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Are Orthopedic Hand Surgeons Undercompensated For Time Spent In The Operating Room? A Study Of Relative Value Units, Trevor Simcox, Sakib Safi, Jacob Becker, Jason Kreinces, Adam Wilson

Faculty, Staff and Student Publications

Background: This study aims to investigate whether compensation is equitable among the most commonly performed orthopedic hand surgeries and when compared with general orthopedic procedures.

Methods: The National Surgical Quality Improvement Program database was queried for all orthopedic procedures, from 2016 to 2018, performed more than 150 times using Current Procedural Terminology (CPT) codes. Physician work relative value unit (wRVU) data were obtained from the 2020 US Centers for Medicare and Medicaid Services fee schedule. Linear regressions were used to determine whether there was an association among wRVU, operative time, and wRVU per hour (wRVU/h). Reimbursement for hand surgery CPT …

Comparison Of Different Reconstruction Flap For Maxillofacial Region: An Original Research, Pallavi Khan Chakraborty, Smit Patel, Misbah Farheen Mulla, Manisha Mangesh Kulkarni, Rummaan Ahmed Sheikh, Anuj Kishor Shukla

Faculty, Staff and Student Publications

INTRODUCTION: Large chunks of the tissue are sacrificed during the surgical procedures for the treatment if oral cancers. Our goal was to assess the viability of "

MATERIAL AND METHODS: Sixty subjects were included in this investigation, and they were divided into 3 groups. The follow-up as accompanied for six months. Comparisons were made for the time for the operations, reduction in the width of the mouth opening and the survival rates of the flaps. The data that was collected for the above two parameters and compared for the significance using the

RESULTS: In the subjects with the PM, the …

Assessment Of The Apical Transportation And Quantity Of Root Canal Dentin Removed Using Different New Rotary File Systems: An Original Study, Harmeet Singh, Anuj K Shukla, Apurva A Jadhav, Anshuman Shetty, Chitharanjan Shetty, Smita D Dutta, Mohammed Mustafa

Faculty, Staff and Student Publications

INTRODUCTION: The rotary systems have found a common application in the clinical practice for the endodontic therapies. Hence, we compared three recent endodontic systems for the comparison of the dentine removal and the apical transportation particularly in the curved canals.

METHODS: Oneshape, Pro Taper Next, and Edgefile X3 were the three systems that were compared. Thirty maxillary mesio buccal canals of the human permanent teeth were compared due to its curved nature. The volume of dentin removed and apical transportation (mm) were measured using micro-computed tomographic imaging (mm). Both the coronal section and the entire canal length had their dentin …

Substrate Derived Sequences Act As Subsite-Blocking Motifs In Protease Inhibitory Antibodies, Hyunjun Choe, Tara Antee, Xin Ge

Faculty, Staff and Student Publications

Proteases are involved in many physiologic processes, and dysregulated proteolysis is basis of a variety of diseases. Specific inhibition of pathogenetic proteases via monoclonal antibodies therefore holds significant therapeutic promise. Inspired by the competitive mechanism utilized by many naturally occurring and man-made protease inhibitors, we hypothesized that substrate-like peptide sequences can act as protease subsite blocking motifs if they occupy only one side of the reaction center. To test this hypothesis, a degenerate codon library representing MMP-14 substrate profiles at P1-P5' positions was constructed in the context of an anti-MMP-14 Fab by replacing its inhibitory motif in CDR-H3 with MMP-14 …

Propensity-Score-Matched Analysis Of Dual Antiplatelet Treatment And Alternative Antiplatelet Regimens After Transcarotid Revascularizations, Hanaa Dakour-Aridi, Raghu L Motaganahalli, Andres Fajardo, Akiko Tanaka, Naveed U Saqib, Gordon H Martin, Stuart A Harlin, Arash Keyhani, Kourosh Keyhani, S Keisin Wang

Faculty, Staff and Student Publications

Objective: Dual antiplatelet therapy (DAPT) continues to be the preferred medication regimen after the placement of a carotid stent using the transcarotid revascularization (TCAR) technique despite a dearth of quality data. Therefore, this investigation was performed to define the risks associated with antiplatelet choice.

Methods: We queried all patients who underwent TCAR captured by the Vascular Quality Initiative from September 2016 to June 2022, to determine the association between antiplatelet choice and outcomes. Patients maintained on DAPT were compared with those receiving alternative regimens consisting of single antiplatelet, anticoagulation, or a combination of the two. A 1:1 propensity-score match was …

Development Of Cancer Surveillance Guidelines In Ataxia Telangiectasia: A Delphi-Based Consensus Survey Of International Experts, Renata Neves, Blanca De Dios Perez, Rafal Panek, Sumit Jagani, Sophie Wilne, Jayesh M Bhatt, Caterina Caputi, Emilia Cirillo, David J Coman, Gregor Dückers, Donald L Gilbert, Mary Kay Koenig, Lobna Mansour, Elizabeth Mcdermott, Micaela Pauni, Claudio Pignata, Susan L Perlman, Oscar Porras, Mariela Betina Porto, Katherine Schon, Pere Soler-Palacin, Sam Nick Russo, Masatoshi Takagi, Marc Tischkowitz, Claire Wainwright, Madhumita Dandapani, Cristine Glazebrook, Mohnish Suri, William P Whitehouse, Robert A Dineen

Faculty, Staff and Student Publications

BACKGROUND/OBJECTIVES: Ataxia telangiectasia (A-T) is a multiorgan disorder with increased vulnerability to cancer. Despite this increased cancer risk, there are no widely accepted guidelines for cancer surveillance in people affected by A-T. We aimed to understand the current international practice regarding cancer surveillance in A-T and agreed-upon approaches to develop cancer surveillance in A-T.

DESIGN/METHODS: We used a consensus development method, the e-Delphi technique, comprising three rounds. Round 1 consisted of a Delphi questionnaire and a survey that collected the details of respondents' professional background, experience, and current practice of cancer surveillance in A-T. Rounds 2 and 3 were designed …

Epilepsy Severity Is Associated With Head Circumference And Growth Rate In Infants With Tuberous Sclerosis Complex, Alexis Levine, Peter Davis, Bo Zhang, Jurriaan Peters, Rajna Filip-Dhima, Simon K Warfield, Anna Prohl, Jamie Capal, Darcy Krueger, E Martina Bebin, Hope Northrup, Joyce Y Wu, Mustafa Sahin

Faculty, Staff and Student Publications

BACKGROUND: Abnormal brain growth in tuberous sclerosis complex (TSC) reflects abnormalities in cellular proliferation and differentiation and results in epilepsy and other neurological manifestations. Head circumference (HC) as a proxy for brain volume may provide an easily tracked clinical measure of brain overgrowth and neurological disease burden. This study investigated the relationship between HC and epilepsy severity in infants with TSC.

METHODS: Prospective multicenter observational study of children from birth to three years with TSC. Epilepsy data were collected from clinical history, and HC was collected at study visits at age three, six, nine, 12, 18, 24, and 36 months. …

Predictors And Temporal Trends Of Withdrawal Of Life-Sustaining Therapy After Acute Stroke In The Florida Stroke Registry, Ayham Alkhachroum, Lili Zhou, Negar Asdaghi, Hannah Gardener, Hao Ying, Carolina M Gutierrez, Brian M Manolovitz, Daniel Samano, Danielle Bass, Dianne Foster, Nicole B Sur, David Z Rose, Angus Jameson, Nina Massad, Mohan Kottapally, Amedeo Merenda, Robert M Starke, Kristine O'Phelan, Jose G Romano, Jan Claassen, Ralph L Sacco, Tatjana Rundek

Faculty, Staff and Student Publications

Temporal trends and factors associated with the withdrawal of life-sustaining therapy (WLST) after acute stroke are not well determined.

DESIGN: Observational study (2008-2021).

SETTING: Florida Stroke Registry (152 hospitals).

PATIENTS: Acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) patients.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Importance plots were performed to generate the most predictive factors of WLST. Area under the curve (AUC) for the receiver operating curve were generated for the performance of logistic regression (LR) and random forest (RF) models. Regression analysis was applied to evaluate temporal trends. Among 309,393 AIS patients, 47,485 ICH patients, and …

Inhibition Of Autophagy In Microglia And Macrophages Exacerbates Innate Immune Responses And Worsens Brain Injury Outcomes, Nivedita Hegdekar, Chinmoy Sarkar, Sabrina Bustos, Rodney M Ritzel, Marie Hanscom, Prarthana Ravishankar, Deepika Philkana, Junfang Wu, David J Loane, Marta M Lipinski

Faculty, Staff and Student Publications

Excessive and prolonged neuroinflammation following traumatic brain injury (TBI) contributes to long-term tissue damage and poor functional outcomes. However, the mechanisms contributing to exacerbated inflammatory responses after brain injury remain poorly understood. Our previous work showed that macroautophagy/autophagy flux is inhibited in neurons following TBI in mice and contributes to neuronal cell death. In the present study, we demonstrate that autophagy is also inhibited in activated microglia and infiltrating macrophages, and that this potentiates injury-induced neuroinflammatory responses. Macrophage/microglia-specific knockout of the essential autophagy gene Becn1 led to overall increase in neuroinflammation after TBI. In particular, we observed excessive activation of …

Postoperative Complications Of True Dropless Cataract Surgery Versus Standard Topical Drops, Evan K Wotipka, Alex J Wright, James Z Fan, David Fuhriman, Alice Z Chuang, Grace C Lindhorst, Robert M Feldman, Eric L Crowell

Faculty, Staff and Student Publications

Purpose Compare postoperative outcomes in cataract surgery between eyes with standard drop regimen versus dropless protocol by residents.

Design Retrospective cohort study between April 1, 2018 and March 31, 2020.

Methods The study was performed at Lyndon B. Johnson General Hospital in Houston, Harris County, Texas. A total of 547 eyes (234 dropless vs. 313 standard) with phacoemulsification cataract surgery and minimum of 1-month follow-up with best-corrected visual acuity (BCVA) were included. Dropless received 40 mg sub-Tenon's triamcinolone and intracameral moxifloxacin. Patients were followed at postoperative day 1 (POD1), week 1 (POW1), and month 1 (POM1). Postoperative rate of BCVA …

Microalbuminuria In Perinatally Hiv-Infected Children And Adolescents In The United States, Roukaya Al Hammoud, Anupama Kalaskar, Gilhen Rodriguez, Gabriela Del Bianco, Cynthia Bell, James R Murphy, Gloria P Heresi

Faculty, Staff and Student Publications

Background: The kidney is a common target for human immunodeficiency virus (HIV), making renal disease a common noninfectious complication of HIV. Microalbuminuria is an important marker that can detect early renal damage. Timely detection of microalbuminuria is important to initiate renal management and stop the progression of renal dysfunction in people with HIV. Limited data are available about renal abnormalities in people with perinatal HIV infection. The objective of this study was to determine the prevalence of microalbuminuria in a cohort of perinatally HIV-infected children and young adults receiving combination antiretroviral therapy and investigate correlations between microalbuminuria and clinical and …

Genome-Wide Association Study Of Thoracic Aortic Aneurysm And Dissection In The Million Veteran Program, Derek Klarin, Poornima Devineni, Anoop K Sendamarai, Anthony R Angueira, Sarah E Graham, Ying H Shen, Michael G Levin, James P Pirruccello, Ida Surakka, Purushotham R Karnam, Tanmoy Roychowdhury, Yanming Li, Minxian Wang, Krishna G Aragam, Kaavya Paruchuri, Verena Zuber, Gabrielle E Shakt, Noah L Tsao, Renae L Judy, Ha My T Vy, Shefali S Verma, Daniel J Rader, Ron Do, Joseph E Bavaria, Girish N Nadkarni, Marylyn D Ritchie, Stephen Burgess, Dong-Chuan Guo, Patrick T Ellinor, Scott A Lemaire, Dianna M Milewicz, Cristen J Willer, Pradeep Natarajan, Philip S Tsao, Saiju Pyarajan, Scott M Damrauer

Faculty, Staff and Student Publications

The current understanding of the genetic determinants of thoracic aortic aneurysms and dissections (TAAD) has largely been informed through studies of rare, Mendelian forms of disease. Here, we conducted a genome-wide association study (GWAS) of TAAD, testing ~25 million DNA sequence variants in 8,626 participants with and 453,043 participants without TAAD in the Million Veteran Program, with replication in an independent sample of 4,459 individuals with and 512,463 without TAAD from six cohorts. We identified 21 TAAD risk loci, 17 of which have not been previously reported. We leverage multiple downstream analytic methods to identify causal TAAD risk genes and …

Stress Responses And Ammonia Nitrogen Removal Efficiency Of Oocystis Lacustris In Saline Ammonium-Contaminated Wastewater Treatment, Linda Ewing-Cobbs, Christina V Danna, Tammy D Tolar, Douglas Granger, Charles S Cox, Mary R Prasad

Faculty, Staff and Student Publications

Traumatic injury is linked increasingly to alterations in both stress response systems and psychological health. We investigated reactivity of salivary analytes of the hypothalamic-pituitary-adrenal axis (cortisol) and autonomic nervous system (salivary alpha amylase, sAA) during a psychosocial stress procedure in relation to psychological health outcomes. In a prospective cohort design, stress reactivity of children ages 8 to 15 years hospitalized for traumatic brain injury (TBI; n = 74) or extracranial injury (EI; n = 35) was compared with healthy controls (n = 51) 7 months after injury. Area under the curve increase (AUCinc) assessed pre-stressor to post-stressor cortisol and …

Satisfaction Of Older Patients With Emergency Department Care: Psychometric Properties And Construct Validity Of The Consumer Emergency Care Satisfaction Scale, Peter L T Hoonakker, Pascale Carayon, Roger L Brown, Rebecca Schwei, Rebecca K Green, Mackenzie Rabas, Ly Hoang, Kathryn L Wust, Rachel Rutkowski, Megan E Salwei, Hanna J Barton, Manish N Shah, Michael S Pulia, Brian W Patterson, Paula V W Dail, Sheryl Krause, Denise Buckley, Jennifer Hankwitz, Nicole E Werner

Faculty, Staff and Student Publications

BACKGROUND: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales.

PURPOSE: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care.

METHODS: We administered 2 surveys to older adults who presented …

Management Of Pediatric Appendicitis During The Covid-19 Pandemic: A Nationwide Multicenter Cohort Study, Brittany Hegde, Elisa Garcia, Andrew Hu, Mehul Raval, Sanyu Takirambudde, Derek Wakeman, Ruth Lewit, Ankush Gosain, Raphael H Parrado, Robert A Cina, Krista Stephenson, Melvin S Dassinger, Daniel Zhang, Moiz M Mustafa, Donna Koo, Aaron M Lipskar, Katherine Scheidler, Kyle J Van Arendonk, Patrick Berg, Raquel Gonzalez, Daniel Scheese, Jeffrey Haynes, Alexander Mina, Irving J Zamora, Monica E Lopez, Steven C Mehl, Elizabeth Gilliam, Katrina Lofberg, Brianna Spencer, Afif N Kulaylat, Brian C Gulack, Matthew Johnson, Matthew Laskovy, Pavan Brahmamdam, Aoi Shimomura, Therese Blanch, Kuojen Tsao, Bethany J Slater

Faculty, Staff and Student Publications

BACKGROUND: The COVID-19 pandemic has impacted timely access to care for children, including patients with appendicitis. This study aimed to evaluate the effect of the COVID-19 pandemic on management of appendicitis and patient outcomes.

METHODS: A multicenter retrospective study was performed including 19 children's hospitals from April 2019-October 2020 of children (age≤18 years) diagnosed with appendicitis. Groups were defined by each hospital's city/state stay-at-home orders (SAHO), designating patients as Pre-COVID (Pre-SAHO) or COVID (Post-SAHO). Demographic, treatment, and outcome data were obtained, and univariate and multivariable analysis was performed.

RESULTS: Of 6,014 patients, 2,413 (40.1%) presented during the COVID-19 pandemic. More …

Extracorporeal Carbon Dioxide Removal With The Hemolung In Patients With Acute Respiratory Failure: A Multicenter Retrospective Cohort Study, Ravindranath Tiruvoipati, Bindu Akkanti, Kha Dinh, Nicholas Barrett, Alexandra May, Jeremy Kimmel, Steven A Conrad

Faculty, Staff and Student Publications

Objectives: Extracorporeal carbon dioxide removal (ECCO 2 R) devices are effective in reducing hypercapnia and mechanical ventilation support but have not been shown to reduce mortality. This may be due to case selection, device performance, familiarity, or the management. The objective of this study is to investigate the effectiveness and safety of a single ECCO 2 R device (Hemolung) in patients with acute respiratory failure and identify variables associated with survival that could help case selection in clinical practice as well as future research.

Design: Multicenter, multinational, retrospective review.

Setting: Data from the Hemolung Registry between April 2013 and June …

Steroids For The Treatment Of Viral Encephalitis: A Systematic Literature Review And Meta-Analysis, Emira Hodzic, Rodrigo Hasbun, Alejandro Granillo, Anna R Tröscher, Helga Wagner, Tim J Von Oertzen, Judith N Wagner

Faculty, Staff and Student Publications

Background: Specific antiviral treatment is only available for a small subset of viral encephalitis (VE). Adjunctive steroids are used, but there is scant evidence evaluating its utility. We present a systematic review and meta-analysis on the outcome of steroid use in VE.

Methods: We conducted a systematic literature review and reported it according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Two observational studies from unpublished or partially published data were added. For the meta-analysis, we employed the metaphor package of the statistical software R-4.3.1.

Results: We screened 378 studies and included 50. 155 patients were …

Are There Sex Differences In Interactive Associations Of Environmental Exposure To Lead (Pb), Mercury (Hg), And Manganese (Mn) With Gst Genes (Gstp1, Gstt1, And Gstm1) In Relation To Asd In Jamaican Children?, Hiba T Zwiya, Maureen Samms-Vaughan, Jan Bressler, Minjae Lee, Courtney Byrd-Williams, Manouchehr Hessabi, Megan L Grove, Sydonnie Shakespeare-Pellington, Katherine A Loveland, Mohammad H Rahbar

Faculty, Staff and Student Publications

Background: Male preponderance is well-established in children with autism spectrum disorder (ASD). Glutathione S-transferase (GST) genes play a crucial role in suppressing oxidative stress triggered by environmental stressors.

Objective: To determine whether the association between metals and ASD differs by sex and by GST genes.

Methods: Using data from 344 pairs of sex-and age-matched cases and controls, we assessed the association of each metal with ASD or ASD severity, by applying conditional logistic regression (CLR) or general linear models (GLM). Sex was assessed as an effect modifier in separate GST genetic models.

Results: For Pb exposure, using a recessive model …

Bystanders Or Not? Microglia And Lymphocytes In Aging And Stroke, Justin N Nguyen, Anjali Chauhan

Faculty, Staff and Student Publications

As the average age of the world population increases, more people will face debilitating aging-associated conditions, including dementia and stroke. Not only does the incidence of these conditions increase with age, but the recovery afterward is often worse in older patients. Researchers and health professionals must unveil and understand the factors behind age-associated diseases to develop a therapy for older patients. Aging causes profound changes in the immune system including the activation of microglia in the brain. Activated microglia promote T lymphocyte transmigration leading to an increase in neuroinflammation, white matter damage, and cognitive impairment in both older humans and …

The Effects Of Obesity And Metabolic Abnormalities On Severe Covid-19-Related Outcomes After Vaccination: A Population-Based Study, Rebeca Kelly, Diego Aviles, Catriona Krisulevicz, Krystal Hunter, Lauren Krill, David Warshal, Olga Ostrovsky

Faculty, Staff and Student Publications

High mortality rates in ovarian cancer have been linked to recurrence, metastasis, and chemoresistant disease, which are known to involve not only genetic changes but also epigenetic aberrations. In ovarian cancer, adipose-derived stem cells from the omentum (O-ASCs) play a crucial role in supporting the tumor and its tumorigenic microenvironment, further propagating epigenetic abnormalities and dissemination of the disease. Epigallocatechin gallate (EGCG), a DNA methyltransferase inhibitor derived from green tea, and Indole-3-carbinol (I3C), a histone deacetylase inhibitor from cruciferous vegetables, carry promising effects in reprograming aberrant epigenetic modifications in cancer. Therefore, we demonstrate the action of these diet-derived compounds in …

Postoperative Complications Of True Dropless Cataract Surgery Versus Standard Topical Drops, Evan K Wotipka, Alex J Wright, James Z Fan, David Fuhriman, Alice Z Chuang, Grace C Lindhorst, Robert M Feldman, Eric L Crowell

Faculty, Staff and Student Publications

Purpose  Compare postoperative outcomes in cataract surgery between eyes with standard drop regimen versus dropless protocol by residents.

Design  Retrospective cohort study between April 1, 2018 and March 31, 2020.

Methods  The study was performed at Lyndon B. Johnson General Hospital in Houston, Harris County, Texas. A total of 547 eyes (234 dropless vs. 313 standard) with phacoemulsification cataract surgery and minimum of 1-month follow-up with best-corrected visual acuity (BCVA) were included. Dropless received 40 mg sub-Tenon's triamcinolone and intracameral moxifloxacin. Patients were followed at postoperative day 1 (POD1), week 1 (POW1), and month 1 (POM1). Postoperative rate of BCVA …

Non-Canonical Wnt Signaling In The Eye, Ruchi Shah, Cynthia Amador, Steven T Chun, Sean Ghiam, Mehrnoosh Saghizadeh, Andrei A Kramerov, Alexander V Ljubimov

Faculty, Staff and Student Publications

Wnt signaling comprises a group of complex signal transduction pathways that play critical roles in cell proliferation, differentiation, and apoptosis during development, as well as in stem cell maintenance and adult tissue homeostasis. Wnt pathways are classified into two major groups, canonical (β-catenin-dependent) or non-canonical (β-catenin-independent). Most previous studies in the eye have focused on canonical Wnt signaling, and the role of non-canonical signaling remains poorly understood. Additionally, the crosstalk between canonical and non-canonical Wnt signaling in the eye has hardly been explored. In this review, we present an overview of available data on ocular non-canonical Wnt signaling, including developmental …

Endovascular Versus Medical Management Of Posterior Cerebral Artery Occlusion Stroke: The Plato Study, Thanh N Nguyen, Muhammad M Qureshi, Davide Strambo, Daniel Strbian, Silja Räty, Christian Herweh, Mohamad Abdalkader, Marta Olive-Gadea, Marc Ribo, Marios Psychogios, Urs Fischer, Anh Nguyen, Joji B Kuramatsu, David Haupenthal, Martin Köhrmann, Cornelius Deuschl, Jordi Kühne Escola, Shadi Yaghi, Liqi Shu, Volker Puetz, Daniel P O Kaiser, Johannes Kaesmacher, Adnan Mujanovic, Dominique Cornelius Marterstock, Tobias Engelhorn, Piers Klein, Diogo C Haussen, Mahmoud H Mohammaden, Hend Abdelhamid, Lorena Souza Viana, Bruno Cunha, Isabel Fragata, Michele Romoli, Francesco Diana, Pekka Virtanen, Kimmo Lappalainen, Judith Clark, Stavros Matsoukas, Johanna T Fifi, Sunil A Sheth, Sergio Salazar-Marioni, João Pedro Marto, João Nuno Ramos, Milena Miszczuk, Christoph Riegler, Ashutosh P Jadhav, Shashvat M Desai, Volker Maus, Maximilian Kaeder, Adnan H Siddiqui, Andre Monteiro, Hesham E Masoud, Neil Suryadevara, Maxim Mokin, Shail Thanki, James E Siegler, Jane Khalife, Italo Linfante, Guilherme Dabus, Negar Asdaghi, Vasu Saini, Christian H Nolte, Eberhard Siebert, Thomas R Meinel, Stefanos Finitsis, Markus A Möhlenbruch, Peter A Ringleb, Anne Berberich, Raul G Nogueira, Uta Hanning, Lukas Meyer, Patrik Michel, Simon Nagel

Faculty, Staff and Student Publications

Background: The optimal management of patients with isolated posterior cerebral artery occlusion is uncertain. We compared clinical outcomes for endovascular therapy (EVT) versus medical management (MM) in patients with isolated posterior cerebral artery occlusion.

Methods: This multinational case-control study conducted at 27 sites in Europe and North America included consecutive patients with isolated posterior cerebral artery occlusion presenting within 24 hours of time last well from January 2015 to August 2022. Patients treated with EVT or MM were compared with multivariable logistic regression and inverse probability of treatment weighting. The coprimary outcomes were the 90-day modified Rankin Scale ordinal shift …

Spontaneous Resolution Of 2 High Flow Cervical Vertebral Arteriovenous Fistulas, Hussein A Zeineddine, Bryden H Dawes, Matthew P Mullarkey, Juan Carlos Martinez-Gutierrez, Peng Roc Chen

Faculty, Staff and Student Publications

Cervical vertebral arteriovenous fistula is a rare entity that is typically managed with endovascular techniques. We describe 2 consecutive cases of spontaneous obliteration of high flow cervical vertebral arteriovenous fistulas following angiography. Our cases pose an interesting natural history course, and we review the role of angiography in the unusual phenomenon of spontaneous obliteration of vascular malformations. These 2 cases bring forward the possibility of conservative management in such lesions.

Mird Pamphlet No 28, Part 1: Mirdcalc—A Software Tool For Medical Internal Radiation Dosimetry, Adam L Kesner, Lukas M Carter, Juan C Ocampo Ramos, Daniel Lafontaine, Edmond A Olguin, Justin L Brown, Bonnie President, Derek W Jokisch, Darrell R Fisher, Wesley E Bolch

Faculty, Staff and Student Publications

Medical internal radiation dosimetry constitutes a fundamental aspect of diagnosis, treatment, optimization, and safety in nuclear medicine. The MIRD committee of the Society of Nuclear Medicine and Medical Imaging developed a new computational tool to support organ-level and suborgan tissue dosimetry (MIRDcalc, version 1). Based on a standard Excel spreadsheet platform, MIRDcalc provides enhanced capabilities to facilitate radiopharmaceutical internal dosimetry. This new computational tool implements the well-established MIRD schema for internal dosimetry. The spreadsheet incorporates a significantly enhanced database comprising details for 333 radionuclides, 12 phantom reference models (International Commission on Radiological Protection), 81 source regions, and 48 target regions, …

Association Of Trauma Molecular Endotypes With Differential Response To Transfusion Resuscitation Strategies, Matthew R Thau, Ted Liu, Neha A Sathe, Grant E O'Keefe, Bryce R H Robinson, Eileen Bulger, Charles E Wade, Erin E Fox, John B Holcomb, W Conrad Liles, Ian B Stanaway, Carmen Mikacenic, Mark M Wurfel, Pavan K Bhatraju, Eric D Morrell

Faculty, Staff and Student Publications

IMPORTANCE: It is not clear which severely injured patients with hemorrhagic shock may benefit most from a 1:1:1 vs 1:1:2 (plasma:platelets:red blood cells) resuscitation strategy. Identification of trauma molecular endotypes may reveal subgroups of patients with differential treatment response to various resuscitation strategies.

OBJECTIVE: To derive trauma endotypes (TEs) from molecular data and determine whether these endotypes are associated with mortality and differential treatment response to 1:1:1 vs 1:1:2 resuscitation strategies.

DESIGN, SETTING, AND PARTICIPANTS: This was a secondary analysis of the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) randomized clinical trial. The study cohort included individuals with severe …

Immunometabolism At The Heart Of Cardiovascular Disease, Matthew Deberge, Rajesh Chaudhary, Samantha Schroth, Edward B Thorp

Faculty, Staff and Student Publications

Immune cell function among the myocardium, now more than ever, is appreciated to regulate cardiac function and pathophysiology. This is the case for both innate immunity, which includes neutrophils, monocytes, dendritic cells, and macrophages, as well as adaptive immunity, which includes T cells and B cells. This function is fueled by cell-intrinsic shifts in metabolism, such as glycolysis and oxidative phosphorylation, as well as metabolite availability, which originates from the surrounding extracellular milieu and varies during ischemia and metabolic syndrome. Immune cell crosstalk with cardiac parenchymal cells, such as cardiomyocytes and fibroblasts, is also regulated by complex cellular metabolic circuits. …

Difficult Or Impossible Facemask Ventilation In Children With Difficult Tracheal Intubation: A Retrospective Analysis Of The Pedi Registry, Annery G Garcia-Marcinkiewicz, Lisa K Lee, Bishr Haydar, John E Fiadjoe, Clyde T Matava, Pete G Kovatsis, James Peyton, Mary L Stein, Raymond Park, Brad M Taicher, Thomas W Templeton

Faculty, Staff and Student Publications

BACKGROUND: Difficult facemask ventilation is perilous in children whose tracheas are difficult to intubate. We hypothesised that certain physical characteristics and anaesthetic factors are associated with difficult mask ventilation in paediatric patients who also had difficult tracheal intubation.

METHODS: We queried a multicentre registry for children who experienced "difficult" or "impossible" facemask ventilation. Patient and case factors known before mask ventilation attempt were included for consideration in this regularised multivariable regression analysis. Incidence of complications, and frequency and efficacy of rescue placement of a supraglottic airway device were also tabulated. Changes in quality of mask ventilation after injection of a …

Thiazolidinedione Use And Retinal Fluid In The Comparison Of Age-Related Macular Degeneration Treatments Trials, Jason Q Core, Peiying Hua, Ebenezer Daniel, Juan E Grunwald, Glenn Jaffe, Maureen G Maguire, Gui-Shuang Ying, Comparison Of Age-Related Macular Degeneration Treatments Trials (Catt) Research Group

Faculty, Staff and Student Publications

BACKGROUND: Thiazolidinediones, commonly used antidiabetic medications, have been associated with an increased risk of development of diabetic macular oedema and increased vascular endothelial cell permeability. Macular neovascularisation in age-related macular degeneration (AMD) and associated fluid leakage may be influenced by thiazolidinediones. This study aims to determine the association between thiazolidinedione usage and retinal morphological outcomes or visual acuity (VA) in patients treated with bevacizumab or ranibizumab for neovascular AMD (nAMD).

METHODS: Secondary analysis of data from the Comparison of Age-related Macular Degeneration Treatments Trials. Participant self-reported diabetes status and thiazolidinedione usage at baseline. VA, intraretinal, subretinal and subretinal pigment epithelium …

Functional Assessment Of The Dural Lymphatic Vessels Using Dynamic Contrast Mri In Multiple Sclerosis, Refaat E Gabr, John A Lincoln, Khader M Hasan, Larry A Kramer

Faculty, Staff and Student Publications

BACKGROUND AND PURPOSE: The discovery of glymphatic function in the human brain has generated interest in waste clearance mechanisms in neurological disorders such as multiple sclerosis (MS). However, noninvasive in vivo functional assessment is currently lacking. This work studies the feasibility of a novel intravenous dynamic contrast MRI method to assess the dural lymphatics, a purported pathway contributing to glymphatic clearance.

METHODS: This prospective study included 20 patients with MS (17 women; age = 46.4 [27, 65] years; disease duration = 13.6 [2.1, 38.0] years, expanded disability status score (EDSS) = 2.0 [0, 6.5]). Patients were scanned on a 3.0T …