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BackgroundAir pollution is a known risk factor for cardiovascular diseases, including stroke. This study examines the impact of county-level air pollution on ischemic and hemorrhagic stroke mortality among U.S. individuals aged 65 and older, emphasizing racial and socioeconomic disparities.MethodsUsing data from the Center for Disease Control (CDC) Interactive Atlas of Heart Disease and Stroke, we analyzed county-level ischemic stroke mortality rates for older residents between 2016 and 2020. The data on air pollution at the county level, specifically particulate matter (PM2.5) levels, were obtained from the CDC. We applied multivariable linear and logistic regression models to examine the association between PM2.5 levels and stroke mortality, as well as the probability of meeting the Environmental Protection Agency (EPA) air quality standards.ResultsCounty-level analysis revealed a significant correlation (R = 0.68, R2 = 0.48, p

Background and objectivesThis study investigates geographic disparities in aneurysmal subarachnoid hemorrhage (aSAH) care for Black patients and aims to explore the association with segregation in treatment facilities. Understanding these dynamics can guide efforts to improve healthcare outcomes for marginalized populations.MethodsThis cohort study evaluated regional differences in segregation for Black patients with aSAH and the association with geographic variations in disparities from 2016 to 2020. The National Inpatient Sample (NIS) database was queried for admission data on aSAH. Black patients were compared to White patients. Segregation in treatment facilities was calculated using the dissimilarity (D) index. Using multivariable logistic regression models, the regional disparities in aSAH treatment, functional outcomes, mortality, and end-of-life care between Black and White patients and the association of geographical segregation in treatment facilities was assessed.Results142,285 Black and White patients were diagnosed with aSAH from 2016 to 2020. The Pacific division (D index = 0.55) had the greatest degree of segregation in treatment facilities, while the South Atlantic (D index = 0.39) had the lowest. Compared to lower segregation, regions with higher levels of segregation (global F test p

BackgroundThis study examines the lasting impact of historical redlining on contemporary neurosurgical care access, highlighting the need for equitable healthcare in historically marginalized communities.ObjectiveTo investigate how redlining affects neurosurgeon distribution and reimbursement in U.S. neighborhoods, analyzing implications for healthcare access.MethodsAn observational study was conducted using data from the Center for Medicare and Medicaid Services (CMS) National File, Home Owner’s Loan Corporation (HOLC) neighborhood grades, and demographic data to evaluate neurosurgical representation across 91 U.S. cities, categorized by HOLC Grades (A, B, C, D) and gentrification status.ResultsOf the 257 neighborhoods, Grade A, B, C, and D neighborhoods comprised 5.40%, 18.80%, 45.8%, and 30.0% of the sample, respectively. Grade A, B, and C neighborhoods had more White and Asian residents and less Black residents compared to Grade D neighborhoods (p

Objective Intraoperative ultrasound (IOUS) is an imaging method that can be used in various neurosurgical procedures. It assists in the removal of brain tumors, hematomas, in the insertion of ventricular catheters, and in spinal and peripheral nerve surgeries. The original studies using IOUS were performed with devices that produced lower-quality images, generating little interest in their use. The introduction of ultrasound devices that yielded higher-quality images associated with a relative low cost and ease of use rendered IOUS attractive. Thus, we started using it in multiple neurosurgical procedures, studying its practicality, efficacy and limitations.

Ewing sarcoma (ES) is a malignant neoplasm that affects bones and soft tissues, usually in young patients. Currently, ES is grouped with other tumors that share the same histological and genotypic characteristics, forming the Ewing Sarcoma Family of Tumors (ESFT), which includes ES of bone, extraosseous ES (peripheral neuroepithelioma), Askin tumor, and peripheral primitive neuroectodermal tumor (PNET). Its origin in peripheral nerves is extremely rare, making its diagnosis and treatment very challenging. We describe a case of a 27-year-old male with extraosseous ES originating in the sciatic nerve, which was surgically removed, and discuss the difficulties encountered in the management of this patient.

Abstract Background Recombinant adeno-associated virus (rAAV) is widely used in the neuroscience field to manipulate gene expression in the nervous system. However, a limitation to the use of rAAV vectors is the time and expense needed to produce them. To overcome this limitation, we evaluated whether unpurified rAAV vectors secreted into the media following scalable PEI transfection of HEK293T cells can be used in lieu of purified rAAV. Methods We packaged rAAV2-EGFP vectors in 30 different wild-type and mutant capsids and subsequently collected the media containing secreted rAAV. Genomic titers of each rAAV vector were assessed and the ability of each unpurified virus to transduce primary mixed neuroglial cultures (PNGCs), organotypic brain slice cultures (BSCs) and the mouse brain was evaluated. Results There was ~ 40-fold wide variance in the average genomic titers of the rAAV2-EGFP vector packaged in the 30 different capsids, ranging from a low ~ 4.7 × 1010 vector genomes (vg)/mL for rAAV2/5-EGFP to a high of ~ 2.0 × 1012 vg/mL for a capsid mutant of rAAV2/8-EGFP. In PNGC studies, we observed a wide range of transduction efficiency among the 30 capsids evaluated, with the rAAV2/6-EGFP vector demonstrating the highest overall transduction efficiency. In BSC studies, we observed robust transduction by wild-type capsid vectors rAAV2/6, 2/8 and 2/9, and by capsid mutants of rAAV2/1, 2/6, and 2/8. In the in vivo somatic brain transgenesis (SBT) studies, we found that intra-cerebroventricular injection of media containing unpurified rAAV2-EGFP vectors packaged with select mutant capsids resulted in abundant EGFP positive neurons and astrocytes in the hippocampus and forebrain of non-transgenic mice. We demonstrate that unpurified rAAV can express transgenes at equivalent levels to lysate-purified rAAV both in vitro and in vivo. We also show that unpurified rAAV is sufficient to drive tau pathology in BSC and neuroinflammation in vivo, recapitulating previous studies using purified rAAV. Conclusions Unpurified rAAV vectors secreted into the media can efficiently transduce brain cells in vitro and in vivo, providing a cost-effective way to manipulate gene expression. The use of unpurified virus will greatly reduce costs of exploratory studies and further increase the utility of rAAV vectors for standard laboratory use.

ABSTRACT The authors present an historical review of aspects of the life of Professor Manuel R. Gómez, a Spanish neuropediatrician, who graduated in Havana and is known internationally for his work while he was in charge of Pediatric Neurology at the Mayo Clinic in Rochester, USA. His main contribution was related to the tuberous sclerosis complex, demystifying the Vogt triad previously used as a diagnostic criterion, and he was considered the “father of the tuberous sclerosis complex “ in the USA.

Las relaciones en familia son fundamentales para la vida de las personas, en especial para las/los adolescentes en cuyo futuro tienen un fuerte impacto, de ahí la importancia de dimensionarlas, a fin de orientar el desarrollo de políticas públicas para la familia. En este artículo damos cuenta de una investigación cuyo objetivo fue evaluar y comparar la percepción de las/los adolescentes con respecto a las prácticas de crianza de sus madres/padres, en función del género de sus hijos/hijas y de su residencia en contextos rural o urbano. Se trata de una investigación cuantitativa y transversal, con representatividad municipal en San Juan del Río, Querétaro, donde se encontró un alto nivel de prácticas permisivas de madres/padres, además de que existe mayor riesgo para los hombres del área urbana, que para los de la rural, de experimentar lejanía emocional de sus padres. Se concluye que, aunque las/los adolescentes tienden a evaluar de manera similar la ejecución de las prácticas de crianza, aún refieren reminiscencias de trato diferenciado por género y contexto.