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Zelquistinel Acts At An Extracellular Binding Domain To Modulate Intracellular Calcium Inactivation Of N-Methyl-D-Aspartate Receptors, Xiao-Lei Zhang, Yong-Xin Li, Nils Berglund, Jeffrey S. Burgdorf, John E. Donello, Joseph R. Moskal, Patric K. Stanton Nov 2024

Zelquistinel Acts At An Extracellular Binding Domain To Modulate Intracellular Calcium Inactivation Of N-Methyl-D-Aspartate Receptors, Xiao-Lei Zhang, Yong-Xin Li, Nils Berglund, Jeffrey S. Burgdorf, John E. Donello, Joseph R. Moskal, Patric K. Stanton

NYMC Faculty Publications

Stinels are a novel class of N-methyl-d-aspartate glutamate receptor (NMDAR) positive allosteric modulators. We explored mechanism of action and NR2 subtype specificity of the stinel zelquistinel (ZEL) in HEK 293 cells expressing recombinant NMDARs. ZEL potently enhanced NMDAR current at NR2A (EC50 = 9.9 ± 0.5 nM) and NR2C-containing (EC50 = 9.7 ± 0.6 nM) NMDARs, with a larger ceiling enhancement at NR2B-NMDAR (EC50 = 35.0 ± 0.7 nM), while not affecting NR2D-containing NMDARs. In cells expressing NR2A and NR2C-containing NMDARs, ZEL exhibited an inverted-U dose-response relation, with a low concentration enhancement and high concentration suppression of NMDAR currents. Extracellular …


Acute Myocardial Injury In Spontaneous Intracerebral Hemorrhage: A Secondary Observational Analysis Of The Fast Trial, Michela Rosso, Helena Stengl, Jan F. Scheitz, Jennifer Lewey, Stephan A. Mayer, Shadi Yaghi, Scott E. Kasner, Jens Witsch Sep 2024

Acute Myocardial Injury In Spontaneous Intracerebral Hemorrhage: A Secondary Observational Analysis Of The Fast Trial, Michela Rosso, Helena Stengl, Jan F. Scheitz, Jennifer Lewey, Stephan A. Mayer, Shadi Yaghi, Scott E. Kasner, Jens Witsch

NYMC Faculty Publications

BACKGROUND: Acute myocardial injury is associated with poor outcomes in patients with acute ischemic stroke, but its prognostic significance in patients with spontaneous intracerebral hemorrhage remains unclear. We investigated whether acute myocardial injury and the direction of the cardiac troponin I (cTnI) change (rising versus falling) affect post-intracerebral hemorrhage outcomes. METHODS AND RESULTS: We re-analyzed the FAST (Factor-Seven-for-Acute-Hemorrhagic-Stroke) trial. Acute myocardial injury was defined as at least 1 cTnI value above the upper reference limit with a rise/fall of >20%. Logistic regression tested for associations (1) between acute myocardial injury (presence versus absence) and poor outcome (modified Rankin Scale 4-6) …


Code-Ich: A New Paradigm For Emergency Intervention, Aleksandra Yakhkind, Wenzheng Yu, Qi Li, Joshua N. Goldstein, Stephan A. Mayer Sep 2024

Code-Ich: A New Paradigm For Emergency Intervention, Aleksandra Yakhkind, Wenzheng Yu, Qi Li, Joshua N. Goldstein, Stephan A. Mayer

NYMC Faculty Publications

PURPOSE OF REVIEW: Intracerebral hemorrhage (ICH) is the most devastating type of stroke, causing widespread disability and mortality. Unfortunately, the acute care of ICH has lagged behind that of ischemic stroke. There is an increasing body of evidence supporting the importance of early interventions including aggressive control of blood pressure and reversal of anticoagulation in the initial minutes to hours of presentation. This review highlights scientific evidence behind a new paradigm to care for these patients called Code-ICH. RECENT FINDINGS: While numerous trials aimed at decreasing hematoma expansion through single interventions had failed to show statistically significant effects on primary …


Disease Mechanisms And Therapeutic Targets In Pulmonary Hypertension: Key Insights From The Special Issue Of Vascular Pharmacology On Pulmonary Hypertension, Beata Wojciak-Stothard, Sachin Gupte, Eduardo Bossone Sep 2024

Disease Mechanisms And Therapeutic Targets In Pulmonary Hypertension: Key Insights From The Special Issue Of Vascular Pharmacology On Pulmonary Hypertension, Beata Wojciak-Stothard, Sachin Gupte, Eduardo Bossone

NYMC Faculty Publications

No abstract provided.


Hpv Infection And Vaccination: A Cross-Sectional Study Of Knowledge, Perception, And Attitude To Vaccine Uptake Among University Students In Qatar, Sohaila Cheema, Amit Abraham, Patrick Maisonneuve, Anupama Jithesh, Karima Chaabna, Reem Al Janahi, Shaunak Sarker, Athba Hussain, Shrinidhi Rao, Albert B. Lowenfels, Ravinder Mamtani Aug 2024

Hpv Infection And Vaccination: A Cross-Sectional Study Of Knowledge, Perception, And Attitude To Vaccine Uptake Among University Students In Qatar, Sohaila Cheema, Amit Abraham, Patrick Maisonneuve, Anupama Jithesh, Karima Chaabna, Reem Al Janahi, Shaunak Sarker, Athba Hussain, Shrinidhi Rao, Albert B. Lowenfels, Ravinder Mamtani

NYMC Faculty Publications

BACKGROUND: Human Papilloma Virus (HPV) infection is a significant public health concern in the Gulf Cooperation Council countries, being widely prevalent and the main risk factor for cervical cancer. We aimed to assess knowledge and perception towards HPV, acceptability of the HPV vaccine, and HPV vaccination rates among university students in Education City, Doha, Qatar. METHODS: This cross-sectional survey utilized proportional quota-sampling, with quotas based on university, sex, and nationality, to recruit students from seven universities between February and September 2022. The English language questionnaire requested socio-demographic information, knowledge, and attitudes about HPV infection and the vaccine. The chi-square test, …


Predictors Of Outcomes And A Weighted Mortality Score For Moderate To Severe Subdural Hematoma, Sima Vazquez, Aarti K. Jain, Bridget Nolan, Eris Spirollari, Kevin Clare, Anish Thomas, Sauson Soldozy, Syed Ali, Vishad Sukul, Jon Rosenberg, Stephan Mayer, Rakesh Khatri, Brian T. Jankowitz, Justin Singer, Chirag Gandhi, Fawaz Al-Mufti Aug 2024

Predictors Of Outcomes And A Weighted Mortality Score For Moderate To Severe Subdural Hematoma, Sima Vazquez, Aarti K. Jain, Bridget Nolan, Eris Spirollari, Kevin Clare, Anish Thomas, Sauson Soldozy, Syed Ali, Vishad Sukul, Jon Rosenberg, Stephan Mayer, Rakesh Khatri, Brian T. Jankowitz, Justin Singer, Chirag Gandhi, Fawaz Al-Mufti

NYMC Faculty Publications

As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score. Of 29,915 patients admitted with moderate-to-severe subdural hematomas, 12,135 (40.6%) died within the …


Form, Function, Mind: What Doesn't Compute (And What Might), Stuart A. Newman Aug 2024

Form, Function, Mind: What Doesn't Compute (And What Might), Stuart A. Newman

NYMC Faculty Publications

The applicability of computational and dynamical systems models to organisms is scrutinized, using examples from developmental biology and cognition. Developmental morphogenesis is dependent on the inherent material properties of developing animal (metazoan) tissues, a non-computational modality, but cell differentiation, which utilizes chromatin-based revisable memory banks and program-like function-calling, via the developmental gene co-expression system unique to the metazoans, has a quasi-computational basis. Multi-attractor dynamical models are argued to be misapplied to global properties of development, and it is suggested that along with computationalism, classic forms of dynamicism are similarly unsuitable to accounting for cognitive phenomena. Proposals are made for treating …


Distinctive Field Effects Of Smoking And Lung Cancer Case-Control Status On Bronchial Basal Cell Growth And Signaling, Olsida Zefi, Spencer Waldman, Ava Marsh, Miao Kevin Shi, Yosef Sonbolian, Batbayar Khulan, Taha Siddiqui, Aditi Desai, Dhruv Patel, Aham Okorozo, Samer Khader, Jay Dobkin, Ali Sadoughi, Chirag Shah, Simon Spivack, Yakov Peter Aug 2024

Distinctive Field Effects Of Smoking And Lung Cancer Case-Control Status On Bronchial Basal Cell Growth And Signaling, Olsida Zefi, Spencer Waldman, Ava Marsh, Miao Kevin Shi, Yosef Sonbolian, Batbayar Khulan, Taha Siddiqui, Aditi Desai, Dhruv Patel, Aham Okorozo, Samer Khader, Jay Dobkin, Ali Sadoughi, Chirag Shah, Simon Spivack, Yakov Peter

NYMC Faculty Publications

RATIONAL: Basal cells (BCs) are bronchial progenitor/stem cells that can regenerate injured airway that, in smokers, may undergo malignant transformation. As a model for early stages of lung carcinogenesis, we set out to characterize cytologically normal BC outgrowths from never-smokers and ever-smokers without cancers (controls), as well as from the normal epithelial "field" of ever-smokers with anatomically remote cancers, including lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) (cases). METHODS: Primary BCs were cultured and expanded from endobronchial brushings taken remote from the site of clinical or visible lesions/tumors. Donor subgroups were tested for growth, morphology, and underlying molecular features …


Pre-Existing Immunocompromising Conditions And Outcomes Of Acute Covid-19 Patients Admitted For Pediatric Intensive Care, Courtney M. Rowan, Brenna Labere, Cameron C. Young, Laura D. Zambrano, Margaret M. Newhams, Suden Kucukak, Elizabeth R. Mcnamara, Elizabeth H. Mack, Julie C. Fitzgerald, Katherine Irby, Aline B. Maddux, Jennifer E. Schuster, Michele Kong, Heda Dapul, Stephanie P. Schwartz, Melania M. Bembea, Laura L. Loftis, Amanda R. Kolmar, Christopher J. Babbitt, Ryan A. Nofziger, Mark W. Hall, Shira J. Gertz, Natalie Z. Cvijanovich, Matt S. Zinter, Natasha B. Halasa, Tamara T. Bradford, Gwenn E. Mclaughlin, Aalok R. Singh, Charlotte V. Hobbs, Kari Wellnitz, Mary A. Staat, Bria M. Coates Aug 2024

Pre-Existing Immunocompromising Conditions And Outcomes Of Acute Covid-19 Patients Admitted For Pediatric Intensive Care, Courtney M. Rowan, Brenna Labere, Cameron C. Young, Laura D. Zambrano, Margaret M. Newhams, Suden Kucukak, Elizabeth R. Mcnamara, Elizabeth H. Mack, Julie C. Fitzgerald, Katherine Irby, Aline B. Maddux, Jennifer E. Schuster, Michele Kong, Heda Dapul, Stephanie P. Schwartz, Melania M. Bembea, Laura L. Loftis, Amanda R. Kolmar, Christopher J. Babbitt, Ryan A. Nofziger, Mark W. Hall, Shira J. Gertz, Natalie Z. Cvijanovich, Matt S. Zinter, Natasha B. Halasa, Tamara T. Bradford, Gwenn E. Mclaughlin, Aalok R. Singh, Charlotte V. Hobbs, Kari Wellnitz, Mary A. Staat, Bria M. Coates

NYMC Faculty Publications

BACKGROUND: We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care. METHODS: Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020-30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included. RESULTS: Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P = .005) and hospitalization was longer (P = .01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19. CONCLUSIONS: In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities.


Commissioning An Ultra-High-Dose-Rate Electron Linac With End-To-End Tests, Tianyuan Dai, Austin M. Sloop, Muhammad R. Ashraf, Jacob P. Sunnerberg, Megan A. Clark, Petr Bruza, Brian W. Pogue, Lesley Jarvis, David J. Gladstone, Rongxiao Zhang Aug 2024

Commissioning An Ultra-High-Dose-Rate Electron Linac With End-To-End Tests, Tianyuan Dai, Austin M. Sloop, Muhammad R. Ashraf, Jacob P. Sunnerberg, Megan A. Clark, Petr Bruza, Brian W. Pogue, Lesley Jarvis, David J. Gladstone, Rongxiao Zhang

NYMC Faculty Publications

Objective. The FLASH effect can potentially be used to improve the therapeutic ratio of radiotherapy (RT) through delivery of Ultra-high-dose-rate (UHDR) irradiation. Research is actively being conducted to translate UHDR-RT and for this purpose the Mobetron is capable of producing electron beams at both UHDR and conventional dose rates for FLASH research and translation. This work presents commissioning of an UHDR Mobetron with end-to-end tests developed for preclinical research.Approach. UHDR electron beams were commissioned with an efficient approach utilizing a 3D-printed water tank and film to fully characterize beam characteristics and dependences on field size, pulse width (PW) and pulse …


A Comparison Of 467 Uroflowmetry Results In Repaired Hypospadias Vs. Normal Male Flows, Joseph Boroda, Jordan Gitlin, Alexander Fang, Paul Zelkovic, Edward Reda, Steven Friedman, Ronnie Fine, Mark Horowitz, Richard Schlussel, Lori Landau-Dyer, Jaime Freyle, Israel Franco Aug 2024

A Comparison Of 467 Uroflowmetry Results In Repaired Hypospadias Vs. Normal Male Flows, Joseph Boroda, Jordan Gitlin, Alexander Fang, Paul Zelkovic, Edward Reda, Steven Friedman, Ronnie Fine, Mark Horowitz, Richard Schlussel, Lori Landau-Dyer, Jaime Freyle, Israel Franco

NYMC Faculty Publications

INTRODUCTION: There are currently no clinical criteria for obstructed urinary flow after hypospadias repair surgery. Previous studies have utilized adult and pediatric nomograms and flow shapes to define obstruction, however these methods are limited by a lack of standardization and lack of interrater reliability when determining flow shapes, respectively. The idealized voider derived flow indexes offer a way to track uroflowmetry results in a volume and age agnostic manner. OBJECTIVE: We sought to evaluate all our hypospadias patients over a 10-year period and identify patients without complications and those with complications and determine their respective flow parameters. Our secondary objective …


Beta-Adrenergic Suppression Of Neuroinflammation In Treatment Of Parkinsonism, With Relevance For Neurodegenerative And Neoplastic Disorders, Mario A. Inchiosa Aug 2024

Beta-Adrenergic Suppression Of Neuroinflammation In Treatment Of Parkinsonism, With Relevance For Neurodegenerative And Neoplastic Disorders, Mario A. Inchiosa

NYMC Faculty Publications

There is a preliminary record suggesting that β-adrenergic agonists may have therapeutic value in Parkinson's disease; recent studies have proposed a possible role of these agents in suppressing the formation of α-synuclein protein, a component of Lewy bodies. The present study focuses on the importance of the prototypical β-adrenergic agonist epinephrine in relation to the incidence of Parkinson's disease in humans, and its further investigation via synthetic selective β-receptor agonists, such as levalbuterol. Levalbuterol exerts significant anti-inflammatory activity, a property that may suppress cytokine-mediated degeneration of dopaminergic neurons and progression of Parkinsonism. In a completely novel finding, epinephrine and certain …


Central Venous Catheter Consideration In Pediatric Oncology: A Systematic Review And Meta-Analysis From The American Pediatric Surgical Association Cancer Committee, Emily R. Christison-Lagay, Erin G. Brown, Jennifer Bruny, Melissa Funaro, Richard D. Glick, Roshni Dasgupta, Christa N. Grant, Abigail J. Engwall-Gill, Timothy B. Lautz, David Rothstein, Ashley Walther, Peter F. Ehrlich, Jennifer H. Aldrink, David Rodeberg, Reto M. Baertschiger Aug 2024

Central Venous Catheter Consideration In Pediatric Oncology: A Systematic Review And Meta-Analysis From The American Pediatric Surgical Association Cancer Committee, Emily R. Christison-Lagay, Erin G. Brown, Jennifer Bruny, Melissa Funaro, Richard D. Glick, Roshni Dasgupta, Christa N. Grant, Abigail J. Engwall-Gill, Timothy B. Lautz, David Rothstein, Ashley Walther, Peter F. Ehrlich, Jennifer H. Aldrink, David Rodeberg, Reto M. Baertschiger

NYMC Faculty Publications

BACKGROUND: Tunneled central venous catheters (CVCs) are the cornerstone of modern oncologic practice. Establishing best practices for catheter management in children with cancer is essential to optimize care, but few guidelines exist to guide placement and management. OBJECTIVES: To address four questions: 1) Does catheter composition influence the incidence of complications; 2) Is there a platelet count below which catheter placement poses an increased risk of complications; 3) Is there an absolute neutrophil count (ANC) below which catheter placement poses an increased risk of complications; and 4) Are there best practices for the management of a central line associated bloodstream …


Cracking The Code: High Ferritin Load With Salmon-Colored Skin Episodes, Paraash Satyal, Walia Sukhcharan, Neriy Yakubov, Benson Babu Aug 2024

Cracking The Code: High Ferritin Load With Salmon-Colored Skin Episodes, Paraash Satyal, Walia Sukhcharan, Neriy Yakubov, Benson Babu

NYMC Faculty Publications

A 37-year-old previously healthy male presented to the Emergency Department with a two-week history of intermittent fevers, joint pain, sore throat, and a diffuse salmon-colored rash. Examination revealed a pruritic rash with joint swelling and red spots in the oropharynx. Initial sepsis management was instituted, but subsequent investigations, including infectious, hematologic, and autoimmune workups, were inconclusive. Notably, elevated ferritin levels prompted consideration of life-threatening conditions like Hemophagocytic Lymphohistiocytosis, which was ultimately ruled out. Adult-onset Still's Disease (AOSD) emerged as the leading diagnosis following the exclusion of other potential causes. A skin biopsy was performed with non-specific findings and corticosteroid treatment …


Effectiveness And Safety Of A Novel, Collapsible Pessary For Management Of Pelvic Organ Prolapse, Kris Strohbehn, Paul M. Wadensweiler, Holly E. Richter, Cara L. Grimes, Charles R. Rardin, Peter L. Rosenblatt, Marc R. Toglia, Gazala Siddiqui, Paul Hanissian Aug 2024

Effectiveness And Safety Of A Novel, Collapsible Pessary For Management Of Pelvic Organ Prolapse, Kris Strohbehn, Paul M. Wadensweiler, Holly E. Richter, Cara L. Grimes, Charles R. Rardin, Peter L. Rosenblatt, Marc R. Toglia, Gazala Siddiqui, Paul Hanissian

NYMC Faculty Publications

BACKGROUND: Pessaries are an effective treatment for pelvic organ prolapse, yet currently available pessaries can cause discomfort during removal and insertion. An early feasibility trial of an investigational, collapsible pessary previously demonstrated mechanical feasibility during a brief 15-minute office trial. Longer-term, patient-centered safety and efficacy data are needed. OBJECTIVE: This study aimed to assess the effectiveness and safety of the investigational vaginal pessary for pelvic organ prolapse at 3 months. STUDY DESIGN: This was a prospective, 7-center, open-label equivalence study with participants serving as their own controls. Subjects were current users of a Gellhorn or ring pessary with ≥stage 2 …


Effects Of Cariprazine On Reducing Symptoms Of Irritability, Hostility, And Agitation In Patients With Manic Or Mixed Episodes Of Bipolar I Disorder, Leslie Citrome, Chunshan Li, Jun Yu, Ken Kramer, Huy-Binh Nguyen Aug 2024

Effects Of Cariprazine On Reducing Symptoms Of Irritability, Hostility, And Agitation In Patients With Manic Or Mixed Episodes Of Bipolar I Disorder, Leslie Citrome, Chunshan Li, Jun Yu, Ken Kramer, Huy-Binh Nguyen

NYMC Faculty Publications

BACKGROUND: Hostility, irritability, and agitation are common in patients with bipolar I disorder. Post hoc analyses evaluated the effect of cariprazine on these symptoms in patients with bipolar I mania. METHODS: Data were pooled from three randomized, double-blind, placebo-controlled phase 3 cariprazine trials in adults with bipolar I manic/mixed episodes (NCT00488618, NCT01058096, NCT01058668); pooled cariprazine doses (3-12 mg/d) were analyzed. Patients were categorized into hostility/irritability and agitation subgroups by baseline scores: Young Mania Rating Scale (YMRS) irritability and disruptive-aggressive behavior items score ≥ 2; Positive and Negative Syndrome Scale (PANSS) hostility item ≥ 2; PANSS-Excited Component (PANSS-EC) total score ≥ …


Electron Beam Response Corrections For An Ultra-High-Dose-Rate Capable Diode Dosimeter, Tianyuan Dai, Austin M. Sloop, Andreas Schönfeld, Veronika Flatten, Jakub Kozelka, Jeff Hildreth, Simon Bill, Jacob P. Sunnerberg, Megan A. Clark, Lesley Jarvis, Brian W. Pogue, Petr Bruza, David J. Gladstone, Rongxiao Zhang Aug 2024

Electron Beam Response Corrections For An Ultra-High-Dose-Rate Capable Diode Dosimeter, Tianyuan Dai, Austin M. Sloop, Andreas Schönfeld, Veronika Flatten, Jakub Kozelka, Jeff Hildreth, Simon Bill, Jacob P. Sunnerberg, Megan A. Clark, Lesley Jarvis, Brian W. Pogue, Petr Bruza, David J. Gladstone, Rongxiao Zhang

NYMC Faculty Publications

BACKGROUND: Ultra-high-dose-rate (UHDR) electron beams have been commonly utilized in FLASH studies and the translation of FLASH Radiotherapy (RT) to the clinic. The EDGE diode detector has potential use for UHDR dosimetry albeit with a beam energy dependency observed. PURPOSE: The purpose is to present the electron beam response for an EDGE detector in dependence on beam energy, to characterize the EDGE detector's response under UHDR conditions, and to validate correction factors derived from the first detailed Monte Carlo model of the EDGE diode against measurements, particularly under UHDR conditions. METHODS: Percentage depth doses (PDDs) for the UHDR Mobetron were …


Epidemiology And Outcomes Of Critical Illness And Novel Predictors Of Mortality In An Ethiopian Medical Intensive Care Unit, Aschalew Worku, Deborah Haisch, Madhavi Parekh, Amir Sultan, Abebe Shumet, Kibrom G/Selassie, Max O'Donnell, Amsalu Binegdie, Charles B. Sherman, Neil W. Schluger Aug 2024

Epidemiology And Outcomes Of Critical Illness And Novel Predictors Of Mortality In An Ethiopian Medical Intensive Care Unit, Aschalew Worku, Deborah Haisch, Madhavi Parekh, Amir Sultan, Abebe Shumet, Kibrom G/Selassie, Max O'Donnell, Amsalu Binegdie, Charles B. Sherman, Neil W. Schluger

NYMC Faculty Publications

Low- and middle-income countries (LMICs) bear most of the global burden of critical illness. Managing this burden requires improved understanding of epidemiology and outcomes in LMIC intensive care units (ICUs), including LMIC-specific mortality prediction scores. This study was a retrospective observational study at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, examining all consecutive medical ICU admissions from June 2014 to April 2015. The primary outcome was ICU mortality; secondary outcomes were prolonged ICU stay and prolonged mechanical ventilation. ICU mortality prediction models were created using multivariable logistic regression and compared with the Mortality Probability Model-II (MPM-II). Associations with secondary …


Liposomal Nanocarriers Of Preassembled Glycocalyx Restore Normal Venular Permeability And Shear Stress Sensitivity In Sepsis: Assessed Quantitatively With A Novel Microchamber System, Shinya Ishiko, Akos Koller, Wensheng Deng, An Huang, Dong Sun Aug 2024

Liposomal Nanocarriers Of Preassembled Glycocalyx Restore Normal Venular Permeability And Shear Stress Sensitivity In Sepsis: Assessed Quantitatively With A Novel Microchamber System, Shinya Ishiko, Akos Koller, Wensheng Deng, An Huang, Dong Sun

NYMC Faculty Publications

The endothelial glycocalyx (EG), covering the luminal side of endothelial cells, regulates vascular permeability and senses wall shear stress. In sepsis, EG undergoes degradation leading to increased permeability and edema formation. We hypothesized that restoring EG integrity using liposomal nanocarriers of preassembled glycocalyx (LNPG) will restore normal venular permeability in lipopolysaccharide (LPS)-induced sepsis model of mice. To test this hypothesis, we designed a unique perfusion microchamber in which the permeability of isolated venules could be assessed by measuring the concentration of Evans blue dye (EBD) in microliter samples of extravascular solution (ES). Histamine-induced time- and dose-dependent increases in EBD in …


Population-Based Study Of Rare Epilepsy Incidence In A Us Urban Population, Kristen Barbour, Niu Tian, Elissa G. Yozawitz, Steven Wolf, Patricia E. Mcgoldrick, Tristan T. Sands, Aaron Nelson, Natasha Basma, Zachary M. Grinspan Aug 2024

Population-Based Study Of Rare Epilepsy Incidence In A Us Urban Population, Kristen Barbour, Niu Tian, Elissa G. Yozawitz, Steven Wolf, Patricia E. Mcgoldrick, Tristan T. Sands, Aaron Nelson, Natasha Basma, Zachary M. Grinspan

NYMC Faculty Publications

OBJECTIVE: This study was undertaken to estimate incidence of rare epilepsies and compare with literature. METHODS: We used electronic health record text search to identify children with 28 rare epilepsies in New York City (2010-2014). We estimated cumulative incidence and compared with literature. RESULTS: Eight of 28 rare epilepsies had five or more prior estimates, and our measurements were within the published range for all. The most common were infantile epileptic spasms syndrome (1 in 2920 live births), Lennox-Gastaut syndrome (1 in 9690), and seizures associated with tuberous sclerosis complex (1 in 14 300). Fifteen of 28 had fewer than …


Real-World Use Of The Updated Refractory Epilepsy Screening Tool For Lennox-Gastaut Syndrome, Steven M. Wolf, Danielle Boyce, Patricia Peña, Jesus Eric Piña-Garza, Jessica J. Roland, Bethany Thomas, Donika Zogejani, Patricia E. Mcgoldrick Aug 2024

Real-World Use Of The Updated Refractory Epilepsy Screening Tool For Lennox-Gastaut Syndrome, Steven M. Wolf, Danielle Boyce, Patricia Peña, Jesus Eric Piña-Garza, Jessica J. Roland, Bethany Thomas, Donika Zogejani, Patricia E. Mcgoldrick

NYMC Faculty Publications

OBJECTIVE: To evaluate the Refractory Epilepsy Screening Tool for Lennox-Gastaut Syndrome (REST-LGS) for real-world identification of LGS in adults and to develop a scoring system for the tool. METHODS: A retrospective chart review of adults with drug resistant epilepsy (DRE) and intellectual development disorder (IDD) was conducted by 2 primary care providers blinded to diagnosis. The REST-LGS was designed via the Modified Delphi Consensus and was previously validated. This tool consists of 8 criteria (4 major, 4 minor) considered indicative of LGS. To account for missing data in the earlier validation study and to evaluate applicability in a real-world setting, …


Selected 2023 Highlights In Congenital Cardiac Anesthesia, Ingrid Moreno-Duarte, Rishi Bharat Parikh, Joanna Paquin, Jochen Steppan, James P. Spaeth, Viviane G. Nasr, Alexander J. Mittnacht, Emad B. Mossad Aug 2024

Selected 2023 Highlights In Congenital Cardiac Anesthesia, Ingrid Moreno-Duarte, Rishi Bharat Parikh, Joanna Paquin, Jochen Steppan, James P. Spaeth, Viviane G. Nasr, Alexander J. Mittnacht, Emad B. Mossad

NYMC Faculty Publications

This article reviews the highlights of pertinent literature of interest to the congenital cardiac anesthesiologist published in 2023. After a search of the US National Library of Medicine PubMed database, several topics emerged where significant contributions were made in 2023. The authors of this article considered the following topics noteworthy to be included in this review: (1) advancements in percutaneous mechanical support in children with congenital heart disease, (2) children with pulmonary hypertension undergoing surgery for congenital heart disease, (3) dexmedetomidine in pediatric cardiac surgery, and (4) recommendations for pediatric heart surgery in the United States: Implications for pediatric cardiac …


Sex Differences In Perihematomal Edema Volume And Outcome After Intracerebral Hemorrhage, Jens Witsch, Quy Cao, Jae W. Song, Yunshi Luo, Kelly L. Sloane, Aaron Rothstein, Christopher G. Favilla, Brett L. Cucchiara, Scott E. Kasner, Steve R. Messé, Huimahn A. Choi, Louise D. Mccullough, Stephan A. Mayer, Aaron M. Gusdon Aug 2024

Sex Differences In Perihematomal Edema Volume And Outcome After Intracerebral Hemorrhage, Jens Witsch, Quy Cao, Jae W. Song, Yunshi Luo, Kelly L. Sloane, Aaron Rothstein, Christopher G. Favilla, Brett L. Cucchiara, Scott E. Kasner, Steve R. Messé, Huimahn A. Choi, Louise D. Mccullough, Stephan A. Mayer, Aaron M. Gusdon

NYMC Faculty Publications

BACKGROUND: Although larger hematoma volume is associated with worse outcome after intracerebral hemorrhage (ICH), the association between perihematomal edema (PHE) volume and outcome remains uncertain, as does the impact of sex on PHE and outcome. Here we aimed to determine whether larger PHE volume is associated with worse outcome and whether PHE volume trajectories differ by sex. METHODS: We conducted a post hoc analysis of the Factor VIIa for Acute Hemorrhagic Stroke Treatment (FAST) trial, which randomized patients with ICH to receive recombinant activated factor VIIa or placebo. Computerized planimetry calculated PHE and ICH volumes on serial computed tomography (CT) …


Shock Index Is A Stronger Predictor Of Outcomes In Older Compared To Younger Patients, Aryan Rafieezadeh, Kartik Prabhakaran, Jordan Kirsch, Joshua Klein, Ilya Shnaydman, Matthew Bronstein, Jorge Con, Bardiya Zangbar Aug 2024

Shock Index Is A Stronger Predictor Of Outcomes In Older Compared To Younger Patients, Aryan Rafieezadeh, Kartik Prabhakaran, Jordan Kirsch, Joshua Klein, Ilya Shnaydman, Matthew Bronstein, Jorge Con, Bardiya Zangbar

NYMC Faculty Publications

INTRODUCTION: The shock index (SI) is a known predictor of unfavorable outcomes in trauma. This study seeks to examine and compare the SI values between geriatric patients and younger adults. METHODS: We conducted a retrospective study of the Trauma Quality Improvement Program database from 2017 to 2019. All patients≥ 25 y with injury severity score ≥ 16 were included. Age groups were defined as 25-44 y (group A), 45-64 y (group B), and ≥65 y (group C). SI was calculated for all patients. The primary outcome was mortality and secondary outcomes were need for blood transfusion and need for major …


Should Neonatal-Perinatal Medicine Move To Two-Year Fellowships?, Shetal Shah, Patrick Myers, Josephine M. Enciso, Alexis S. Davis, Elizabeth E. Crouch, Andrea M. Scheurer, Clara Song, Satyan Lakshminrusimha Aug 2024

Should Neonatal-Perinatal Medicine Move To Two-Year Fellowships?, Shetal Shah, Patrick Myers, Josephine M. Enciso, Alexis S. Davis, Elizabeth E. Crouch, Andrea M. Scheurer, Clara Song, Satyan Lakshminrusimha

NYMC Faculty Publications

The duration of the majority of fellowships in pediatrics has been three-years. With increasing shortages of some outpatient-based pediatric subspecialists, shorter two-year fellowships are being considered for clinically oriented trainees not interested in a career based on research. Shortening the duration of fellowship may have some financial merits such as achieving a higher salary earlier after shorter training. However, we feel that continuing with a three-year duration for neonatology is more pragmatic at this time due to reductions in intensive care rotations during residency, time required to achieve procedural excellence, the need for exposure to quality assurance methodology, proficiency in …


The Evolving Role Of Disproportionality Analysis In Pharmacovigilance, Michele Fusaroli, Emanuel Raschi, Elisabetta Poluzzi, Manfred Hauben Aug 2024

The Evolving Role Of Disproportionality Analysis In Pharmacovigilance, Michele Fusaroli, Emanuel Raschi, Elisabetta Poluzzi, Manfred Hauben

NYMC Faculty Publications

INTRODUCTION: From 2009 to 2015, the IMI PROTECT conducted rigorous studies addressing questions about optimal implementation and significance of disproportionality analyses, leading to the development of Good Signal Detection Practices. The ensuing period witnessed the independent exploration of research paths proposed by IMI PROTECT, accumulating valuable experience and insights that have yet to be seamlessly integrated. AREAS COVERED: This state-of-the-art review integrates IMI PROTECT recommendations with recent acquisitions and evolving challenges. It deals with defining the object of study, disproportionality methods, subgrouping, masking, drug-drug interaction, duplication, expectedness, the debated use of disproportionality results as risk measures, integration with other types …


Socioeconomic Disparities In Pediatric Traumatic Brain Injury Transfer Patterns: An Analysis Of Area Deprivation Index And Clinical Outcomes, Joon Yong Chung, Sabrina L. Zeller, Jared B. Cooper, Jared M. Pisapia, Iwan Sofjan, Matthew Wecksell, Irim Salik Aug 2024

Socioeconomic Disparities In Pediatric Traumatic Brain Injury Transfer Patterns: An Analysis Of Area Deprivation Index And Clinical Outcomes, Joon Yong Chung, Sabrina L. Zeller, Jared B. Cooper, Jared M. Pisapia, Iwan Sofjan, Matthew Wecksell, Irim Salik

NYMC Faculty Publications

BACKGROUND: Traumatic brain injury (TBI) poses a significant health burden, particularly among pediatric populations, leading to long-term cognitive, physical, and psychosocial impairments. Timely transfer to specialized trauma centers is crucial for optimal management, yet the influence of socioeconomic factors, such as the Area Deprivation Index (ADI), on transfer patterns remains understudied. METHODS: A retrospective study was conducted on pediatric TBI patients presenting to a Level I Pediatric Trauma Center between January 2012 and July 2023. Transfer status, distance, mode of transport, and clinical outcomes were analyzed in relation to ADI. Statistical analyses were performed using Student t-test and analysis of …


Gastrointestinal Alpha Heavy Chain Disease With Persistent Campylobacter Jejuni Colonization And Refractory Giardiasis, Wei Tang, Zilan Lin, Pritika Sharma, Gabriel Heering, Brad Dworkin, Amir Steinberg, Fouzia Shakil, Beth Schorr-Lesnick Aug 2024

Gastrointestinal Alpha Heavy Chain Disease With Persistent Campylobacter Jejuni Colonization And Refractory Giardiasis, Wei Tang, Zilan Lin, Pritika Sharma, Gabriel Heering, Brad Dworkin, Amir Steinberg, Fouzia Shakil, Beth Schorr-Lesnick

NYMC Faculty Publications

Alpha heavy chain disease (αHCD) is a rare variant of the mucosa-associated lymphoid tissue lymphoma characterized by expression of a monotypic truncated immunoglobulin α heavy chain. αHCD frequently involves the gastrointestinal (GI) tract, and its pathogenesis has been linked to clonal B-cell expansion from chronic immune stimulation by infectious agents. We report a rare case of GI αHCD with 5 concomitant pathogens identified on a GI multiplex real-time polymerase chain reaction panel, featured by persistent Campylobacter jejuni colonization and refractory giardiasis.


Role Of Calcineurin In Regulating Renal Potassium (K) Excretion: Mechanisms Of Calcineurin Inhibitor-Induced Hyperkalemia, Xin-Peng Duan, Cheng-Biao Zhang, Wen-Hui Wang, Dao-Hong Lin Aug 2024

Role Of Calcineurin In Regulating Renal Potassium (K) Excretion: Mechanisms Of Calcineurin Inhibitor-Induced Hyperkalemia, Xin-Peng Duan, Cheng-Biao Zhang, Wen-Hui Wang, Dao-Hong Lin

NYMC Faculty Publications

Calcineurin, protein phosphatase 2B (PP2B) or protein phosphatase 3 (PP3), is a calcium-dependent serine/threonine protein phosphatase. Calcineurin is widely expressed in the kidney and regulates renal Na and K transport. In the thick ascending limb, calcineurin plays a role in inhibiting NKCC2 function by promoting the dephosphorylation of the cotransporter and an intracellular sorting receptor, called sorting-related-receptor-with-A-type repeats (SORLA), is involved in modulating the effect of calcineurin on NKCC2. Calcineurin also participates in regulating thiazide-sensitive NaCl-cotransporter (NCC) in the distal convoluted tubule. The mechanisms by which calcineurin regulates NCC include directly dephosphorylation of NCC, regulating Kelch-like-3/CUL3 E3 ubiquitin-ligase complex, which …


Potential Association Of Blood Transfusion In Deceased Donors With Outcomes Of Liver Transplantation In The United States, Kenji Okumura, Abhay Dhand, Ryosuke Misawa, Hiroshi Sogawa, Gregory Veillette, Seigo Nishida Aug 2024

Potential Association Of Blood Transfusion In Deceased Donors With Outcomes Of Liver Transplantation In The United States, Kenji Okumura, Abhay Dhand, Ryosuke Misawa, Hiroshi Sogawa, Gregory Veillette, Seigo Nishida

NYMC Faculty Publications

BACKGROUND: Donor blood transfusion may potentially affect transplant outcomes through an inflammatory response, recipient sensitization, or transmission of infection. The aim of this study was to evaluate the association of donor blood transfusion with outcomes of liver transplantation (LT). METHODS: From January 2004 to December 2022, donor blood transfusion information was available for 113,017 adult recipients of LT in the United Network for Organ Sharing database and was classified into 4 levels of transfusion: no-transfusion (N = 68,130), transfusion of 1-5 units (N = 33,629), 6-10 units (N = 8067), and >10 units (N = 5329). Recipient survival analysis was …