Digital Commons Network^™

Centrally Inserted Central Catheter Placement Using A Novel, Handheld, Image-Guided, Robotic Device: Results Of Initial Feasibility Trial In Patients, James P Herlihy, William E Cohn, Adrian Ebner

Faculty, Staff and Students Publications

Background: Central venous access devices (CVADs) are an essential and widely used tool for the treatment of the critically ill, patients undergoing major surgery, and for many patients requiring hemodialysis. Automation of centrally inserted central catheters (CICCs) could potentially make CVAD placement safer, more effective, and more accessible. A new device that uses ultrasound image-guided, robotic needle placement, in addition to traditional Seldinger technique, to place a CICC is described.

Objective: The device was used in a small, first-in-human, trial for placing non-tunneled hemodialysis catheters (NTHDCs), in order to determine feasibility of clinical use.

Methods: Consecutive patients requiring a NTHDC, …

Molecular Mechanisms In Masld/Mash-Related Hcc, Xiaobo Wang, Liang Zhang, Bingning Dong

Faculty, Staff and Students Publications

Liver cancer is the third leading cause of cancer-related deaths and ranks as the sixth most prevalent cancer type globally. NAFLD or metabolic dysfunction-associated steatotic liver disease, and its more severe manifestation, NASH or metabolic dysfunction-associated steatohepatitis (MASH), pose a significant global health concern, affecting approximately 20%-25% of the population. The increased prevalence of metabolic dysfunction-associated steatotic liver disease and MASH is parallel to the increasing rates of obesity-associated metabolic diseases, including type 2 diabetes, insulin resistance, and fatty liver diseases. MASH can progress to MASH-related HCC (MASH-HCC) in about 2% of cases each year, influenced by various factors such …

Mutations In The Key Autophagy Tethering Factor Epg5 Link Neurodevelopmental And Neurodegenerative Disorders Including Early-Onset Parkinsonism, Hormos Salimi Dafsari, Celine Deneubourg, Kritarth Singh, Reza Maroofian, Zita Suprenant, Ay Lin Kho, Neil J Ingham, Karen P Steel, Preethi Sheshadri, Franciska Baur, Lea Hentrich, Birgit Gerisch, Mina Zamani, Cesar Alves, Ata Siddiqui, Haidar S Dafsari, Mehri Salari, Anthony E Lang, Michael Harris, Alice Abdelaleem, Saeid Sadeghian, Reza Azizimalamiri, Hamid Galehdari, Gholamreza Shariati, Alireza Sedaghat, Jawaher Zeighami, Daniel Calame, Dana Marafi, Ruizhi Duan, Adrian Boehnke, Gary D Clark, Jill A Rosenfeld, Carrie A Mohila, Dora Steel, Saurabh Chopra, Suvasini Sharma, Nicolai Kohlschmidt, Steffi Patzer, Afshin Saffari, Darius Ebrahimi-Fakhari, Büşra Eser Çavdartepe, Irene J Chang, Erika Beckman, Renate Peters, Andrew Paul Fennell, Bernice Lo, Luisa Averdunk, Felix Distelmaier, Martina Baethmann, Frances Elmslie, Kairit Joost, Sheela Nampoothiri, Dhanya Yesodharan, Hanna Mandel, Amy Kimball, Antonie D Kline, Cyril Mignot, Boris Keren, Vincent Laugel, Katrin Õunap, Kalpana Devadathan, Frederique M C Van Berkestijn, Arpana Silwal, Saskia Koene, Sumit Verma, Mohammed Yousuf Karim, Chahynez Boubidi, Majid Aziz, Gehad Elghazali, Lauren Mattas, Mohammad Miryounesi, Farzad Hashemi-Gorji, Shahryar Alavi, Nayereh Nouri, Mehrdad Noruzinia, Saeideh Kavousi, Arveen Kamath, Sandeep Jayawant, Russell Saneto, Nourelhoda A Haridy, Pinar Ozkan Kart, Ali Cansu, Madeleine Joubert, Claire Beneteau, Kyra E Stuurman, Martina Wilke, Tahsin Stefan Barakat, Homa Tajsharghi, Annarita Scardamaglia, Sadeq Vallian, Semra Hız, Ali Shoeibi, Reza Boostani, Narges Hashemi, Meisam Babaei, Norah Saleh Alsaleh, Julie Porter, Tania Attié-Bitach, Pauline Marzin, Dorota Wicher, Jessica I Gold, Elisabeth Schuler, Amna Kashgari, Rakan F Alanazi, Wafaa Eyaid, Marc Engelen, Mirjam Langeveld, Burkhard Stüve, Yun Li, Gökhan Yigit, Bernd Wollnik, Mariana H G Monje, Dimitri Krainc, Niccolò E Mencacci, Somayeh Bakhtiari, Michael Kruer, Emanuela Argilli, Elliott Sherr, Yalda Jamshidi, Ehsan Ghayoor Karimiani, Yiu Wing Sunny Cheung, Ivan Karin, Giovanni Zifarelli, Peter Bauer, Wendy K Chung, James R Lupski, Manju A Kurian, Jörg Dötsch, Jürgen-Christoph Von Kleist-Retzow, Thomas Klopstock, Matias Wagner, Calvin Yip, Andreas Roos, Rita Carsetti, Carlo Dionisi-Vici, Mathias Gautel, Michael R Duchen, Adam Antebi, Henry Houlden, Manolis Fanto, Heinz Jungbluth

Faculty, Staff and Students Publications

Objective: Autophagy is a fundamental biological pathway with vital roles in intracellular homeostasis. During autophagy, defective cargoes including mitochondria are targeted to lysosomes for clearance and recycling. Recessive truncating variants in the autophagy gene EPG5 have been associated with Vici syndrome, a severe early-onset neurodevelopmental disorder with extensive multisystem involvement. Here, we aimed to delineate the extended, age-dependent EPG5-related disease spectrum.

Methods: We investigated clinical, radiological, and molecular features from the largest cohort of EPG5-related patients identified to date, complemented by experimental investigation of cellular and animal models of EPG5 defects.

Results: Through worldwide collaboration, we identified 211 patients, 97 …

Inhibition Of Bmper Mitigates Pulmonary Hypertension By Modulating Lrp1-Yap Interaction In Smooth Muscle Cells, Hua Mao, Claire M Li, Bing Sun, Christopher S Ward, Alan R Waich-Cohen, Ivan O Rosas, Howard J Huang, Harry Karmouty-Quintana, Liang Xie, Lavannya M Pandit, Xinchun Pi

Faculty, Staff and Students Publications

Background: BMPER (bone morphogenetic protein-binding endothelial regulator) is a secreted protein that is highly expressed in endothelial cells. It regulates the BMP (bone morphogenetic protein) pathway during vascular development and adulthood. Mutations in the BMP pathway are recognized as risk factors for pulmonary arterial hypertension group 1 pulmonary hypertension (PH). However, the roles of BMPER in pulmonary arterial hypertension remain unknown.

Methods: We assessed BMPER expression in Group 1 pulmonary arterial hypertension patient samples and examined its role in vascular remodeling using in vivo and in vitro approaches.

Results: BMPER level was elevated in pulmonary arterial hypertension lungs and significantly …

Six Drivers Of Aging Identified Among Genes Differentially Expressed With Age, Ariella Coler-Reilly, Zachary Pincus, Erica L Scheller, Roberto Civitelli

2020-Current year OA Pubs

Many studies have compared gene expression in young and old samples to gain insights on aging, the primary risk factor for most chronic diseases. However, these studies only identify associations without distinguishing drivers of aging from compensatory geroprotective responses or incidental downstream effects. Here, we introduce a workflow to characterize causal effects of differentially expressed genes on lifespan. First, we performed a meta-analysis of 25 gene expression datasets comprising samples of various tissues from healthy, untreated adult mammals (humans, dogs, and rodents) at two distinct ages. Genes were ranked by the number of datasets in which they exhibited consistent differential …

The Multilevel Limb-Loss And Preservation Rehabilitation Continuum Model (Mlprc): An Evidence-Based Implementation Model Integrating Multiple Perspectives To Improve Outcomes For People Facing Limb Loss, Prateek Grover, Elvin Geng, Rachel G Tabak

2020-Current year OA Pubs

BACKGROUND: The patient journey from threatened to actual limb loss, subsequent rehabilitation, and limb preservation through the health system is complicated and prone to delays, attrition, and inequities. A shared multi(socioecological)-level conceptualization of this journey among the multiple stakeholders is the first step for systematically improving limb care through identification of bottlenecks and gaps, contributory factors, and responsive interventions and implementation strategies.

OBJECTIVE: To meet this knowledge gap by presenting a novel implementation model, the Multilevel Limb-loss and Preservation Rehabilitation Continuum (MLPRC), that can be used to develop multilevel applications.

METHODS: MLPRC was developed in three overlapping steps: (1) design …

Comparing Effectiveness And Safety Of Left Atrial Appendage Closure Devices: A Network Meta-Analysis Of Randomized Controlled Trials, John W Davis, Steven L Mai, Wissam Harmouch, Jenna Reisler, Micaela Mackay, Elizabeth Davis, Pavel Osmancik, Michael W Rich

2020-Current year OA Pubs

INTRODUCTION: Atrial fibrillation-related stroke is a leading cause of morbidity and mortality. The comparative effectiveness and safety of left atrial appendage closure (LAAC) devices, compared with one another and with anticoagulation, is unclear.

METHODS: We conducted a systematic review and network meta-analysis (NMA) of all clinical trials comparing the Watchman and Amplatzer Amulet LAAC devices with each other or with warfarin or direct oral anticoagulants (DOACs). The primary comparison was between LAAC devices with secondary comparisons to anticoagulation. The primary effectiveness outcomes were any stroke and all-cause death. Safety outcomes included any thromboembolism, device embolization, and pericardial effusion.

RESULTS: There …

Moderators Of Antidepressant Augmentation Versus Switch In The Optimum Randomised Controlled Trial, Helena K Kim, Jordan F Karp, Helen Lavretsky, Daniel M Blumberger, Patrick J Brown, Alastair J Flint, Emily Lenard, J Philip Miller, Charles F Reynolds, Steven P Roose, Eric J Lenze, Benoit H Mulsant

2020-Current year OA Pubs

BACKGROUND: Older adults with treatment-resistant depression (TRD) benefit more from treatment augmentation than switching. It is useful to identify moderators that influence these treatment strategies for personalised medicine.

AIMS: Our objective was to test whether age, executive dysfunction, comorbid medical burden, comorbid anxiety or the number of previous adequate antidepressant trials could moderate the superiority of augmentation over switching. A significant moderator would influence the differential effect of augmentation versus switching on treatment outcomes.

METHOD: We performed a preplanned moderation analysis of data from the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) randomised controlled trial (

RESULTS: Of …

Comparison Of Rule- And Large Language Model-Based Phenotype Extraction From Clinical Notes For Neurofibromatosis Type 1, Levi Kaster, Ethan Hillis, Inez Y Oh, Elizabeth C Cordell, Randi E Foraker, Albert M Lai, Stephanie M Morris, David H Gutmann, Philip R O Payne, Aditi Gupta

2020-Current year OA Pubs

INTRODUCTION: Neurofibromatosis type 1 (NF1) is a rare genetic disorder affecting multiple organ systems with significant clinical heterogeneity. Managing individuals with NF1 is challenging due to variability in disease progression and outcomes and limited early risk assessment tools.

OBJECTIVE: This study aims to develop an effective, generalizable, user-friendly clinical entity extraction pipeline for identifying NF1-related phenotypes from unstructured clinical notes to enhance research and risk-modeling efforts. We compare the benefits of rule-based natural language processing (NLP) vs large language models (LLMs) for this purpose.

MATERIALS AND METHODS: Four phenotype extraction pipelines (3 LLM-based vs 1 rule-based) were developed to automatically …

Hospitalizations As An Outcome Measure In Courage-Als, Stacy A Rudnicki, Timothy M Miller, Et Al.

2020-Current year OA Pubs

No abstract provided.

Identifying Performance Differences Between Two Pulse Oximetry Systems In Simulated Critical Neonatal Conditions, Brian King, Jake Dove, Scott J Mcgonigle, Warwick A Ames, Zachary A Vesoulis

2020-Current year OA Pubs

OBJECTIVE: Pulse oximetry is used to guide critical clinical decisions in neonatology. We used a vital signs simulator to compare performance of two pulse oximetry systems in conditions not tested in standardized clinical verification studies.

STUDY DESIGN: We devised a set of simulated tissue translucency, perfusion, peripheral oxygen saturation (SpO

RESULTS: The mean SpO

CONCLUSION: Significant performance differences can be observed when comparing pulse oximeters at low translucency and perfusion conditions. Patient simulators cannot replace clinical testing but provide a safe and cost-effective method for additional performance profiling.

Composing A Kaleidoscope: A Scholarly Personal Narrative Of Academia In A Time Of Digital Overload, Suzanne Porath

Mid-Western Educational Researcher

s Scholarly Personal Narrative (SPN) explores the experience of fractured academic identity amid illness, remote teaching, and digital saturation. Anchored in the methodology of SPN as described by Nash (2004) this narrative integrates personal storytelling with critical reflection and theoretical engagement. Drawing on Rushkoff’s concept of digiphrenia, Makowka’s fractal identity, and Gergen’s absent presence, the paper examines how academic life in the digital age increasingly demands simultaneous performances of self across disjointed timelines and virtual spaces. Through vignettes of presenting at concurrent conferences, teaching from chemotherapy bays, and supporting a dissertation defense in unlikely places, this piece reflects on the …

Index: Subject Index-12 Months Ended July 1971; Author Index-12 Months Ended July 1971, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Tax Trends, Harry Z. Garian, John F. Kalben

Tax Adviser

No abstract provided.

Whys And Hows Of Tax Writing, Jerome K. Pescow

Tax Adviser

No abstract provided.

A Second Chance At The Second Amendment, Blake Creekmur

Kentucky Law Journal

No abstract provided.

Fines, Fees, & Felon Disenfranchisement: An Unjust Punishment Barring A Fundamental Right, Molly Crain

Kentucky Law Journal

No abstract provided.

A New Report Of Entick V. Carrington (1765), T. T. Arvind, Christian R. Burset

Kentucky Law Journal

No abstract provided.

Faux Federalism, Amanda B. Hurst

Kentucky Law Journal

No abstract provided.

Protecting Unbelief: Restoring Section Five Of Kentucky's Constitution, Samuel Weaver

Kentucky Law Journal

No abstract provided.

The Ratchet Wreck: Equality's Leveling Down Problem, Louis Michael Seidman

Kentucky Law Journal

No abstract provided.

Unworthy Heirs: The Slayer Rule And Beyond, Mary Elizabeth Morey

Kentucky Law Journal

No abstract provided.

Paying To Punish: How Criminal Legal Debt In Kentucky Extends Beyond The Proportionate Punishment, Morgan King

Kentucky Law Journal

No abstract provided.

Trumping Tradition: Redefining The Family Farmer, Dalton Stanley

Kentucky Law Journal

No abstract provided.

Cruel And Unusual Camping, Cameron Baskett

Kentucky Law Journal

No abstract provided.

Reconsideration Of Kentucky's Prohibition Of Special And Local Legislation, Laurance B. Vanmeter

Kentucky Law Journal

No abstract provided.

Is Truth Truth?, James R. Steiner-Dillon

Kentucky Law Journal

No abstract provided.

Balancing Broad Disclosure And Candid Consideration: Third-Party Consultants And Intra-Agency Exemptions Under The Freedom Of Information Act, Zac Losey

Kentucky Law Journal

No abstract provided.

Underestimating Fraud, David Kwok

Kentucky Law Journal

No abstract provided.

Incorporation By Any Other Name? Comparing Congress' Federalization Of Tribal Court Criminal Procedure With The Supreme Court's Regulation Of State Courts, Jordan Gross

Kentucky Law Journal

No abstract provided.