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Study Objective: To determine the association of repeat polypectomy with patient and/or polyp characteristics, surgical setting, and type of hysteroscopic equipment., Methods: Retrospective cohort study including all women who had undergone operative hysteroscopy for the removal of endometrial polyps between 1/2012-12/2022 in our division. Operative hysteroscopy with resection of endometrial polyps was performed using a bipolar loop resectoscope, miniaturized hysteroscopic instruments (bipolar needle, scissors, and graspers), or a tissue-removal device (from April 2021), with or without general anesthesia., Results: Benign polyps were removed in 722 women in an outpatient setting and without any anesthesia (n = 64, 8.9 %) or in an operating theatre under general anesthesia (n = 658, 91.1 %). Their mean age was 55.8 ± 12.4 years, 432 (59.8 %) were menopausal, and 41 (5.7 %) reported having previously undergone a polypectomy. The mean size of the resected polyp was 19.9 ± 8.0 mm, and ≥ 2 polyps were removed in 188 (26.0 %) cases. Repeat polypectomy was performed in 32 (4.4 %) women after 3.0 ± 1.9 years, and it was significantly more common among women whose index polypectomy was performed in an outpatient setting (12.5 % versus 3.6 % operating theatre, p = 0.005), and in women who underwent polypectomy by miniaturized hysteroscopic instruments compared with a loop resectoscope or a tissue removal device (8.3 %, 4.2 %, and 0 %, respectively, p = 0.03). On the multivariate analysis, hysteroscopy without anesthesia was significantly associated with repeat polypectomy (odds ratio = 3.5, 95 % confidence interval 1.1-12.1, p = 0.04), while the choice of hysteroscopic equipment was not (odds ratio = 1.1, 95 %, confidence interval 0.3-3.5, p = 0.9). Patient age, menopausal status, and size and number of polyps were not significantly associated with repeat polypectomy., Conclusions: Repeat hysteroscopic polypectomy is relatively uncommon and possibly associated with the choice of hysteroscopic equipment and provision of anesthesia., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Smorgick received consultation fees from Symbionix, Empress Medical and Ark Surgical, and payments for lectures from Medtronic and Abbvie. All other authors have no disclosures., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Addressing global concerns about youth mental health requires understanding longitudinal pathways to psychological maladjustment among diverse youth. Hostile attribution bias (HAB) and hostile rumination (HR) are cognitive vulnerabilities associated with multiple forms of psychological maladjustment among diverse youth. This study longitudinally examined whether HR mediates the relation of HAB to aggression, anxiety, and depression symptoms in a sample of adolescents from three countries. Participants included 532 mothers, 384 fathers, and 566 youth (50% female) from Colombia, Italy (Naples and Rome), and the U.S. (White, Black, and Latinx). Structural equation modeling indicated that youth-reported HR at Time 2 (mean age = 12.58 years) significantly mediated the relation of youth-reported HAB at Time 1 (mean age = 10.89 years) to parent-reported aggression and anxiety symptoms at Time 3 (mean age = 13.71 years; aggression: b = 0.05, 95% bootstrap CI = [0.006, 0.14]; anxiety: b = 0.06, 95% bootstrap CI = [0.01, 0.16]); but not to parent-reported depression symptoms at Time 3 (b = 0.02, 95% bootstrap CI = [-0.04, 0.08]). A reverse model indicated HAB at Time 3 significantly mediated the relation of HR at Time 2 to anxiety symptoms at Time 4 (mean age = 14.99 years; b = -0.01, 95% bootstrap CI = [-0.04, -0.001]), but not to aggression or depression symptoms at Time 4. Multi-group analyses indicated focal mediational paths did not vary significantly across national, regional, and racial subgroups or gender. Findings support the Integrative Cognitive Model of Aggression, providing evidence that HAB and HR may be vulnerability factors for aggression and anxiety among diverse youth., Competing Interests: Compliance with Ethical Standards. Funding: Open access funding provided by the Carolinas Consortium. This research was funded by the Jacobs Foundation, the Josiah Charles Trent Memorial Foundation, the Transdisciplinary Prevention Research Center at Duke University, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant RO1-HD054805]. Competing Interests: The authors report there are no competing interests to declare., (© 2025. The Author(s).)

Transcarotid artery revascularization (TCAR) is a relatively new and technically challenging procedure that carries a non-negligible risk of complications. Risk prediction tools may help guide clinical decision-making but remain limited. We developed machine learning (ML) algorithms that predict 1-year outcomes following TCAR. The Vascular Quality Initiative (VQI) database was used to identify patients who underwent TCAR between 2016 and 2023. We identified 115 features from the index hospitalization (82 pre-operative [demographic/clinical], 14 intra-operative [procedural], and 19 post-operative [in-hospital course/complications]). The primary outcome was 1-year post-procedural stroke or death. The data was divided into training (70%) and test (30%) sets. Six ML models were trained using pre-operative features with tenfold cross-validation. Overall, 38,325 patients were included (mean age 73.1 [SD 9.0] years, 14,248 [37.2%] female) and 2,672 (7.0%) developed 1-year stroke or death. The best pre-operative prediction model was XGBoost, achieving an AUROC of 0.91 (95% CI 0.90-0.92). In comparison, logistic regression had an AUROC of 0.68 (95% CI 0.66-0.70). The XGBoost model maintained excellent performance at the intra- and post-operative stages, with AUROC's (95% CI's) of 0.92 (0.91-0.93) and 0.94 (0.93-0.95), respectively. Our ML algorithm has potential for important utility in guiding peri-operative risk-mitigation strategies to prevent adverse outcomes following TCAR., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background/Objectives : Preschool children learn to express emotions in accordance with sociocultural norms. Parental emotion talk (ET) has been theorized to shape these processes. Limited research has examined preschoolers' observed emotion expressions and emotion-related behaviors in culturally diverse samples. We sought to explore the following: (1) cultural group differences and similarities in observed emotion expressions (anger, sadness, and positive emotions) and emotion-related behaviors between Chinese American and Mexican American preschoolers, and (2) the concurrent links between parental ET and children's emotion expressions. Methods : In a sample of 86 children (age range = 38 to 70 months, 62% girls) from low-income immigrant families (Mexican Americans/MA = 43 and Chinese Americans/CA = 43), the observed children's emotion expressions and emotion-related behaviors were coded based on a frustration-eliciting task. Parental ET quality and quantity were coded from transcripts of a parent-child shared reading task. Results : MA children expressed more anger and sadness, but the two groups did not differ on positive emotions or emotion-related behaviors. Multiple regressions showed that children whose parents engaged in more ET expressed higher levels of anger and sadness and used more non-feeling state languages than children whose parents engaged in less ET. Conclusions : The results revealed cultural variations in preschool-age children's emotion expressions and provided support for associations between parental ET and children's emotion expressions.