Digital Commons Network^™

When Plasticity Becomes Pathological: Sequential Decreases In Basolateral Amygdala Response To Threat Cues Predict Failure To Recover From Ptsd, Alyssa Roeckner, Esther Lin, Rebecca Hinrichs, Nathaniel G. Harnett, Lauren A M. Lebois, Sanne J H Van Rooij, Timothy D. Ely, Tanja Jovanovic, Vishnu P. Murty, Robert A. Swor

Articles

No abstract provided.

Disentangling Sex Differences In Ptsd Risk Factors: A Systematic Overview And Multiple Mediation Analysis The The Aurora Study, Stephanie Haering, Antonia V. Seligowski, Sarah Linnstaedt, Vasiliki Michopoulos, Stacey L. House, Francesca Beaudoin, Xinming An, Thomas C. Neylan, Gari Clifford, Robert A. Swor

Articles

No abstract provided.

The Impact Of Us Abortion Policy On Rheumatology Clinical Practice: A Cross-Sectional Survey Of Rheumatologists, Bonnie L. Bermas, Irene Blanco, Rosalind Ramsey-Goldman, Ashira D. Blazer, Megan E.B. Clowse, Cuoghi Edens, Greer Donley, Leslie Pierce, Catherine Wright, Mehret Birru Talabi

Articles

In June of 2022, the US Supreme Court's decision in Dobbs v Jackson Women’s Health overturned Roe v Wade, finding that there was no federal constitutional right to abortion. Subsequently, almost one third of states have near-total abortion bans in effect. Our team distributed a confidential web-based survey to a sample of US-based rheumatologists to assess how the Dobbs decision is affecting the clinical care of reproductive-age females with rheumatic diseases (RMDs), including teratogen prescribing, pregnancy termination referrals, and rheumatologists’ perceived vulnerability to criminalization.

Rethinking Resilience Using The R-Factor: Neurobiological Mechanisms Of Static And Dynamic Components Of Resilience Following Trauma, Sanne Van Rooij, Justin Santos, Cecilia A. Hinojosa, Timothy Ely, Nathaniel Harnett, Vishnu P. Murty, Lauren Lebois, Tanja Jovanovic, Stacey House, Robert A. Swor

Articles

Resilience is a dynamic process of recovery after trauma, but in most studies it is conceptualized as the absence of specific psychopathology following trauma. Using the large emergency department AURORA study (n=1,865, 63% women), we took a longitudinal, dynamic and transdiagnostic approach to define a static resilience (r) factor, that could explain >50% of variance in mental wellbeing 6-months following trauma, and a dynamic r-factor, which represented recovery from initial symptoms. We assessed its neurobiological profile across threat, inhibition, and reward processes using fMRI collected 2-weeks post-trauma. Our neuroimaging results suggest that resilience is promoted by activation of higher-level cognitive …

A Comprehensive Review Of Covid-19: Associated Endocrine Manifestations, Saif Khan Md, Maryam Karim Mbbs, Vasu Gupta, Heenam Goel Md, Rohit Jain Md

Articles

Coronavirus disease 2019 (COVID-19) has played a significant part in systematic damage, affecting lives and leading to significant mortality. The endocrine system is one of the systems affected by this pandemic outbreak. The relationship between them has been identified in previous and ongoing research. The mechanism through which severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) can achieve this is similar to that for organs that express angiotensin-converting enzyme 2 receptors, which is the primary binding site of the virus. Endocrine cells widely express angiotensin-converting enzyme 2 receptors and transmembrane serine protease 2, the primary mediators initiating the acute phase of the disease. …

Pilot Study Of The Association Between Microbiome And The Development Of Adverse Posttraumatic Neuropsychiatric Sequelae After Traumatic Stress Exposure, Abigail L. Zeamer, Marie-Claire Salive, Xinming An, Stacey L. House, Francesca L. Beaudoin, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Robert A. Swor

Articles

Background Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biologic mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as possibilities for intervention. Microbiome composition at the time of trauma exposure has been poorly examined regarding neuropsychiatric outcomes. We aimed to determine whether baseline the gut microbiomes of trauma-exposed emergency department patients who later develop APNS have dysfunctional gut microbiome profiles and discover potential associated mechanisms.

Methods We performed metagenomic analysis on stool samples (n=51) from a subset of adults enrolled in the Advancing …

Acute Outcomes For The Full Us Cohort Of The Flash Mechanical Thrombectomy Registry In Pulmonary Embolism, Caitlin Toma, Wissam A. Jaber, Mitchell D. Weinberg, Matthew C. Bunte, Sameer Khandhar, Brian Stegman

Articles

Background

Evidence supporting interventional pulmonary embolism (PE) treatment is needed.

Aims

We aimed to evaluate the acute safety and effectiveness of mechanical thrombectomy for intermediate- and high-risk PE in a large real-world population.

Methods

FLASH is a multicentre, prospective registry enrolling up to 1,000 US and European PE patients treated with mechanical thrombectomy using the FlowTriever System. The primary safety endpoint is a major adverse event composite including device-related death and major bleeding at 48 hours, and intraprocedural adverse events. Acute mortality and 48-hour outcomes are reported. Multivariate regression analysed characteristics associated with pulmonary artery pressure and dyspnoea improvement.

Results …

Incidence And Prevalence Of Keratoconus Based On Scheimpflug Imaging, Elsie Chan, Elaine W. Chong, Samantha Sze-Yee Lee, Maria Franchina, Seyhan Yazar, Peter Eastwood, Nigel Mcardle, David A. Mackey, Gareth Lingham

Articles

The prevalence of keratoconus (Belin/Ambrόsio Enhanced Ectasia Display Score ≥2.6 on Scheimpflug imaging) in a longitudinal, community cohort study from Western Australia was 3.4% (n=26/755). Keratoconus incidence over an 8-year period was 2.2% (n=15/669).

Subfoveal Choroidal Imaging In High Myopic Nepalese Cohort, Parash Gyawali, Ashutosh Jnawali, Anish Kharal, Manish Subedi, Sandeep Kandel, Prajjol Raj Puri, Nabin Paudel

Articles

Current image captioning models produce fluent captions, but they rely on a one-size-fits-all approach that does not take into account the preferences of individual end-users. We present a method to generate descriptions with an adjustable amount of content that can be set at inference-time, thus providing a step toward a more user centered approach to image captioning.

Abortion Pills, David S. Cohen, Greer Donley, Rachel Rebouché

Articles

Abortion is now illegal in roughly a third of the country, but abortion pills are more widely available than ever before. Though antiabortion advocates and legislators are attacking pills with all manner of strategies, clinics, websites, and informal networks are openly facilitating the distribution of abortion pills, legally and illegally, across the United States. This Article is the first to explain this defining aspect of the post-Roe environment and the novel issues it raises at the level of state law, federal policy, and on-the-ground advocacy.

This Article first details antiabortion strategies to stop pills by any means necessary. These tactics …

Roundtable Discussion: 68-Year-Old Man With Mhspc, Jason M. Hafron

Articles

No abstract provided.

Case Discussion: 66-Year-Old Man With Low-Volume Prostate Cancer, Jason M. Hafron

Articles

An interview with Michigan Institute of Urology's Doctor Jason M. Hafron is presented. He presents a case of a 66-year-old male with low-volume prostate cancer to discuss his possible prognosis and the risk group he should be categorized. He explains his preferred approach to treat the patient like ordering a bone scan, computed tomography (CT) of the chest, abdomen and pelvis, and germline testing. He recommends some treatments for metastatic castration-sensitive prostate cancer (CSPC).

Surgical Treatment Of Multiple Deforming Xanthomas Of The Foot And Ankle With Complete Excision And Rotational Skin Flaps: A Case Report, Qanita Ali, Rachelle Randall, Lawrence M. Fallat

Articles

Xanthomas are cholesterol rich nodular dermal lesions characterized by lipid-laden macrophages that accumulate in skin and tendons.1 These lesions are frequently associated with hyperlipidemia disorders characterized by impaired cholesterol metabolism and accelerated atherosclerotic plaque development.2 Until recently, xanthomas were considered mere cosmetic lesions, however extensive evidence has shown that the presence of xanthomas signify increased cardiovascular risk and reduced average lifespan.3 Treatment centers around lipid lowering agents and rarely are these masses large enough to require surgical resection, thus there is very little literature discussing proper surgical excision.4, 5 We present a rare case of a 65 year old female …

A Case Series Of Three Patients With Rare Pantalar Dislocation, Marissa Mogavero, Andrew Robitaille, Lawrence M. Fallat

Articles

Total talar dislocations are rare, significant surgical challenges for foot and ankle surgeons. These dislocations can be very difficult to manually close-reduce, requiring immediate surgical intervention secondary to arterial impingement, pain and risk of skin necrosis attributable to skin tenting. In this case series, we report on three patients who presented to the emergency room following a traumatic ankle injury. Ankle radiographs and computed tomography (CT) scans were obtained, revealing pantalar dislocations. Closed reduction utilizing Charnley’s principles was attempted in the emergency room through manual accentuation of the deformity, traction and reduction. Closed reduction was unsuccessful in all three patients …

Tibiotalocalcaneal Fusion With Bulk Femoral Head Allograft In A Patient With A Rare, Trauma Induced, Rigid, Cavovarus Foot Deformity, Josh Carroll, Joseph Wolf, Lawrence M. Fallat

Articles

Tibiotalocalcaneal (TTC) arthrodesis with bulk femoral head allograft is a commonly performed limb salvage procedure when dealing with complex deformity. However, little has been reported in patients who receive tibiotalocalcaneal arthrodesis with femoral head allografts for a rigid cavovarus foot type. The purpose of this case report was to examine the outcomes of a tibiotalocalcaneal arthrodesis with a femoral head allograft in a diabetic patient with a trauma induced rigid cavovarus deformity who had complete lateral dislocation of the talar body. The secondary purpose was to highlight the preservation of limb length in the surgical extremity when utilizing a tibiotalocalcaneal …

A Rare Benign Soft-Tissue Chondroma In The Plantar Foot: A Case Report, Ashley Mariano, Lawrence M. Fallat

Articles

Extraskeletal chondromas are rare, benign cartilaginous neoplasms that are usually found in adults and often present as a slow growing solitary mass. We present a case of a 78-year-old male who initially presented with a painful hyperkeratotic lesion to the plantar aspect of his right foot resembling a porokeratosis. He noted increased pain when bearing weight. Initial radiographs revealed no osseous pathology, bone spurs or foreign bodies that correlated with the area of pain. Due to failed conservative treatment that consisted of regular debridement, surgical excision of the lesion was performed which revealed a large underlying hard nodule. The nodular …

Vitamin B12 Deficiency In Nitrous Oxide Abuse, Colby Jones, Jordan Verlare, Reehan Ali

Articles

33yo F presents to ED with numbness & tingling in hands, feet for 10 days. History of recreational drug use, including nitrous oxide 'whippets.' Unremarkable Head CT was obtained.

Impact Of Urgent Care Centers And Telehealth In The Ed, Javed Osmani, Michael Muradian, Christina Brown, Nicholas Stark

Articles

No abstract provided.

What You Need To Know About Em Administration Fellowships, Michael Muradian

Articles

No abstract provided.

Plasma Induced Reactive Oxygen Species-Dependent Cytotoxicity In Glioblastoma 3d Tumourspheres, Janith Wanigasekara, Carlos Barcia, Patrick J. Cullen, Brijesh Tiwari, James F. Curtin

Articles

The aim of this study was to determine the effects of a pin‐to‐plate cold atmospheric plasma (CAP) on U‐251 MG three‐dimensional (3D) glioblastoma spheroids under different conditions. 3D tumorspheres showed higher resistance to the CAP treatment compared to 2D monolayer cells. A single CAP treatment was able to induce cytotoxicity, while multiple CAP treatments augmented this effect. CAP was also able to induce cytotoxicity throughout the tumoursphere, and we identified that reactive oxygen species(ROS) plays a major role, while H2O2plays a partial role in CAP‐induced cytotoxicity in tumour-spheres. We conclude that ROS‐dependent cytotoxicity is induced uniformly throughout glioblastoma and epidermoid …

Use And Awareness Of Heated Tobacco Products In Europe, Silvano Gallus, Alessandra Lugo, Xiaoqiu Liu, Elisa Borroni, Luke Clancy, Giuseppe Gorini, Maria José Lopez, Anna Odone, Krzysztof Przewozniak, Olena Tigova, Piet A. Van Den Brandt, Constantine Vardavas, Esteve Fernandez, Tackshs Project Investigators

Articles

Background: Heated tobacco products (HTP) are new forms of tobacco consumption with limited information available on their use among the general population. Our objective was to analyze the prevalence and associations of use of HTP across 11 countries in Europe.

Methods: Within the TackSHS Project, in 2017-2018 we conducted a cross-sectional study with information on HTP use in the following countries: Bulgaria, England, France, Germany, Greece, Italy, Latvia, Poland, Portugal, Romania and Spain. In each country, face-to-face interviews were performed on a representative sample of around 1,000 subjects aged ≥15 years, for a total of 10,839 subjects.

Results: Overall, 27.8% …

Re: Safety, Tolerability, And Efficacy Of Liris 400 Mg In Women With Interstitial Cystitis/Bladder Pain Syndrome With Or Without Hunner Lesions, R Evans, A Kohan, R Moldwin, D Radecki, T Geib, K M. Peters

Articles

Editorial Comment: The lidocaine-releasing intravesical system (LiRIS) is a passive, nonresorbable intravesical system inserted cystoscopically and designed to provide continuous, controlled release of lidocaine into the bladder over a 2-week period, after which it is removed. There was a positive anticipation that this treatment system might provide symptomatic relief for at least a segment of patients with interstitial cystitis/bladder pain syndrome (IC/BPS), based on the logic of the rationale and from results in 2 small studies, 1 of which was presented at the American Urological Association annual meeting in 2016,1 showing positive results in patients with Hunner lesions (HL). This …

The New Abortion Battleground, David S. Cohen, Greer Donley, Rachel Rebouché

Articles

This Article examines the paradigm shift that is occurring now that the Supreme Court has overturned Roe v. Wade. Returning abortion law to the states has spawned perplexing legal conflicts across state borders and between states and the federal government. This article emphasizes how these issues intersect with innovations in the delivery of abortion, which can now occur entirely online and transcend state boundaries. The interjurisdictional abortion wars are coming, and this Article is the first to provide the roadmap for the immediate aftermath of Roe’s reversal and what lies ahead.

Judges and scholars, and most recently the Supreme …

Re-Thinking Strategy After Roe, David S. Cohen, Greer Donley, Rachel Rebouché

Articles

The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturns nearly fifty years of precedent and radically changes abortion law, throwing both sides of the debate into uncharted territory. This essay, published in the immediate aftermath of Dobbs, offers some initial thoughts about what the changed legal landscape means for abortion rights legal advocacy. Our focus in recent writings has been to identify concrete measures federal and state actors can take to secure abortion access after Dobbs. Here, we investigate a more overarching concern: what fundamental values and strategies should govern the abortion rights movement going …

Medication Abortion Exceptionalism, Greer Donley

Articles

Restrictive state abortion laws garner a large amount of attention in the national conversation and legal scholarship, but less known is a federal abortion policy that significantly curtails access to early abortion in all fifty states. The policy limits the distribution of mifepristone, the only drug approved to terminate a pregnancy so long as it is within the first ten weeks. Unlike most drugs, which can be prescribed by licensed healthcare providers and picked up at most pharmacies, the Food and Drug Administration only allows certified providers to prescribe mifepristone, and only allows those providers to distribute the drug to …

Direct Oral Anticoagulants For Stroke Prevention In Patients With Atrial Fibrillation And Bioprosthetic Heart Valves, Vardhmaan Jain, Kirtipa Bhatia, Devika Aggarwal, Agam Bansal, Bharat Narasimhan, Michael J. Hendrickson, Sameer Arora, Michael J. Ricciardi, Arman Qamar

Articles

No abstract provided.

A New Pediatric Monteggia Fracture Type 4 Variant, Ehab S. Saleh

Articles

Introduction: Monteggia fracture-dislocations are rare and complex injuries that usually involve a fracture of the proximal ulna associated with a proximal radioulnar and radiocapitellar joint dislocations. These injuries comprise

Financial Toxicity During Breast Cancer Treatment: A Qualitative Analysis To Inform Strategies For Mitigation, Laila A. Gharzai, Kerry A. Ryan, Lauren Szczygiel, Susan Goold, Grace Li Smith, Sarah T. Hawley, John A.E. Pottow, Reshma Jagsi

Articles

Financial toxicity from cancer treatment is a growing concern. Its impact on patients requires refining our understanding of this phenomenon. We sought to characterize patients' experiences of financial toxicity in the context of an established framework to identify knowledge gaps and strategies for mitigation. Semistructured interviews with patients with breast cancer who received financial aid from a philanthropic organization during treatment were conducted from February to May 2020. Interviews were transcribed and coded until thematic saturation was reached, and findings were contextualized within an existing financial toxicity framework. Thirty-two patients were interviewed, of whom 58% were non-Hispanic White. The mean …

Allogenic Fibular Bone Graft Reconstruction With Complete Regeneration Of The Lateral Malleolus After En Bloc Resection Of A Distal Fibular Aneurysmal Bone Cyst: A Case Report, Kalli E. Mortenson, Lawrence M. Fallat

Articles

Aneurysmal bone cysts are expansile lytic lesions that most commonly affect the metaphysis of long tubular bones. These lesions are locally aggressive and predominately occur within the first two decades of life. Currently the most widely used surgical treatment involves intralesional curettage of the affected bone. However, there have been several reports of high recurrence rates with this technique. We present a case of a 12 year old female who presented with an aneurysmal bone cyst of the lateral malleolus of the right ankle. The patient underwent multiple surgeries and ultimately had complete surgical resection of the cystic lesion and …

Going Off The Deep End - The Life And Controversies Of Henry Heimlich, Md, Bradford L. Walters, Matthew Drogowski

Articles

No abstract provided.