% male) in a large tertiary hospital in Riyadh, Kingdom of Saudi Arabia. We compared variables of interest using a t-test and chi-squared analyses and explored significant associations using binary logistic regression analysis.

Results: We found significant associations between the occurrence of seizures on EEGs and several variables, including patient age, ICU admission due to status epilepticus, history of epilepsy or previous neurosurgical procedure, coma state, …

Identifying Risk Factors For The Rising Prevalence Of Multiple Sclerosis In Saudi Arabia: A Case-Control Analysis, Omar Babateen, Jamil Adnan Samkari, Rewaa Abdulaziz Alkaki, Sadin Ayman Alamri, Manal Mutlaq Alzahrani, Mussaed Saleh Alharbi, Ali Abdulrazaq Alghamdi, Amwaj Sultan Aljurays, Amjad Faleh Aldosari, Seraj Makkawi

Neurosciences

Objective: This study aims to identify risk factors linked to the increasing prevalence of multiple sclerosis (MS) in Saudi Arabia. Multiple sclerosis is a chronic autoimmune condition affecting the central nervous system, marked by inflammation and damage to nerves and the myelin sheath.

Method: A case-control study conducted from September 2022 to January 2024 included 832 participants—263 diagnosed with MS and 569 controls. Controls were matched by age, gender, residence, and employment status. Data was collected using a validated questionnaire, with written consent obtained from participants aged 18 and older. Logistic regression analysis was used to ascertain risk factors.

Results: …

Efficacy Of Erenumab In Patients With Treatment-Resistant Chronic Migraine And Medication Overuse Headache, Mohamed F. Binfalah, Anwar A. Alrayyes, Hussein H. Alhafnawi, Moiz O. Bakhiet

Neurosciences

Objective: To evaluate the efficacy and safety of erenumab, a monoclonal antibody that targets the calcitonin gene-related peptide (CGRP) receptor, in patients with treatment-resistant chronic migraine and medication overuse headache.

Methods: A single-center, retrospective observational study conducted at University Medical Center on 73 patients with both medication-overuse headache and treatment-resistant chronic migraine who failed at least three oral preventive medications and/or botulinum toxin injections. Clinical data were extracted from the medical records and patient interviews. The patients received monthly erenumab injections 70 mg. Key outcomes included monthly migraine days, headache severity (visual analog scale [VAS]), headache impact test (HIT-6), acute …

Association Between Extracranial Artery Stenosis And Cerebral Small-Vessel Disease In Patients With Ischemic Stroke, Ahmad Ghoochani-Khorasani, Seyed Hadi Aghili, Seyed Zakaria Hosseini, Seyed Amir Hasan Habibi, Mehri Farhangranjbar, Mahdi Abdi

Neurosciences

Objective: To review the relationship between extracranial artery stenosis (ECAS) severity and total cerebral small-vessel disease (CSVD) burden and evaluated 5-year mortality, disability, and stroke recurrence in ischemic stroke patients. Cerebral small-vessel disease and ECAS often share risk factors such as hypertension and atherosclerosis and coexist in ischemic stroke. Although ECAS affects large-artery disease, its impact on total CSVD burden on MRI and subsequent clinical outcomes is not well defined.

Methods: We retrospectively reviewed the medical records of 348 patients older than 35 who had suffered acute ischemic stroke and were admitted to selected hospitals in Tehran, Iran from March …

Vagal Nerve Stimulation As Therapy For Drug-Resistant Epilepsy: A Tertiary Hospital Experience Of Outcomes And Efficacy In King Abdullah Medical City, Bassam G. Sef, Abeer S. Albalawi, Ahmed M. Alhajji, Muhammed M. Irfan, Hanadi M. Abu Alela

Neurosciences

Objective: To determine the efficacy and safety of vagus nerve stimulation (VNS) for reducing the frequency of seizures and complications in drug-resistant epilepsy.

Methods: This was a retrospective case series study conducted in King Abdullah Medical City from January 2015 to December 2021 hospital record. All patients undergoing VNS were enrolled according to inclusion and exclusion criteria. Patients were followed up for 12 months, and the seizure frequency and number of epileptic drugs used were evaluated. A paired sample t-test was applied to compare the outcome variables considering p-value < 0.05 as significant.

Results: Among 9 enrolled patients, four were females, and five …

Insights Into Stroke Risk And Prediction For Underweight Individuals, Saeed Awad M. Alqahtani, Moutasem S. Aboonq

Neurosciences

This review explores the relationship between underweight status and stroke risk and outcomes. Although the impact of obesity on stroke is well-documented, the harmful effects of being underweight are often overlooked. Drawing on evidence from observational studies, case-control studies, and meta-analyses, this review highlights that underweight individuals face increased mortality, poorer functional recovery, and higher rates of major adverse cardiovascular events and recurrent strokes post-stroke. Challenges in stroke prediction for this population are examined, including the limited research focus, shortcomings of existing risk assessment tools such as the CHA₂DS₂-VASc score, and population-specific factors affecting underweight prevalence …