Background: Emergency airway management is a crucial and complex procedure frequently performed in the emergency department (ED). Airway contamination usually caused by blood, secretions, and emesis impairs ventilation, reduces successful intubation, and increases the complication rates, leading to difficult laryngoscopy, delayed intubation, and increased mortality rates. One technique employed to decontaminate these airways when standard approaches fail is Suction-Assisted Laryngoscopy and Airway Decontamination (SALAD). Methods: A comprehensive literature search was conducted across PubMed, Cochrane, and Science direct databases following a specific search strategy. All search results were screened in a two-stage process (title–abstract and full-text screening) in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Data from finalized articles were extracted using a standardized excel file developed a priori. Lastly, quality and risk of bias were assessed using appropriate tools according to respective study designs, and data were narratively synthesized. Results: A total of 224 records were identified. Upon screening, seven studies were included consisting of five simulation-based studies and two clinical case reports. Simulation studies reported that SALAD training significantly improved first-pass intubation success (53.7–90.2%), reduced time to intubation (up to 30 s), and enhanced airway visualization. Clinical cases further reported successful first-pass intubation in patients with massive airway contamination without complications. Overall, across both study types, the SALAD technique improved airway management performance, provider confidence, and airway contamination control compared to standard suction techniques. Conclusions: This systematic review highlights the benefits of the SALAD technique by enhancing airway visualization, reinforcing it as a significant tool for contaminated airway management. Trainees who underwent SALAD training demonstrated improved first-pass intubation success, reduced intubation time, and increased operator confidence. While data from the included studies seems promising, most studies are small simulation-based studies with limited clinical outcome data. Given its clinical relevance and educational value, future studies must prioritize high-quality research in clinical environments to establish SALAD’s efficacy and to define its role in integration into prehospital protocols.

Background: Endometrial cancer (EC) is a common malignancy found among women. It is ranked as the 6th most common cancer among women and the 15th most common cancer globally. Increasing prevalence of several factors like obesity and other metabolic disorders have caused a growing trend of prevalence of endometrial cancer. The standard approach of treatment with excellent prognosis is total hysterectomy with bilateral salpingo-oophorectomy (TH/BSO). However, due to its drawback of complete infertility, newer approaches of fertility-sparing approaches are emerging to combat this challenge. Clinicians must choose the most suitable candidates for fertility-sparing surgery (FSS) using the present existing conventional criteria with regard to the patient’s age, tumor characteristics, and fertility goals. The limitations using the conventional criteria can be eliminated by refining the criteria with molecular prognostic factors to ease the candidate selection process for FSS. Methods: Relevant literature regarding molecular subtypes, hormone therapy sensitivity, clinical assessment, and guidelines pertaining to fertility preservation in EC were retrieved from several electronic databases and articles addressing the role of molecular profiling in predicting patient response, guiding patient selection, and/or informing the development of therapies for fertility preservation in early-stage EC, particularly in women of reproductive age were included. Primary focus was on areas of consensus, emerging trends, and evidence gaps that warrant further investigation. This review will assess the integration of molecular prognostic factors to refine the patient selection criteria and guide FSS in early-stage EC. We will present existing clinical criteria, ongoing clinical trials, limitations, and the advantages of integrating molecular data on patient selection, treatment safety, and fertility outcomes. Results: Four distinct molecular subtypes have been classified which includes POLE-mut, MMR-d, p53-abn and NSMP. POLE-mut subtype had excellent prognosis with >95% patients achieving complete remission with <2% recurrence rate followed by MMRd and NSMP with intermediate prognosis and lastly p53-abn with poor prognosis of 60–70% achieving complete remission and 30–40% having recurrence. The data highlights the clinical value of molecular classification in selecting appropriate candidates for fertility sparing surgery (FSS). Conclusions: There is a lack of integration of molecular subtypes for clinicians to choose candidates for FSS and this gap should be addressed. Further research must be performed to follow personalized medicine to refine their treatment plan.

Primary parapharyngeal space (PPS) tumors are rare neoplasms comprising 0.5% of head and neck tumors. Their complex anatomical location and proximity to critical neurovascular structures pose significant surgical challenges. While transcervical and transcervical-combined approaches represent the primary surgical techniques, no comprehensive systematic comparison exists. This systematic review compared surgical success, complications, functional outcomes, and recurrence rates between these approaches. Following PROSPERO registration (CRD420251037201), we searched PubMed, Cochrane, Web of Science, Google Scholar, and ScienceDirect without date restrictions. Independent dual screening identified retrospective cohort studies and case series comparing both approaches. Data extraction and risk of bias assessment employed standardized tools, with synthesis conducted per PRISMA 2020 guidelines using narrative analysis. Ten studies encompassing 505 patients with 508 tumors met inclusion criteria. Both approaches achieved excellent complete resection rates (95–100%). Transcervical approaches demonstrated lower overall complication rates (4.8–52.6%) versus transcervical-combined approaches (7.7–100%), though rates varied substantially by tumor type, and differences likely reflect case selection rather than approach-specific effects. Cranial nerve injuries (VII, X, XII) constituted predominant complications. Infratemporal fossa approaches showed the highest morbidity. Recurrence rates ranged from 0–30.3% without consistent patterns favoring either approach. Transcervical-combined approaches were essential for superior compartment extension and for skull base involvement. Both transcervical and transcervical-combined approaches achieve excellent tumor resection with acceptable morbidity when appropriately selected. For most benign PPS tumors, a transcervical approach may be preferred. Combined approaches may be considered in specific anatomic scenarios that require enhanced exposure, particularly when the superior compartment and skull base are involved, although the decision is always highly individual.

Endovascular thrombectomy [EVT] has revolutionized acute ischemic stroke care by restoring macrovascular reperfusion in large vessel occlusion; however, a persistent “reperfusion–outcome gap” remains, leaving nearly half of successfully recanalized patients without functional independence. This review aims to bridge this translational gap by establishing a mechanistic and procedural framework for adjunctive pharmacotherapy designed to target the microvascular, thromboinflammatory, and reperfusion-related injuries left unaddressed by purely mechanical models. Synthesis of recent literature reveals that futile recanalization is driven by three distinct anatomical and biological bottlenecks: distal microembolization, microcirculatory no-reflow, and ischemia–reperfusion injury. Furthermore, the inconsistency of clinical trial results reflects a critical precision deficit, including dilution of treatment effects across heterogeneous reperfusion grades, inadequate stroke etiology stratification, delayed pharmacologic intervention relative to evolving microvascular injury, and reliance on functional endpoints that inadequately capture tissue-level reperfusion. To address these limitations, this review outlines a tri-axial clinical decision framework integrating reperfusion status, stroke etiology and hemorrhagic risk, which maps specific patient phenotypes, such as incomplete macrovascular reperfusion or underlying intracranial atherosclerotic disease, to targeted pharmacologic strategies including microcatheter-directed intra-arterial thrombolytics and glycoprotein IIb/IIIa inhibitors. The review further argues that future progress will require imaging-guided identification of residual hypoperfusion, mechanistically enriched patient enrolment, and incorporation of biological and tissue-level reperfusion endpoints alongside conventional functional outcomes. Ultimately, closing the reperfusion–outcome gap will require moving beyond empirical, universal drug administration toward a precision, pharmacologically augmented EVT paradigm that aligns adjunctive therapy with mechanism-specific procedural phenotypes and prioritizes true tissue-level recovery over angiographic success alone.

Background: Gliomas are characterized by a high degree of molecular heterogeneity, which impairs the reproducibility of predictive biomarkers derived from bulk-based molecular profiling due to immune/stromal contamination of tumors and the high prevalence of the IDH mutation signature. Methods: In this study, we used MOFA+ to derive intrinsic molecular signatures from transcriptional, methylation, and genomic profiles of a cohort of 667 diffuse gliomas in the Cancer Genome Atlas database. Thereafter, factor scores were derived for two separate Chinese Glioma Genome Atlas batches (Batch 1, n = 325; Batch 2, n = 693) without any retraining on the model. The prognostic independence of identified molecular signatures was assessed using multivariable Cox regression adjusted for IDH mutation status and tumor purity; purity-residualized survival analyses; IDH-stratified Cox regression in each cohort; validation by concordance index against established molecular signatures; and survival extreme profiling. To characterize the biological significance of factor signatures, we projected gene set signatures corresponding to each factor signature onto a single-cell RNA-seq dataset of GBM (GSE131928). Results: MOFA+ identified 12 latent factors, of which a vascular–extracellular matrix (ECM) remodeling axis (Factor 1) explained the highest multi-omics variance (24.9%) and was the strongest independent prognostic factor. In multivariable Cox regression adjusting for IDH status and tumor purity, Factor 1 remained independently prognostic (HR = 1.67, 95% CI 1.27–2.20, p = 0.0002); in a fully-adjusted model additionally including age, WHO grade, MGMT methylation, and 1p/19q codeletion (plus radiotherapy and chemotherapy status in the CGGA cohorts), Factor 1 remained prognostic in both CGGA cohorts (CGGA1: HR = 1.50, p = 3.8 × 10⁻⁵; CGGA2: HR = 1.18, p = 0.003) but lost significance in TCGA (HR = 1.04, p = 0.83), consistent with the cohort-dependent magnitude reported in the IDH-stratified and meta-regression analyses below. Purity-residualized survival analysis showed negligible attenuation of the Factor 1 signal (raw HR = 3.57 vs. residualized HR = 3.72; concordance 96.5%). Within IDH-wildtype gliomas, Factor 1 was significant in both external validation cohorts (CGGA1: HR = 1.64, FDR = 4.6 × 10⁻⁶; CGGA2: HR = 1.20, FDR = 0.02), though the TCGA IDH-wildtype subgroup showed a trend that did not survive FDR correction (FDR = 0.060). All validation was performed without model retraining. Within IDH-mutant gliomas, Factor 1 was strongly prognostic in both CGGA cohorts but was not significant in TCGA (HR = 1.17, FDR = 0.33). These findings should therefore be interpreted as consistent in directionality across cohorts but not uniformly replicated at the FDR-adjusted significance threshold in the TCGA discovery dataset. Concordance index benchmarking on a matched subset (n = 503) showed Factor 1 achieved discrimination comparable to the Mesenchymal signature (C = 0.797 vs. 0.801; ΔC = −0.004) while outperforming four other established classifiers. Factor 1 consistently separated patients with extreme survival phenotypes (OS < 6 vs. >15 months) across all three cohorts (all log-rank p < 0.001). Projection onto a single-cell GBM atlas (GSE131928), supported by inferCNV-based malignant-cell classification, localized the Vascular–ECM program to malignant cells and the Immune–ECM axis to myeloid compartments. Conclusions: The Vascular–ECM axis is a consistent, prognostic program robust to purity adjustment for diffuse gliomas that remains relevant across IDH-defined subgroups in three independent datasets comprising 1685 patients. The Vascular–ECM axis is a reproducible, purity-robust prognostic program in diffuse glioma, with directionally consistent adverse effects across TCGA, CGGA Batch 1, and CGGA Batch 2 (pooled n = 1685). Given the strong co-loading of endothelial, ECM, and myeloid genes observed in the single-cell projection, Factor 1 is best interpreted as a vascular/ECM-associated tumor–microenvironment ecosystem program rather than a malignant-cell-autonomous signature. Its FDR-adjusted significance within IDH-stratified subgroups is cohort-dependent and robust in both CGGA cohorts but attenuated in the TCGA IDH-wildtype (FDR = 0.060) and TCGA IDH-mutant (FDR = 0.33) strata. The pooled signal should therefore be interpreted as evidence of a generalizable biological program rather than a uniformly replicated subgroup-specific biomarker. It is possible to calculate factor scores based on RNA sequencing alone using fixed loadings (Z = XWᵀ), which may have implications for future translational applications. All findings are correlative; a causal role for the Vascular–ECM program in glioma progression, invasion, or therapy resistance remains to be established through functional perturbation experiments.