Digital Commons Network^™

Comparing The Expression Of Estrogen Receptors, Progesterone Receptors, And Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy And Excision Specimens In Invasive Breast Carcinoma Cases. Is There A Need For Universal Repeat Testing? Experience From A Community Hospital, Astrid M. Sacasa, Gul Emek Wymer, Susana Ferra

HCA Healthcare Journal of Medicine

Background

The current national recommendation is that breast biomarkers estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) testing should be done on all primary invasive breast carcinomas and on recurrent or metastatic tumors. Repeat testing on a subsequent excision specimen is not indicated unless results appear discordant with the histopathologic findings. The objective of the current study was to evaluate the need for adopting universal reflex re-testing of breast biomarkers in excision specimens in our institution.

Methods

The study population included 70 sequential invasive breast cancer patients where the results of ER, PR, and …

Opioid Free Anesthesia In Arthroscopic Knee Surgery: A Feasible Approach To Patient Care, Carson Gifford, Denise Vidal, Dail Kim, Austin Goff, Paul Reynolds

HCA Healthcare Journal of Medicine

Background

The opioid epidemic has prompted exploration of opioid-free anesthesia (OFA) techniques, but the optimal approach is still debated. While some OFA protocols substitute opioids with other agents, these alternatives can introduce their own risks. The objective of this study was to investigate whether eliminating intraoperative opioids without analgesic substitution in arthroscopic knee procedures affects postoperative pain control and opioid requirements.

Methods

We conducted a retrospective analysis of 205 patients who underwent arthroscopic knee procedures between August and November 2023. Patients were divided into 2 groups: those who received intraoperative fentanyl (25-200 mcg, n = 144) and those who received …

Psychological Adaptation In Colorectal Cancer Survivors: Pilot Study Findings, Anuja L. Sarode, Emily M. Su, Amber Kerstetter-Fogle, Steve Paciorek, Erica L. Laipply

HCA Healthcare Journal of Medicine

Background

In this pilot study, we examined psychological impacts of colorectal cancer (CRC), focusing on cancer-related posttraumatic stress disorder (CR-PTSD) symptoms, posttraumatic growth (PTG), and their relationship with coping strategies in surgically treated CRC patients.

Methods

This prospective pre- and postoperative pilot study assessed CRC patients at 2 time points, pre- and postoperative. Psychological symptoms were evaluated using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) and the PTG Inventory Short Form (PTGI-SF). Coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (COPE) instrument. Changes in CR-PTSD, PTG, and coping …

Coping Beyond Cancer: Exploring Fear Of Recurrence In Colorectal Cancer Survivors—A Pilot Investigation, Emily M. Su, Steve Paciorek, Erica L. Laipply, Anuja L. Sarode

HCA Healthcare Journal of Medicine

Background

Evidence is limited on the fear of cancer recurrence (FCR) among colorectal cancer (CRC) survivors in the US, especially regarding patterns and trends of post-recovery coping mechanisms. This pilot mixed-methods study quantified FCR, examined its associations with Brief COPE domains, and contextualized coping through qualitative analysis.

Methods

Twenty-three patients who successfully underwent CRC surgery were included in this pilot study. Fear of cancer recurrence was measured using the FCR Inventory (FCRI) Short Form, and coping strategies were assessed with the Brief Coping Orientation to Problems Experienced (COPE) survey. Descriptive statistics summarized participant characteristics, FCR, and COPE scores. Spearman correlation …

Predictors Of Complete Obliteration And Favourable Outcome After Single-Modality Treatment For Low-Grade Arteriovenous Malformations: A Multicentre Study, Angelica Fuentes, Salem Tos, Natasha Ironside, Georgios Mantziaris, Yuki Shinya, Basel Musmar, Hamza Adel Salim, Nimer Adeeb, Christopher Ogilvy, Douglas Kondziolka, Ali Alaraj, Min Park, Adam Dmytriw, Hussein Zeineddine, Finn Mccarthy, Hussam Abou-Al-Shaar, Ahmed Abdelsalam, Mustafa Baskaya, Cagdas Ataoglu, Anthony Sanchez-Forteza, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Howard Riina, Arwin Rezai, Sahin Hanalioglu, Ufuk Erginoglu, Johannes Pöppe, Davide Simonato, Yan-Lin Li, Sandeep Kandregula, Dhairya Lakhani, Christoph Griessenauer, Rahim Abo Kasem, Alejandro Spiotta, Ajit Puri, Jasmeet Singh, Anna Luisa Kuhn, Jan Karl Burkhardt, Robert Starke, Laligam Sekhar, Michael Levitt, David Altschul, Neil Haranhalli, Malia Mcavoy, Paul Foreman, Osama Zaidat, Mohammad Almajali, Hakeem Shakir, Alfred Pokmeng See, Adib Abla, Aashay Patel, Andrew Nguyen, Matthew Koch, Visish Srinivasan, Peng Roc Chen, Spiros Blackburn, Ketan Bulsara, Peter Kan, Louis Kim, Omar Choudhri, Stavropoula Tjoumakaris, Pascal Jabbour, Amey Savardekar, Hugo Cuellar, Michael Lawton, Bharat Guthikonda, Jacques Morcos, Jason Sheehan

Department of Neurology Faculty Papers

INTRODUCTION: Patient and arteriovenous malformation (AVM) characteristics that portend success after treatment for low-grade brain AVMs remain unknown.

PATIENTS AND METHODS: We utilised the MISTA multicentre registry to identify patients with Spetzler-Martin (SM) grade I or II AVMs treated with stand-alone curative-intent intervention (resection, stereotactic radiosurgery [SRS] or endovascular embolisation). Bivariate and multivariable analyses were performed to identify patient and AVM characteristics predictive of complete obliteration or favourable outcome (complete obliteration without new permanent deficit or post-treatment haemorrhage).

RESULTS: A total of 522 patients were included (292 microsurgery, 152 SRS, 78 embolisation). Complete obliteration rates differed between microsurgery (95.9%), SRS …

Variation In Meningioma Recurrence Risk Estimates Across Observational Cohorts: The Influence Of Calendar Time, Who Classifications, Geographical Settings, And Healthcare Systems, Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W Mcdermott, Fang Wang, Pedro Góes, Manoel Antonio De Paiva Neto, Ricardo Komotar, Michael E Ivan, Aria Jamshidi, Evan Luther, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Olivia Claire Barrett, Randy Jensen, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen, Andrea Daniela Maier

Duncan NRI Faculty and Staff Publications

Purpose: Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables.

Results: Recurrence risk …

Current Procedural Terminology Codes Combined With Hip And Femur Diagnosis-Related Groups Provide A More Accurate Assessment Of Costs., Robert A. Hymes, Daniel L. Rodkey, Max A. Schulman, Christopher Kuenze, Jeff E. Schulman, Jalen N. Broome, Sydney L. Payne, Greg E. Gaski

Jefferson Hospital Staff Papers and Presentations

Introduction: Diagnosis-Related Groups (DRGs) have become the basis of the Center of Medicare & Medicaid Services (CMS) hospital reimbursement system. Wide variability of patient factors and procedures bundled into a single DRG may contribute to significant cost variation and limited usefulness when analyzing economic performance. This investigation sought to analyze variation in hip and femur fracture inpatient costs as assessed by DRG and Current Procedural Terminology (CPT) codes.

Materials and methods: Patients age ≥ 18 treated with operatively managed fractures of the hip and femur at a Level 1 trauma center from 2019 to 2021 were retrospectively reviewed. Patients categorized …

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …

Cadonilimab Plus Chemotherapy In Pd-L1-Low Gastroesophageal Cancer: A Bispecific Opportunity?, Sohiel Deshpande, Daniel Lin

Department of Medical Oncology Faculty Papers

No abstract available.

Endothelin Receptor Antagonists In Resistant Hypertension And Proteinuric Kidney Disease: Receptor Strategy And Volume Management, Corey Keith Goldman, Jesse M. Goldman

Division of Nephrology Faculty Papers

This narrative review examines how endothelin receptor antagonists (ERAs) can be used at the intersection of difficult-to-control hypertension, chronic kidney disease (CKD), and albuminuria or proteinuria. For clinicians, the central question is not receptor selectivity alone, but whether a specific agent, indication, dose, background therapy, and monitoring plan can deliver meaningful blood-pressure or kidney benefit without unacceptable fluid retention. Pulmonary arterial hypertension established the pharmacology and major safety liabilities of the class; the current implementation questions for hypertension and kidney specialists arise in systemic hypertension and proteinuric kidney disease. Aprocitentan is the first and only ERA approved for hypertension; in …

Allograft Tendon Pretensioning Technique Guide., Joseph R Brown, Robert W Mendicino

Surgery Articles

In foot and ankle surgery, allograft tendons are frequently used in both primary and revision cases to enhance stability and function. However, postoperative complications, such as creep, can compromise the intended correction and stability over time. This paper presents a practical guide on pretensioning techniques prior to implantation, aiming to reduce creep and improve long-term outcomes. Using two common allograft specimens, we demonstrate pretensioning methods with specific focus on tendon stitching, techniques for securing the allograft to the graft board, optimal tensioning and time parameters. We recommend pretensioning at 80 N for approximately 30 min to effectively decrease creep and …

Valvular Heart Failure Is A Distinct Heart Transplant Phenotype With Comparable Adjusted Survival To Other Heart Failure Etiologies, Devon Kelley, Varun Kathawate, Joyce Ho, Andrew Belec, Takahiro Tashima, Kazuhiro Ueno, Jessica Dominic, Pavan Atluri

Division of Cardiology Faculty Papers

PURPOSE: Valvular heart failure (VHF) accounts for 1-5% of heart transplant listings. Comparative outcomes relative to other heart failure etiologies remain poorly characterized. This study defines the VHF phenotype and compares waitlist and transplant outcomes to other heart failure recipients.

METHODS: This retrospective cohort study uses the UNOS thoracic transplant database to analyze adult, first-time, heart-only listings with a diagnosis of heart disease. Patients were grouped by diagnosis as VHF or non-VHF. The primary outcome was waitlist events; post-transplant survival and outcomes were secondary analyses. Subgroup analysis was performed in the post-2018 allocation era.

RESULTS: VHF recipients were older (55.3 …

Optimizing Heart Failure-Specific Disease Management Programs And Patient Care In Saudi Arabia: A Saudi Heart Association Position Statement, Abeer Bakhsh, Fakhr Al Ayoubi, Fayez Elshaer, Hanan B. Albackr, Hanin A. Bogari, Ibrahim Jelaidan, Ismail Raslan, Kamal Al Ghalayini, Maryam Alqaseer, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Heart failure (HF) represents a major and growing health burden in Saudi Arabia, with high morbidity, frequent hospitalizations, and substantial system-level costs. Despite advances in guideline-directed medical therapy, gaps in diagnosis, care coordination, and longitudinal management persist. Structured, multidisciplinary heart failure–specific disease management programs (HF-DMPs) have been shown to improve outcomes and healthcare efficiency, yet their implementation remains inconsistent across the Kingdom.

Methods: The Saudi Heart Association (SHA) convened a multidisciplinary expert panel to develop a national position statement on HF-DMPs. Recommendations were formulated through structured consensus, informed by a comprehensive review of international guidelines, clinical trials, real-world evidence, …

Measuring Family Involvement In Early Intervention Services For Children Who Are Dhh: A Scoping Review, Marie Martinez, Blair Richlin, Kristina Blaiser

Journal of Early Hearing Detection and Intervention

Background: Family involvement after a child has been identified as deaf or hard of hearing (DHH) is often recommended as “best practice” for Family Centered Early Intervention (FCEI; Szarkowski et al., 2024) and a catalyst for improved outcomes. Defining actions of a family will inform high-quality family support programs. This scoping review aims to explore and document family involvement as well as the current systems of measurement used in early intervention DHH family-centered services.

Purpose: The specific aim of this scoping review was to identify the operational definitions of family involvement and metrics used with families of children who are …

Machine Learning For Functional Outcome Prediction After Vestibular Schwannoma Surgery: A Systematic Review And Diagnostic Test Accuracy Meta-Analysis, Shiva Nischal, Shaan Patel, Musa China, Kush Kale, Yi Hein Chai, Santosh Guru, William Muirhead, Patrick Grover

Department of Neurosurgery Faculty Papers

PURPOSE: Machine learning (ML) models have been increasingly applied to predict postoperative facial nerve dysfunction and hearing preservation after vestibular schwannoma (VS) surgery. However, reported performance varies substantially, and the overall diagnostic accuracy and clinical reliability of these models remain uncertain. We conducted a systematic review and diagnostic test accuracy meta-analysis to characterise the current state and methodological readiness of ML-based prediction of these outcomes.

METHODS: PubMed, Embase, and CENTRAL were searched from inception to February 2026. Studies evaluating ML-based prediction of facial nerve function or hearing preservation following VS surgery were included. Diagnostic performance metrics were pooled using random-effects …

Interpretable Multimodal Learning For Integrating Neuroimaging And Genetic Data In Alzheimer’S Disease, Kun Zhao, Siyuan Dai, Yingying Zhang, Guodong Liu, Pengfei Gu, Chenghua Lin, Paul M. Thompson, Alex D. Leow, Heng Huang, Haoteng Tang

Computer Science Faculty Publications

Introduction: Early detection of Alzheimer's disease (AD) requires models that combine brain structure changes with genetic risk, but existing methods struggle to align these different data types.

Methods: We present R-GenIMA, an interpretable multimodal large language model that pairs a region-of-interest vision transformer with genetic prompting to jointly analyze structural MRI and single nucleotide polymorphisms (SNPs). Each brain region becomes a visual token and SNP profiles are encoded as structured text, letting the model link regional atrophy to genetic factors through cross-modal attention. Tested on the ADNI cohort, R-GenIMA performs well in classifying four groups: normal cognition, subjective memory concerns, …

An Investigation Of Pelvic Kinematics And Implications For Total Hip Arthroplasty, Kathryn Holland Colone

Electronic Theses and Dissertations

Total hip arthroplasty (THA) is one of the most commonly performed orthopaedic procedures, with approximately 500,000 surgeries performed annually in the United States alone. Although THA is widely regarded as highly successful, postoperative complications persist, highlighting the multifactorial nature of THA outcomes. Previous studies have demonstrated the importance of implant positioning and soft tissue mechanics, yet challenges remain in optimizing surgical decisions on a patient-specific basis. Recent advances in surgical planning tools have shifted the focus of preoperative planning toward optimizing patient-specific outcomes, highlighting the need to better understand how patient anatomy, surgical technique, and joint mechanics interact to influence …

Glucagon Like Peptide 1 Receptor Agonists In Patients With Inflammatory Bowel Disease: Safety, Clinical Effectiveness And Anti-Inflammatory Mechanisms, Shannon Fernando, Joy Zhao, Kevan Josloff, Nida Zubair, Aakash Desai, Raina Shivashankar, Patricia L. Kozuch, Cuckoo Choudhary, Gary Lichtenstein, Priya Sehgal

Division of Gastroenterology and Hepatology Faculty Papers

INTRODUCTION: The prevalence of obesity among patients with inflammatory bowel disease (IBD) continues to rise and is associated with adverse IBD outcomes and diminished treatment response. This study reviews the clinical safety and efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with IBD and comorbid obesity and explores their theorized anti-inflammatory mechanisms.

METHODS: Published articles through July 2026 were identified via a PubMed search for a narrative review using terms related to GLP-1RA, IBD, safety, effectiveness, and outcomes. Data extraction focused on GLP-1RA intervention details, IBD-related outcomes and inflammatory markers, and proposed anti-inflammatory mechanisms.

RESULTS: GLP-1RA therapy promotes weight …

Mechanism Of Injury And Fracture Status Influence Outcomes After Central Cord Injury, Karlo M. Pedro, Mohammed Ali Alvi, Kathleen Zang, Christopher Lozano, Jetan H. Badhiwala, Jefferson R. Wilson, James Harrop, James D. Guest, Bizhan Aarabi, Christopher I. Shaffrey, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

Central cord syndrome (CCS) is the most common form of incomplete cervical spinal cord injury (SCI), yet its optimal management remains controversial. We examined whether stratifying CCS by injury stability improves treatment assessment. CCS was defined as an American Spinal Injury Association Impairment Scale (AIS) C/D cervical SCI with a ≥5-point lower-upper extremity motor score difference and classified as CCS-stable (CCS-S) or -unstable (CCS-U) based on the absence or presence of fracture/dislocation. Functional recovery at 1 year was assessed using the functional independence measure (FIM) motor score. Among 291 patients, 131 (45%) had CCS-S. These patients were older and more …

From “Fixer” To “Facilitator”: A Clinical Review Of Shared Medical Appointments As A Strategy For Workforce Sustainability, Barbara A. Slusher

Lynchburg Journal of Medical Science

Clinician burnout remains a significant threat to workforce sustainability, particularly in resource-constrained settings managing complex chronic diseases. While shared medical appointments (SMAs) have demonstrated clear benefits in patient satisfaction and access, their impact on clinician well-being and professional fulfillment is less clearly defined. This review evaluates whether participation in SMAs improves clinician satisfaction and mitigates burnout by facilitating a conceptual transition from isolated “Fixer” to collaborative “Facilitator.”

A targeted literature search of PubMed, the Cochrane Library, and Google Scholar identified peer-reviewed publications examining shared medical appointments and clinician-centered outcomes, including burnout, clinician satisfaction, and workforce sustainability. …

Umbilical Artery Doppler In Fetal Growth Restriction, Britanie Dollard

Lynchburg Journal of Medical Science

Umbilical artery (UA) Doppler velocimetry is a noninvasive tool used to assess placental vascular resistance and improve risk stratification in pregnancies complicated by suspected fetal growth restriction (FGR). Placental insufficiency remains a leading cause of stillbirth and neonatal morbidity, making early identification critical for optimizing perinatal outcomes. This clinical review synthesizes current evidence regarding the role of UA Doppler in identifying placental insufficiency, outlines key waveform interpretations, and evaluates how Doppler findings guide clinical management and delivery planning. Evidence and major society guidelines support UA Doppler as a targeted surveillance tool in high-risk pregnancies complicated by suspected FGR. Progressive abnormalities, …

Hidden Infarctions: Understanding And Managing Myocardial Infarction With Non-Obstructive Coronary Arteries Through A Multimodal Lens, Catalina Esquivel

Lynchburg Journal of Medical Science

Myocardial infarction with non-obstructive coronary arteries (MINOCA) accounts for 5–15% of myocardial infarctions and disproportionately affects women and minority populations. It is defined by clinical evidence of myocardial ischemia with

Countering Hpv Vaccine Misinformation On Social Media: Practical Strategies For Healthcare Providers, David Baldwin

Lynchburg Journal of Medical Science

Human papillomavirus (HPV) vaccination is a highly effective strategy for preventing cervical and other HPV-related cancers; however, vaccine hesitancy remains a significant barrier to optimal vaccination rates. Social media has become a major source of health information while simultaneously amplifying misinformation that influences parental attitudes toward HPV vaccination. This narrative literature review examined the relationship between social media misinformation and HPV vaccine hesitancy and identified evidence-based strategies healthcare providers can use to improve vaccine confidence.

A literature search of PubMed and Google Scholar identified 31 articles published between 2016 and 2025, of which 19 met inclusion criteria. The literature demonstrates …

Predictors Of Adalimumab Durability In Hidradenitis Suppurativa: A Multicenter Cohort Study, Albert T. Young, Arashleen Pannu, Alexander Velaoras, Roland Leyson, Rayad B. Shams, Alexandra Turfe, Andrea Dai, Mohsen Mokhtari, Sarah Bassett, Joshua Vazhappilly, Richard W. Hass, Iltefat Hamzavi, Christopher J. Sayed, Qing-Sheng Mi, Sherry Yang

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Adalimumab is widely used for hidradenitis suppurativa (HS), but treatment durability varies and predictors of sustained benefit remain uncertain.

OBJECTIVE: To identify clinical and laboratory factors associated with adalimumab treatment durability in HS.

METHODS: We retrospectively studied 135 adults with HS who initiated adalimumab as first biologic therapy across three academic centers from 2013 to 2023. Outcomes were categorized as primary failure (12-24 weeks), secondary failure (24 weeks-2 years), or sustained response (>2 years) based on discontinuation for inefficacy. Predictors of treatment durability were evaluated using ordinal logistic regression.

RESULTS: In univariable analyses, Hurley stage 3, higher body …

Cells And Networks In Flux: Rethinking Ontogenesis And Pathogenesis, Mark L. Tykocinski

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Organ and tissue functions emerge from the coordinated activity of cell networks. Therapeutics that act on pathogenic cell networks, modulating their cellular interplay, follow naturally. Over several decades, our laboratory has developed a series of approaches for rewiring cell networks, culminating in a class of cell surface-directed signal converter proteins (SCPs) that do so by modulating juxtacrine and autocrine signaling in and among their nodal cells. A first such SCP has now produced encouraging clinical data for cancer immunotherapy. Yet, these early network-directed fusion proteins rest on a deliberately simplified picture: discrete end-cell types plugged into graphically tractable networks. That …

International Federation Of Clinical Neurophysiology Standardized Stereo-Electroencephalography Terminology, Birgit Frauscher, Guoping Ren, Chifaou Abdallah, Fabrice Bartolomei, Milan Brazdil, Francine Chassoux, Patrick Chauvel, Mark Cook, Beate Diehl, Guada Fernandez Baca Vaca, Stefano Francione, Vadym Gnatkovsky, Walter Gonzalez, Akio Ikeda, Jean Gotman, Julia Jacobs, Lara Jehi, Philippe Kahane, Hui Ming Khoo, Sam Lhatoo, Louis Maillard, Daniel Mansilla, Aileen Mcgonigal, Ioana Mindruta, Dang Khoa Nguyen, Piero Perucca, Ivan Rektor, Sylvain Rheims, Philippe Ryvlin, Stephan Schuele, Andreas Schulze-Bonhage, Margitta Seeck, Jaysingh Singh, Michael Sperling, Rainer Surges, Laura Tassi, Eugen Trinka, Manjari Tripathi, Shuang Wang, Samuel Wiebe, Gregory Worrell, Sandor Beniczky

Department of Neurology Faculty Papers

OBJECTIVE: Stereo-electroencephalography (SEEG) is an intracranial EEG methodology used in presurgical epilepsy evaluation to precisely delineate the epileptogenic zone and associated networks. Although established for decades, its global adoption has accelerated due to a favorable safety profile and clinical effectiveness. However, inconsistent terminology limits comparability of findings and multicenter collaboration. This guideline addresses this gap by providing standardized SEEG terminology based on international consensus.

METHODS: A working group of 41 experts appointed by the International Federation of Clinical Neurophysiology (IFCN) Executive Committee used a modified Delphi process to develop standardized terminology. The process included two meetings and four Delphi rounds, …

2026 Focused Update Of The Saudi Heart Association Guidelines On Best Practices In The Management Of Chronic Coronary Syndromes, Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra Abdulahad A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.

Methods: A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus …

Remarkable Seizure Reduction With Trofinetide Treatment In An Adult With Rett Syndrome: A Case Report, Semihan Adegbite, Pooneh Memar Ardestani, Maromi Nei

Department of Neurology Faculty Papers

No abstract provided.

Improved Foraminal Expansion And Pain Scores Following Placement Of Novel Expandable Interlaminar Stabilization Device For Lumbar Spinal Stenosis, Robert P. Norton, Ian Koch, Kendra Primavera, Roy Y. Miloh, Alex R. Vaccaro, Mitchell K. Ng

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: To evaluate radiographic durability and clinical outcomes following placement of a novel expandable interlaminar stabilization device for single-level lumbar spinal stenosis. Specifically, we aimed to: 1) quantify immediate postoperative posterior column distraction; 2) determine whether foraminal expansion is improved postoperatively without radiographic subsidence; and (3) assess potential improvements in patient-reported pain/clinical outcomes.

METHODS: A retrospective review was performed of adult patients undergoing single-level decompression supplemented by an interlaminar device for symptomatic lumbar spinal stenosis by a single surgeon from 2024 to 2025. Radiographic parameters included anterior, middle, and posterior disc height, foraminal height, and …

Evaluation Of A Multiantigen Mrna Vaccine Against Eehv1a In Asian Elephants, Lauren Farris, Jessica Watts, Jeroen Pollet, Christine Molter, Sarah Cannizzo, Michael Wenninger, Jessica Heinz, Rebecca Eddy, Jessica Emerson, Dewey Maddox, Paul D Ling

Faculty, Staff and Students Publications

Elephant endotheliotropic herpesvirus (EEHV) is endemic in Asian elephants and can cause fatal hemorrhagic disease (HD) in juveniles, with calves aged 1-8 years being most vulnerable, particularly following the decline of maternal antibodies. Current supportive treatments, which commonly include fluids, plasma infusions, and human anti-herpesvirus drugs, are not consistently effective, highlighting the urgent need for preventative strategies. To address this challenge, we generated an EEHV1A multi-antigen mRNA vaccine targeting four conserved herpesvirus entry proteins (gB, gH, gL, and gO), which elicited robust humoral and cellular immune responses in mice without adverse effects. Based on these preclinical findings, a vaccine trial …