Positional transient loss of consciousness and hemispheric deficits in the setting of severe four-vessel extracranial cerebrovascular disease

Carotid artery stenosis typically causes hemispheric neurologic effects by atheroembolism. Nonhemispheric symptoms, such as syncope, are generally not attributable to extracranial carotid disease. This report describes a 62-year-old woman with severe bilateral carotid artery stenosis, right vertebral artery occlusion, and severe left vertebral artery stenosis who presented with transient loss of consciousness and unilateral weakness when upright. Her symptoms resolved after right carotid endarterectomy. Whereas vertebrobasilar insufficiency alone can cause syncope, in the case of severe multivessel cerebrovascular disease, unilateral carotid revascularization was successful in treating the patient\u27s transient loss of consciousness, suggesting global cerebral hypoperfusion as the cause

Innominate Artery Pseudoaneurysm From a Salter-Harris Fracture of the Sternoclavicular Joint

Fractures and dislocations of the sternoclavicular joint (SCJ) are uncommon, accounting for \u3c5% of all shoulder girdle injuries. They are relatively more common in the pediatric population than in the adult population and can often present concurrently as a posteriorly displaced medial clavicular dislocation with a fracture through the unfused physis. It is especially important to recognize this injury, because its management and potential sequelae are very different from those for fractures of the clavicle shaft. This type of injury frequently requires closed or open operative management because fracture-dislocation of the SCJ can be associated with potentially serious complications such as pneumothorax, brachial plexus injury, vagus nerve injury, tracheal injury, and vascular compromise. Few case reports describe fracture-dislocation of the SCJ resulting in vascular injuries. We describe the case of a 17-year-old boy who sustained a blunt hockey injury resulting in a right physeal fracture-dislocation of the SCJ causing an innominate artery pseudoaneurysm. This was treated with excision of the pseudoaneurysm, bovine pericardial patch angioplasty repair of the innominate artery, and open reduction and internal fixation of the medial clavicular physeal fracture

Development of a Surgical Workforce Access Team (SWAT) in the Battle Against COVID-19

In response to the COVID-19 pandemic, our vascular surgery division has implemented a 24/7 vascular access team to provide line placement services throughout our medical center. We believe this model allows us to maximize our skillset while providing an important service for the hospital during this crisis. Additionally, this model allows us to control our own workforce and preserve workforce availability in the likely event that some of our providers contract the disease

Enhancement and suppression effects resulting from information structuring in sentences

Information structuring through the use of cleft sentences increases the processing efficiency of references to elements within the scope of focus. Furthermore, there is evidence that putting certain types of emphasis on individual words not only enhances their subsequent processing, but also protects these words from becoming suppressed in the wake of subsequent information, suggesting mechanisms of enhancement and suppression. In Experiment 1, we showed that clefted constructions facilitate the integration of subsequent sentences that make reference to elements within the scope of focus, and that they decrease the efficiency with reference to elements outside of the scope of focus. In Experiment 2, using an auditory text-change-detection paradigm, we showed that focus has similar effects on the strength of memory representations. These results add to the evidence for enhancement and suppression as mechanisms of sentence processing and clarify that the effects occur within sentences having a marked focus structure

CEERS Key Paper VII: Emission Line Ratios from NIRSpec and NIRCam Wide-Field Slitless Spectroscopy at z>2

We use James Webb Space Telescope Near-Infrared Camera Wide Field Slitless Spectroscopy (NIRCam WFSS) and Near-Infrared spectrograph (NIRSpec) in the Cosmic Evolution Early Release survey (CEERS) to measure rest-frame optical emission-line of 155 galaxies at z>2. The blind NIRCam grism observations include a sample of galaxies with bright emission lines that were not observed on the NIRSpec masks. We study the changes of the Ha, [OIII]/Hb, and [NeIII]/[OII] emission lines in terms of redshift by comparing to lower redshift SDSS and CLEAR samples. We find a significant (>3$\sigma$) correlation between [OIII]/Hb with redshift, while [NeIII]/[OII] has a marginal (2$\sigma$) correlation with redshift. We compare [OIII]/Hb and [NeIII]/[OII] to stellar mass and Hb SFR. We find that both emission-line ratios have a correlation with Hb SFR and an anti-correlation with stellar mass across the redshifts 0<z<9. Comparison with MAPPINGS~V models indicates that these trends are consistent with lower metallicity and higher ionization in low-mass and high-SFR galaxies. We additionally compare to IllustriousTNG predictions and find that they effectively describe the highest [OIII]/Hb ratios observed in our sample, without the need to invoke MAPPINGS models with significant shock ionizionation components.Comment: 16 pages, 11 figure

Glucocorticoids Decrease Hippocampal and Prefrontal Activation during Declarative Memory Retrieval in Young Men

Glucocorticoids (GCs, cortisol in human) are associated with impairments in declarative memory retrieval. Brain regions hypothesized to mediate these effects are the hippocampus and prefrontal cortex (PFC). Our aim was to use fMRI in localizing the effects of GCs during declarative memory retrieval. Therefore, we tested memory retrieval in 21 young healthy males in a randomized placebo-controlled crossover design. Participants encoded word lists containing neutral and emotional words 1 h prior to ingestion of 20 mg hydrocortisone. Memory retrieval was tested using an old/new recognition paradigm in a rapid event-related design. It was found that hydrocortisone decreased brain activity in both the hippocampus and PFC during successful retrieval of neutral words. These observations are consistent with previous animal and human studies suggesting that glucocorticoids modulate both hippocampal and prefrontal brain regions that are crucially involved in memory processing

Early Life Child Micronutrient Status, Maternal Reasoning, and a Nurturing Household Environment have Persistent Influences on Child Cognitive Development at Age 5 years : Results from MAL-ED

Funding Information: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. This work was also supported by the Fogarty International Center, National Institutes of Health (D43-TW009359 to ETR). Author disclosures: BJJM, SAR, LEC, LLP, JCS, BK, RR, RS, ES, LB, ZR, AM, RS, BN, SH, MR, RO, ETR, and LEM-K, no conflicts of interest. Supplemental Tables 1–5 and Supplemental Figures 1–3 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. Address correspondence to LEM-K (e-mail: [email protected]). Abbreviations used: HOME, Home Observation for Measurement of the Environment inventory; MAL-ED, The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project; TfR, transferrin receptor; WPPSI, Wechsler Preschool Primary Scales of Intelligence.Peer reviewe