Articles: surgery.
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Better local control but higher rates of adverse radiation events (ARE) have been reported when combining American Society for Radiation Oncology (ASTRO)-guideline-suggested dose (SD) stereotactic radiosurgery (SRS) with immunotherapy or targeted therapy for melanoma brain metastases. The objective of this study is to explore the efficacy and safety of lower prescription doses compared with ASTRO guidelines for single-fraction SRS for patients with melanoma metastases who are concurrently receiving immunotherapy or targeted therapy. ⋯ This study provides evidence that RD SRS could offer reduced toxicity rates, while maintaining high local control as compared with the current guideline-SDs for the treatment of melanoma brain metastases.
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The POTTER calculator, a widely used interpretable artificial intelligence (AI) risk calculator, has been validated in population-based studies and shown to predict outcomes in emergency general surgery (EGS) patients better than surgeons. We sought to prospectively validate POTTER. ⋯ This is the first prospective validation of the AI-enabled POTTER calculator. The superior accuracy, user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative patient and family counseling.
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Moyamoya disease (MMD) is characterized by progressive steno-occlusion of the internal carotid arteries, leading to compensatory collateral vessel formation. The optimal surgical approach for MMD remains debated, with bilateral revascularization potentially offering more comprehensive protection but involving more extensive surgery compared to unilateral revascularization. This study aims to compare bilateral revascularization and unilateral revascularization short-term safety profile in the treatment of MMD. ⋯ This study found no significant differences between bilateral and unilateral revascularization in MMD. Patients who had bilateral revascularization had higher tendency of perioperative stroke, though not statistically significant. Further prospective studies are needed to validate these results.
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Women represent ∼20% of the national neurosurgical resident cohort but only ∼10% of academic neurosurgeons in the United States. Recognizing that the publication of scientific literature contributes to academic advancement, we measured authorship trends of academic neurosurgeons to query publication differences as an explanation for the discrepancy of female representation in academic positions. ⋯ These data suggest that women publish earlier but have fewer first-author publications at -1 year, the timepoint of peak publication for both genders. There was no significant gender difference in rates of the first author and all publications over the years 0 to 10. The ratio of publications to the h-index did not differ significantly but showed a trend suggesting that women produce higher-impact articles and may need fewer publications to achieve the same change in the h-index.