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INTRODUCTION: Vascular contributions to cognitive impairment and dementia (VCID) represent a major factor in cognitive decline in older adults. The present study examined the relationship between cerebrovascular reactivity (CVR) measured by magnetic resonance imaging (MRI) and cognitive function in a multi-site study, using a predefined hypothesis. METHODS: We conducted the study in a total of three analysis sites and 263 subjects. Each site performed an identical CVR MRI procedure using 5% carbon dioxide inhalation. A global cognitive measure of Montreal Cognitive Assessment (MoCA) and an executive function measure of item response theory (IRT) score were used as outcomes. RESULTS: CVR and MoCA were positively associated, and this relationship was reproduced at all analysis sites. CVR was found to be positively associated with executive function. DISCUSSION: The predefined hypothesis on the association between CVR and a global cognitive score was validated in three independent analysis sites, providing support for CVR as a biomarker in VCID. HIGHLIGHTS: This study measured a novel functional index of small arteries referred to as cerebrovascular reactivity (CVR). CVR was positively associated with global cognition in older adults. This finding was observed in three independent cohorts at three sites. Our statistical analysis plan was predefined before beginning data collection.

Social determinants of health (SDOH)--conditions in which children live, learn, and play--affect child health and well-being. Publicly funded services in education and child welfare systems are important resources to support child well-being, but cross-system coordination is rare. Leveraging integrated administrative data from 60,287 6th graders enrolled in public schools in Minnesota, we used latent class analysis (LCA) to examine patterns of cross-system SDOH, including educational services and involvement in child welfare. Five classes emerged. The largest class was characterized by a few multi-system SDOH and had low service needs. Two classes had differing patterns of school service use, one with a greater likelihood of special education service use alone and the other characterized by the use of multiple school services. Two classes were characterized by cross-system SDOH/service use (e.g., homelessness, child protection, placement in care, mental health, and special education services). We then assessed whether race/ethnicity predicted class membership and tested educational distal outcomes. American Indian, Black, and Latinx children had higher odds of exposure to both cross-system SDOH classes. Students facing any SDOH, particularly those with greater multi-system SDOH exposure, had worse attendance and academic achievement. Our study indicates that children are navigating complex experiences of SDOH and service needs, with a disproportional likelihood that Black children, Indigenous children, and other children of color (BIPOC) experience SDOH. Identifying patterns of SDOH provides an opportunity for policymakers and practitioners to intervene to promote health equity. By understanding facilitators and barriers to child well-being, the results inform how child-serving systems can strive toward health equity.

Observations show that the ice water content (IWC) in mixed-phase clouds (MPCs) tends to occur in clusters. However, it is not sufficiently understood which ice crystal formation and growth processes play a dominant role in IWC clustering in clouds. One important ice growth process is riming, which occurs when liquid water droplets freeze onto ice crystals upon contact. Here we use airborne measurements of MPCs at mid- and high-latitudes to investigate the spatial variability of ice clusters in clouds and how this variability is linked to riming. We use data from the IMPACTS (mid-latitudes) and the HALO-(AC)3 (high-latitudes) aircraft campaigns, where spatially and temporally colocated cloud radar and in situ measurements were collected. We derive riming and IWC by combining cloud radar and in situ measurements. Ice cluster scales in clouds are quantified using pair correlation functions. During all analyzed flight segments, riming is responsible for 66 % and 63 % of the total IWC during IMPACTS and HALO-(AC)3, respectively. In mid-latitude MPCs, riming does not significantly change IWC cluster scales but increases the probability of cluster occurrence. In cold-air-outbreak MPCs observed during HALO-(AC)3, riming leads to additional in-cloud IWC clustering at spatial scales of 3–5 km due to the presence of mesoscale updraft features. An increased liquid water path might increase the effect, but it is not a necessary criterion. These results can be used to evaluate and constrain models' representations of MPCs.

Abstract Background We aimed to determine the association of neutrophil-to-lymphocyte ratio (NLR) with non-arteritic anterior ischemic optic neuropathy (NAION). Methods We conducted a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus and Web of Science were searched from the establishment of the database to May 5, 2022 to find the relevant studies. The quality of the included literature was evaluated with the Newcastle–Ottawa scale (NOS). The results are reflected in the form of standard mean difference (SMD) and 95% confidence interval (CI). Results Finally, six articles were included in our study. Compared with healthy controls, patients’ NLR levels were significantly higher (SMD = 0.47; CI 95% = 0.30–0.65, p

Abstract Background Chronic subdural hematoma (CSDH) is an important medical condition characterized by the accumulation of blood in the subdural space. Several methods have been explored, including surgical intervention and administration of tranexamic acid, which is a conservative treatment option. This meta-analysis aimed to assess the effectiveness and safety of tranexamic acid in CSDH management. Methods A systematic literature search was performed according to the PRISMA and MOOSE guidelines. This study included cohort and randomized controlled trials involving adults with chronic subdural hematoma (CSDH) who were treated with intravenous tranexamic acid. The primary outcome measures were recurrence and adverse events. Results Six studies encompassing 2024 participants were included. Studies have shown that tranexamic acid reduced recurrence rates (OR, 0.32; 95% CI: 0.27–0.38, p = 0.16; I2 = 0%), although the result was non-significant. However, the analysis of adverse events indicated a moderate level of heterogeneity (OR, 1.14; 95% CI: 0.60–2.15, p = 0.07; I2 = 57%), suggesting a potential safety concern. Conclusion In conclusion, this meta-analysis suggests tranexamic acid (TXA) may reduce chronic subdural hematoma (CSDH) recurrence, though significance varied across studies. Adverse effects with TXA were similar to controls. Larger trials are needed to confirm TXA’s role in CSDH management.

Objective: Research indicates that coping styles mediate self-control and health outcomes. Emotion- and problem-focused coping strategies (eg, getting advice or planning) are used to address stressors. In contrast, avoidance-focused strategies (eg, substance use) are used to escape distress and are associated with greater alcohol problems. The purpose of this study was to examine associations between college students' levels of self-control, coping styles, and alcohol use and problems. Participants and Methods: 183 undergraduates completed questionnaires regarding self-control, coping styles, and alcohol consumption and problems. We hypothesized that self-control would be associated with alcohol problems through avoidance-focused coping, but not emotion- or problem-focused coping. Results: Our results were consistent with our hypothesis with and without controlling for alcohol consumption. Undergraduates lower in self-control who engage in avoidance-focused coping may experience greater alcohol problems. Conclusions: University programs dedicated to addressing substance use among undergraduates may develop workshops that promote problem- or emotion-focused coping strategies as alternatives to avoidance-focused strategies.

The integration of biologics in endovascularly treated intracranial aneurysms is a significant area of focus in an evolving field. By presenting the clinical relevance, pathogenesis, management (historical and current), and emerging biologics themselves, this work provides a broad overview of the current landscape of the biologics under current investigation. Growth factors, cytokines, and biologic-coated coils are compared and described as modalities to increase healing, aneurysm occlusion, and long-term recovery. These emerging biologics may increase the efficacy and durability of less invasive endovascular methods and potentially change standard practice with continued exploration.

Background: To summarize the results of available studies for investigating the role of neutrophil to lymphocyte ratio (NLR) in testicular cancer (tCa). Methods: The search was conducted on PubMed, Scopus, and Web of Science up to November 21, 2021. Finally, a total of 31 studies were included in this review. Results: NLR was higher in tCa patients compared to healthy controls and benign testis pathologies, and decreased significantly after orchiectomy. An elevated NLR predicts poor prognosis, advanced stage, presence of nodal or distant metastases, contralateral tumor development, lower time-to-cancer specific death, worse OS, and poorer response to chemotherapy. However, NLR could not differentiate between seminomas and non-seminomatous tCa. Discussion: NLR has a significant diagnostic and prognostic value in tCa.

Traumatic brain injury (TBI) results from external biomechanical forces that cause structural and physiological disturbances in the brain, leading to neuronal, axonal, and vascular damage. TBIs are predominantly mild (65%), with moderate (10%) and severe (25%) cases also prevalent. TBI significantly impacts health, increasing the risk of neurodegenerative diseases such as dementia, post injury. The initial phase of TBI involves acute disruption of the blood–brain barrier (BBB) due to vascular shear stress, leading to ischemic damage and amyloid-beta accumulation. Among the acute cerebrovascular changes after trauma are early progressive hemorrhage, micro bleeding, coagulopathy, neurovascular unit (NVU) uncoupling, changes in the BBB, changes in cerebral blood flow (CBF), and cerebral edema. The secondary phase is characterized by metabolic dysregulation and inflammation, mediated by oxidative stress and reactive oxygen species (ROS), which contribute to further neurodegeneration. The cerebrovascular changes and neuroinflammation include excitotoxicity from elevated extracellular glutamate levels, coagulopathy, NVU, immune responses, and chronic vascular changes after TBI result in neurodegeneration. Severe TBI often leads to dysfunction in organs outside the brain, which can significantly impact patient care and outcomes. The vascular component of systemic inflammation after TBI includes immune dysregulation, hemodynamic dysfunction, coagulopathy, respiratory failure, and acute kidney injury. There are differences in how men and women acquire traumatic brain injuries, how their brains respond to these injuries at the cellular and molecular levels, and in their brain repair and recovery processes. Also, the patterns of cerebrovascular dysfunction and stroke vulnerability after TBI are different in males and females based on animal studies.

Introduction: Atlas and axis fractures are the most severe cervical fractures which may result in complete paralysis or death. The purpose of the current study is to identify disparities regarding length of stay (LOS), mortality, and demographic factors in patients with the most serious cervical spine fractures utilizing a nationally representative database. MATERIALS AND METHODS: The Nationwide Emergency Department Sample was utilized to provide a representative sample for patients with a primary diagnosis of C1 or C2 fracture presenting to emergency departments in years from October 2015 to December 2019. A multivariable logistic regression model was used to estimate LOS for different patient demographics, including gender, race, and age. Results: A weighted sample of 7,262,791 patients presented to emergency rooms in the United States between 2015 and 2019. The mean age at admission was 76 years old, 52.6% of patients were female, and 83.0% identified as white. Patients between 45 and 65 and patients over 65 were significantly more likely to have an increased LOS. Women were less likely to have an increased LOS than men. Patients identifying as Black were significantly more likely to have increased LOS over white patients. In addition, patients who had an increased LOS were more likely to die in the hospital than patients with a shorter LOS. Conclusion: This study provides patient characteristics that help providers determine patient risk factors for increased hospital LOS and in-hospital mortality for those suffering from C1 and C2 fractures. Clinicians should be made aware of these disparities to allow equitable delivery of care.

Global warming is amplified in the Arctic. However, numerical models struggle to represent key processes that determine Arctic weather and climate. To collect data that help to constrain the models, the HALO–(𝒜𝒞)3 aircraft campaign was conducted over the Norwegian and Greenland seas, the Fram Strait, and the central Arctic Ocean in March and April 2022. The campaign focused on one specific challenge posed by the models, namely the reasonable representation of transformations of air masses during their meridional transport into and out of the Arctic via northward moist- and warm-air intrusions (WAIs) and southward marine cold-air outbreaks (CAOs). Observations were made over areas of open ocean, the marginal sea ice zone, and the central Arctic sea ice. Two low-flying and one long-range, high-altitude research aircraft were flown in colocated formation whenever possible. To follow the air mass transformations, a quasi-Lagrangian flight strategy using trajectory calculations was realized, enabling us to sample the same moving-air parcels twice along their trajectories. Seven distinct WAI and 12 CAO cases were probed. From the quasi-Lagrangian measurements, we have quantified the diabatic heating/cooling and moistening/drying of the transported air masses. During CAOs, maximum values of 3 K h−1 warming and 0.3 g kg−1 h−1 moistening were obtained below 1 km altitude. From the observations of WAIs, diabatic cooling rates of up to 0.4 K h−1 and a moisture loss of up to 0.1 g kg−1 h−1 from the ground to about 5.5 km altitude were derived. Furthermore, the development of cloud macrophysical (cloud-top height and horizontal cloud cover) and microphysical (liquid water path, precipitation, and ice index) properties along the southward pathways of the air masses were documented during CAOs, and the moisture budget during a specific WAI event was estimated. In addition, we discuss the statistical frequency of occurrence of the different thermodynamic phases of Arctic low-level clouds, the interaction of Arctic cirrus clouds with sea ice and water vapor, and the characteristics of microphysical and chemical properties of Arctic aerosol particles. Finally, we provide a proof of concept to measure mesoscale divergence and subsidence in the Arctic using data from dropsondes released during the flights.