Medicine and Health Sciences Commons^™

Recent Trends In The Ophthalmology Match, Michael Pratt, Ma

inSIGHT

Ophthalmology remains a competitive field to match for residency, with applications far outnumbering available positions. The criteria for a successful match are unclear owing to differences in data reporting from the SF Match system as compared to the National Residency Match Program, a relatively low volume of scholarly research about the ophthalmology match, and the transition of the USMLE Step 1 exam to pass/fail grading in 2022. This narrative review, while not intended as a guide to become a competitive applicant for residency, will summarize the 2024 ophthalmology match cycle results, report the specific match rate for Sidney Kimmel Medical …

Vascular, Immunological, And Mechanical Factors In Normal Tension Glaucoma: A Multidimensional Approach To Pathogenesis, Rachel E. Cain

inSIGHT

Glaucoma is characterized by progressive degeneration of retinal ganglion cells leading to optic neuropathy and visual field loss.

The major risk factor for glaucoma is elevated intra-ocular pressure (IOP) (Fig. 1). However, 30-40% of patients with glaucoma have normal IOP, leading to the classification of normal-tension glaucoma (NTG) (Fig. 1 C, E).^1,2 The prevalence of NTG varies between populations, with Asians having the highest prevalence (77- 92%), followed by Africans (57%), and Caucasians (30-39%).³ In a landmark study, the collaborative normal tension glaucoma study group (CNTGS) showed that a 30% reduction in IOP in NTG patients slowed the …

Giving More Than Vision: The Evolution And Impact Of Give Kids Sight Day, Leah Prischak, Bs

inSIGHT

Current literature strongly suggests that quality of life is diminished in children with visual impairments.¹ In many situations, visual impairment (VI) can be a serious barrier in obtaining the typical experiences and accomplishments of childhood. Evidence suggests an association between visual acuity, refractive error, and child academic performance.² VI is also associated with the prevalence of more intangible, psychological obstacles in areas such as independence and autonomy, concerns about the future, social relationships, participation, and acceptance.³

Retina In 10 Years—Exciting Developments, Amer Ahmed

inSIGHT

Significant advancements in the field of retina are expected over the next decade.

Wet AMD: Emerging Therapies
Wet age-related macular degeneration (AMD) is a chronic eye condition and a leading cause of vision loss in older adults. It occurs when abnormal blood vessels grow beneath the macula. These vessels are fragile and prone to leaking blood or fluid, which damages the retina and leads to rapid central vision loss.¹

Insight, Volume 5, Issue 1, 2025

inSIGHT

Contents

8 - Retina in 10 Years—Exciting Developments
By Amer Ahmed

12 - Giving More than Vision: The Evolution and Impact of Give Kids Sight Day
By Leah Prischak

15 - Vascular, Immunological, and Mechanical Factors in Normal Tension Glaucoma: A Multidimensional Approach to Pathogenesis
By Rachel Cain

22 - Recent Trends in the Ophthalmology Match
By Michael Pratt

25 - Idiopathic Intracranial Hypertension: A Comprehensive Review of Diagnosis and Management
By Sriya Sadhu

31 - Day in the Life of an Orbital and Oculoplastic Surgeon
By Alexis Duffy

35 - Idiopathic Intracranial Hypertension
By Tejal Patel

42 - Genetic …

The Impact Of Cage Position, Radiographic Parameters, And Hounsfield Units On Subsidence Rate After One To Three Level Anterior Cervical Discectomy And Fusion, Jarod Olson, Jonathan Dalton, Omar H. Tarawneh, Rajkishen Narayanan, Alec Giakas, Rachel Huang, Joydeep Baidya, Robert J. Oris, Joshua Mathew, William A. Green, Nicholas B. Pohl, Anthony Labarbiera, Benjamin Crain, Nathaniel Pineda, Joseph Rajasekaran, Gordon Hua, Mark F. Kurd, Jeffrey A. Rihn, Jose A. Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: The study design was a retrospective cohort.

OBJECTIVE: The objective of the study was to validate the relationship between Hounsfield units (HU) and subsidence, including multilevel anterior cervical discectomy and fusion (ACDF). Cage/graft subsidence commonly occurs after ACDF. Prior work on 1-level ACDF found increased subsidence rates in patients with lower HUs.

MATERIALS AND METHODS: Adults who underwent 1-3 level ACDF at a tertiary center and had preoperative computed tomography scans were included (2018-2022). HUs were assessed ~5 mm caudal to the superior endplate. Six-month postoperative radiographs were evaluated for cage/graft positioning, screw loosening, and subsidence. Receiver operating …

Rapid Mapping Of Spinal And Supraspinal Connectome Via Self-Targeting Glucose-Based Carbon Dots, Yasin B. Seven, Elif S. Seven, Emel Kirbas Cilingir, Komal Parikh, Mehmet Aydin, Edward K. Luca, Jayakrishnan Nair, Roger M. Leblanc

Department of Physical Therapy Faculty Papers

The spinal cord is a highly dynamic network, playing significant roles in the vital functions of the brain. Disorders of the spinal cord, such as spinal cord injury and amyotrophic lateral sclerosis (ALS), are associated with neurodegeneration, often resulting in morbidity and mortality. The blood-brain barrier (BBB) poses a major challenge to imaging and therapeutic agents because less than 2% of small-molecule drugs and almost no large-molecule drugs can cross the BBB. Furthermore, spatial spectroscopy studies have shown highly heterogeneous BBB crossing with significant accumulation at the unintended brain regions. Thus, targeting systems that can cross the BBB at the …

Early Blood Pressure Targets In Acute Spinal Cord Injury: A Randomized Clinical Trial, Ruba Sajdeya, N. David Yanez, Michael Kampp, Michael D. Goodman, David Zonies, Brandon Togioka, Andrew Nunn, Robert D. Winfield, Niels D. Martin, Anirudh Kohli, Toan T. Huynh, David O. Okonkwo, Roy A. Poblete, Emily J. Gilmore, Randall M. Chesnut, Aaron E. Bunnell, Tetsu Ohnuma, Mona Hashemaghaie, Miriam M. Treggiari

Department of Surgery Faculty Papers

IMPORTANCE: Early blood pressure management is central to neurologic resuscitation of spinal cord injury; however, the role of augmented blood pressure is unclear.

OBJECTIVE: To compare the efficacy and safety of augmented vs conventional blood pressure on 6-month neurologic outcomes after acute spinal cord injury.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter randomized clinical trial took place from October 3, 2017, to July 26, 2023, and assessed patients 18 years or older with spinal cord injury followed up for 6 months at 13 large US trauma centers.

INTERVENTIONS: Patients were equally randomized to augmented (>85-90 mm Hg) or conventional ( …

Efficacy And Safety Of Rigosertib In Patients With Recessive Dystrophic Epidermolysis Bullosa-Associated Advanced/Metastatic Cutaneous Squamous Cell Carcinoma, Martin Laimer, Andrew P. South, Elisabeth Mayr, Sophie Kitzmueller, Lauren Banner, Michael Alexander, Linda Hosler, Henry Yang, Matthew Parris, Meena Arora, Georg Zimmermann, Gregor Schweighofer-Zwink, Johann Bauer, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Recessive dystrophic epidermolysis bullosa (RDEB) is an epithelial fragility disease primarily affecting the skin and is caused by variants in the COL7A1 gene. Individuals with RDEB are predisposed to develop highly aggressive cutaneous squamous cell carcinomas (SCCs) which are the most common cause of premature death. There is a lack of effective prevention or treatment options for patients with RDEB-SCC.

OBJECTIVES: To evaluate the antitumour activity and safety of the polo-like kinase-1 (PLK1) inhibitor, rigosertib, two investigator-initiated open-label, single-arm phase II studies were opened in Europe and the USA and enrolled five patients with RDEB diagnosed with locally advanced …

Editorial: Wearable Technology: The New Ornament Of Network Physiology, Ankita Srivastava, Santosh Kumar Yadav

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Introduction: The landscape of personal health monitoring is rapidly transforming, driven by advances in wearable technology. These devices, designed to be worn comfortably on the body, can capture real-time physiological data often difficult to obtain in traditional clinical settings. What began as a simple device for activity trackers for walking steps, heart rate, and blood oxygen saturation has evolved to play a crucial role in monitoring more complex physiological parameters critical for chronic disease management and preventative health.

The integration of artificial intelligence (AI) is further expanding the potential of wearable devices, enabling deeper analysis and predictive modeling of the …

The Impact Of Foraminotomy On Patient-Reported Outcomes Following 3+ Level Posterior Cervical Decompression And Fusion For Myeloradiculopathy, Robert J. Oris, Jonathan Dalton, Joydeep Baidya, Tariq Z. Issa, Tyler D. Alexander, Jarod Olson, Rachel Huang, Chloe Herczeg, Omar Tarawneh, Rajkishen Narayanan, Michael Carter, Jonah Hammerstedt, Sebastian Quiana, Mark Kurd, Barrett I. Woods, I David Kaye, Thomas Cha, Jose A Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: To evaluate whether patients with myeloradiculopathy experience better improvement in patient-reported outcome measures (PROMs) from the addition of foraminotomy in the setting of posterior cervical decompression and fusion (PCDF).

METHODS: Adult patients who underwent ≥≥ 3-level PCDF (2017-2022) at a single tertiary center were retrospectively identified. Patients were included if their indication was myeloradiculopathy - patients were excluded if they had a combined anterior/posterior approach, an indication of infection/tumor/trauma, or incomplete 1-year PROMs. Operative notes were evaluated to identify the patients who had a foraminotomy specifically for neuro-decompression. Patients with or without foraminotomy were evaluated for demographic/surgical variables, surgical …

Predictors Of All-Cause In-Hospital Mortality In Patients With Malignant Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors, Elvis Obomanu, Tarfa Verinumbe, Tinsae Anebo, Colton Jones, Claudia Dourado

Einstein Health Papers

BACKGROUND: Factors influencing in-hospital mortality in patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) remain understudied, highlighting gaps in optimizing acute clinical outcomes. This study aimed to identify sociodemographic and clinical predictors of all-cause in-hospital mortality in this population.

METHODS: Using 2016 - 2020 data from the National Inpatient Sample (NIS), patients with malignant well-differentiated GEP-NETs were identified via the International Classification of Diseases, 10th Revision (ICD-10) codes. The primary outcome was in-hospital mortality. Sociodemographic and clinical variables (heart failure (HF), malnutrition, Charlson Comorbidity Index (CCI), and tumor site) were analyzed using multivariable logistic regression.

RESULTS: Among 5,642 patients (mean age …

Impact Of Tricuspid Regurgitation On The Clinical Outcomes Of Patients With Heart Failure, Muhammad U. Almani, Rasha Khan, Noor Fatima, Muhammad Yousuf, Aman Amanullah

Einstein Health Papers

BACKGROUND: Tricuspid regurgitation (TR) is a common occurrence in patients with heart failure (HF), and its role in disease progression has gained attention in recent years. Although TR can worsen clinical outcomes in HF patients, the impact of gender, racial, and socioeconomic factors remains largely unexplored. With growing evidence supporting the role of percutaneous interventions for the treatment of significant TR, understanding these disparities is more crucial than ever.

METHODS: Data were extracted from the National Inpatient and National Readmission 2016-2020 Databases. We used ICD-10 code I50 to identify the patients primarily admitted for HF and subdivided the cohort into …

Bard1: A Friend Or Foe In Pancreatic Ductal Adenocarcinoma?, Lily Zekavat, Aditi Jain

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive solid malignancy with poor overall prognosis and limited response to standard treatments. Growing interest in the modulation of DNA repair mechanisms, including the homologous recombination (HR) repair pathway, has opened new avenues for therapeutic development. BARD1 (BRCA1-Associated RING Domain 1) plays a complex role in tumor biology, functioning either as a tumor suppressor or as an oncogenic driver, depending on isoform expression, cellular context, and regulatory environment. In this review, we examine the dual roles of BARD1, focusing on its regulation and paradoxical activities in PDAC. We summarize evidence that BARD1 and BARD1 …

Performance Of 123i-Ioflupane Spect Striatal Binding In Dementia With Lewy Bodies, Emily F. Maly, Frank P. Difilippo, Brittany Lapin, Yadi Li, Sarah Berman, Andrea C. Bozoki, Jori E. Fleisher, James E. Galvin, David J. Irwin, Carol F. Lippa, Irene Litvan, Debby W. Tsuang, Cyrus P. Zabetian, Angela S. Taylor, Lynn M. Bekris, Oscar L. Lopez, Douglas Galasko, James B. Leverenz

Department of Neurology Faculty Papers

INTRODUCTION: We aimed to determine whether ¹²³I-ioflupane single-photon emission computed tomography (SPECT) striatal binding ratio (SBR) correlated with parkinsonian motor symptoms in dementia with Lewy bodies (DLB) and if SBR predicts worsening of parkinsonism over time.

METHODS: A retrospective cohort study of the U.S. Dementia with Lewy Bodies Consortium dataset including individuals with DLB with baseline ¹²³I-ioflupane SPECT analyzed with DaTQUANT and baseline and 24-month Movement Disorder Society Unified Parkinson's Disease Rating Scale–Part III (MDS-UPDRS-III). A subset had cerebrospinal fluid α-synuclein seed amplification assay (SAA) evaluation.

RESULTS: Baseline mean SBRs were significant predictors of baseline and 24-month MDS-UPDRS-III …

The Predilection Of Specific Diseases To Affect Different Sections Of The Esophagus, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Certain esophageal diseases have a predilection for affecting different parts of the esophagus. This predilection is noted in our clinical practice as we investigate various esophageal diseases using multiple imaging and motility studies, as well as endoscopic procedures with biopsies. Clinical presentations vary with the stage and location of the disease. Clinicians can suspect certain diseases when a particular part of the esophagus is involved and then can perform appropriate investigations. Esophageal diseases with section involvement, with their symptomatology, diagnostic tests, and management, have been discussed in this narrative review. This review aims to revisit those diseases with a current …

Reaching International Consensus On The Definition Of Refractory Migraine Using The Delphi Method, Jennifer Robblee, Fawad A. Khan, Michael J. Marmura, Hope L. O'Brien, Lawrence D. Robbins, Marielle K. Samaha, Morris Levin, Simona Sacco, Raffaele Ornello, Stephanie J. Nahas, Heike Hesse, Annika Ehrlich, Adam S. Sprouse-Blum, Christina Sun-Edelstein, Bronwyn Jenkins, Elizabeth K, Seng, Shivang Joshi, Meredith J. Barad, Mi Ji Lee, Sheena K. Aurora, Mario Fernando Prieto Peres

Department of Neurology Faculty Papers

Aim: Despite its frequency in tertiary headache centers, the International Classification of Headache Disorders, 3rd edition (ICHD-3) does not include refractory migraine. Multiple definitions have been proposed with a recent 2020 proposal for both refractory migraine and resistant migraine by the European Headache Federation (EHF). The aim is to reach an international consensus on the definition of refractory migraine.

Methods: This study is a Delphi consensus carried out by a group of international experts in headache medicine. Following a focus group, a panel of 20 experts and one facilitator reviewed the EHF proposed criteria to build upon their definitions. The …

Educational Case: Diabetic Nephropathy, Emily W. Gripp, Joanna Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Primary objective

The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see https://www.academicpathologyjournal.org/pcme.

Objective UTK5.4: Diabetic Nephropathy. Describe the pathogenesis of diabetic nephropathy and the associated clinicopathologic features. Competency 2: Organ System Pathology; Topic: Kidney (UTK); Learning Goal 5: Glomerular Disorders.

Secondary objective

Objective CHEM1.5: Renal Disorders. Discuss the …

Radiosensitization Of Intrahepatic Cholangiocarcinoma And Metastatic Disease In The Liver Using Microbubble Cavitation: Results From A Phase 2 Clinical Trial, Corinne E. Wessner, Tania Siu Xiao, Allison Chang, Jenny Liu, Weelic Chong, Ji-Bin Liu, Kristen Bradigan, Flemming Forsberg, Andrej Lyshchik, Patrick O'Kane, Scott W. Keith, Stephen R. Topper, Kevin Anton, John R. Eisenbrey

Department of Radiology Faculty Papers

Ultrasound triggered microbubble destruction (UTMD) has been shown to sensitize tumors to radiation. This study evaluated the feasibility, safety, and efficacy of using UTMD for radiosensitization in participants with intrahepatic cholangiocarcinoma (ICC) and/or metastatic disease to the liver (MDL) receiving Yttrium-90 transarterial radioembolization (Y90-TARE). This was a prospective single-center IRB-approved clinical trial. Participants received four contrast ultrasound sessions: 1-2 weeks prior to Y90-TARE, 1-4 h post-treatment, and 1 week and 2 weeks post-Y90-TARE. The control group consisted of 1:1 nearest-neighbor propensity score matched historical controls participants that received Y90-TARE as part of standard-of-care. Safety was evaluated through general lab values, …

Potential For Therapeutic Alteration Of The Underlying Biology Of Epilepsy, Michael R. Sperling, Jurriaan M. Peters, Qian Wu, Michelle Guignet, H. Steve White, Evelyn K. Shih, Leock Y. Ngo, Enrique Carrazana, Adrian L. Rabinowicz

Department of Neurology Faculty Papers

Approximately 30-35% of people with epilepsy experience seizures despite taking antiseizure medications. Recurrent seizures that are independent of status epilepticus can be associated with neuronal injury and structural changes to the brain, as well as diminished cognitive function, mood, and quality of life. A treatment that alters the underlying biology of epilepsy, thereby reducing the seizure burden and its attendant consequences, would be of great value in preventing these detrimental effects. In this review, we summarize preclinical and clinical research on pharmacological treatments that may favorably alter the underlying biology of epilepsy (i.e., disease modification or antiepileptogenesis). A reduction in …

Development And Validation Of An Ai-Based Lung Lobe Auto-Contouring Tool Using Radiation Therapy Planning Free-Breathing Images, Peter Ciaccio, Joseph Lombardo, Andrew Fuquay, Soroush Pahlavian, Rachel Grimm, Jun Kang, Wookjin Choi, Paul Sullivan, Yevgeniy Vinogradskiy

Department of Radiation Oncology Faculty Papers

BACKGROUND: Pulmonary toxicity can occur during radiation therapy of the lungs. Dose metrics evaluated at the lobar level can improve the ability to predict toxicity. Contouring lung lobes is challenging and time consuming. Currently there are limited dosimetry studies evaluating the dose to lung lobes. The purpose of this work was to develop and validate an artificial intelligence (AI) lung lobe auto-contouring algorithm using radiation therapy planning images.

MATERIALS AND METHODS: Fifty lung cancer patients from two institutions were analyzed, and a clinician contoured all five lung lobes [left upper lobe (LUL), left lower lobe (LLL), right upper lobe (RUL), …

Association Between Climate Change Awareness And Depression & Anxiety: Findings From A U.S. Sample, Stanley Nkemjika, Colvette Brown, Henry Onyeaka, Srikanta Banerjee, Jennifer Oliphant

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Exploring the connection between climate change awareness and overall well-being is crucial, particularly in how it impacts both the environment and mental health. The mental health consequences of climate change and its awareness have not been thoroughly examined, especially in the U.S. In this study, the relationship between awareness of climate change and depression or anxiety among U.S. adults was explored. Similarly, the role of climate change awareness has not been explored in relation to mental health concerns.

METHODS: Based on the HINTS-6 dataset, a nationally representative, cross-sectional survey conducted by the National Cancer Institute, a variety of statistical …

A Novel Sialylation Pathway Mediated By Extracellular Vesicles In Aggressive Prostate Cancer, Camila A. Bach, Md Niamat Hossain, Ishan J. Chaudhari, Cecilia E. Verrillo, Nicole M. Naranjo, Isabella Amoroso, Anna Testa, Samuel Sey, W. Kevin Kelly, Susan L. Bellis, Aurelio Lorico, Ada G. Blidner, Gabriel A. Rabinovich, Lucia R. Languino

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Altered cell surface glycosylation is a hallmark of cancer; among aberrant glycan structures, hypersialylated proteins contribute to disease progression. The enzyme ST6 β-galactoside α2,6-sialyltransferase 1 (ST6GAL1) mediates α2,6-linked sialylation of N-glycosylated proteins and is upregulated in many cancers, including prostate cancer (PrCa). We propose that ST6GAL1 may be released by cancer cells in small extracellular vesicles (sEVs) in the PrCa tumor microenvironment to potentially modulate cell surface sialylation in recipient cells. We isolated sEVs from PrCa cells by density gradient separation and characterized them by nanoparticle tracking analysis using ZetaView and immunoblotting analysis. We identified ST6GAL1 in both its membrane-bound …

Distinct Transcriptional Regulation Of The Wnt And Tgfβ Signaling Families Associated With Wound Healing And Fibrotic Outcomes To Lens Injury, Catherine Lalman, Kylie R. Stabler, Joshua Disatham, Lisa A. Brennan, Marc Kantorow, Janice L. Walker

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Posterior capsule opacification (PCO) is a fibrotic complication of cataract surgery caused by aberrant repair of residual lens cells. It remains unclear how the lens injury response shifts toward a pathological repair process. Here, we performed a transcriptional analysis of two major pro-fibrotic pathways, the TGF-β superfamily and Wnt signaling pathways to determine how they are differentially regulated during regenerative wound healing versus fibrosis in a lens injury model. For these studies, RNA sequencing was performed on an ex vivo lens explant system that models post-surgical healing within regenerative and fibrotic microenvironments, from 0 to 3 days post-injury. Fibrotic conditions …

Erratum To “Cardiac Screening Findings And Referral Patterns In Male African-American Basketball Players: Analysis Of The Heartbytes Registry”[The American Journal Of Cardiology 243 (2025) 73-80], Douglas Corsi, Avinash Saraiya, Maggie Doyle, Vacha Shah, Blaise O’Malley, Grace Qiu, Renee Lanstaff, Imran Masood, Brian Osler, Alexander Hajduczok, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

No abstract provided.

The Colonic Crypt: Cellular Dynamics And Signaling Pathways In Homeostasis And Cancer, Anh L. Nguyen, Molly A. Lausten, Bruce M. Boman

College of Life Sciences Faculty Papers

The goal of this review is to expand our understanding of how the cellular organization of the normal colonic crypt is maintained and elucidate how this intricate architecture is disrupted during tumorigenesis. Additionally, it will focus on implications for new therapeutic strategies targeting Epithelial-Mesenchymal Transition (EMT). The colonic crypt is a highly structured epithelial unit that functions in maintaining homeostasis through a complex physiological function of diverse cell types: SCs, transit-amplifying (TA) progenitors, goblet cells, absorptive colonocytes, Paneth-like cells, M cells, tuft cells, and enteroendocrine cells. These cellular subpopulations are spatially organized and regulated by multiple crucial signaling pathways, including …

Modeling Musculoskeletal Combat Casualty Care: Nato Trauma System Performance In Large Scale Combat Operations, Mark P. Cote, Kaitlyn E. Holly, Roman J. Schoenfeld, Matthew R. Bryan, Malina O. Hatton, Mitchel B. Harris, Tracey P. Koehlmoos, Andrew J. Schoenfeld

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: It is unclear whether the current North Atlantic Treaty Organization (NATO) trauma system will be effective in the setting of Large-Scale Combat Operations (LSCO). We sought to model the efficacy of the NATO trauma system in the setting of LSCO. We also intended to model novel scenarios that could better adapt the current system to LSCO.

METHODS: We developed a discrete-event simulation model for patients with combat musculoskeletal injuries treated within the standard NATO system. The primary outcome of the model was survival. The model's health states were characterized as stable, hypovolemia, sepsis, shock, or death. The model simulated …

National Alliance Of Sickle Cell Centers Consensus Standards For Transition To Adult Care In Sickle Cell Disease, Stephanie Howe Guarino, Akshat Jain, Mohan Madisetti, Kenneth Rivlin, Payal C. Desai, Julie Kanter, Sophie Lanzkron, Deepa Manwani

Division of Gastroenterology and Hepatology Faculty Papers

Sickle cell disease (SCD), an autosomal recessive hemoglobinopathy, affects ∼100 000 people in the United States.1 The process of transitioning from pediatric to adult SCD health care systems can be disjointed and poorly coordinated, contributing to the high morbidity and mortality seen in this population. There is no universally accepted definition of a successful SCD care transition, nor are there existing standards and recommendations for SCD clinicians. National Alliance of Sickle Cell Centers (NASCC) uses a described modified Delphi process to reach consensus among its members, through which we defined standards and recommendations for transitioning care from pediatric to adult …

Integrating Ki-67 And Treatment Strategies To Guide Prognosis In High-Grade Meningiomas: A Multivariable Analysis Of Prognostic Factors In Who Grade Ii/Iii Meningiomas, Anthony Chen, Aneesh Reddy, Toren Ikea-Mario, Shray Jain, Zhenghao Xiao, Nilanjan Haldar, Md, James J. Evans, Md, Wenyin Shi, Md, Phd

Department of Radiation Oncology Posters

Introduction

• High-grade meningiomas (WHO Grade II/III) are associated with high recurrence rates and poor survival despite aggressive therapy
• Adjuvant radiotherapy’s (RT) benefit after gross total resection (GTR) remains uncertain and histopathologic markers such as Ki-67 may further refine risk stratification and inform postoperative management
• AIM: to identify the role of RT and clinicopathologic predictors of local failure-free survival (LFFS) and overall survival (OS) in high-grade meningiomas

Can Low-Dose Radiation Therapy (Ld-Rt) Aid In Chronic Subdural Hematoma (Csdh) Management? Literature Review And Proposed Clinical Trial Design, Ryan Shah, Bs, Nilanjan Haldar, Md, Debanjan Haldar, Md, Keenan Piper, Md, Wenyin Shi, Md, Phd, Pascal Jabbour, Md

Department of Radiation Oncology Posters

Introduction + Methods

• Chronic subdural hematoma (cSDH) is a common neurosurgical condition, complicated by high rates of hematoma recurrence.
• There is growing interest in less invasive management options for primary and adjunctive treatment, such as middle meningeal artery embolization (MMAE).
• Low-dose radiation therapy (LD-RT) is an emerging noninvasive treatment for a range of inflammatory conditions, raising the question of whether LD-RT could benefit cSDH patients.
• Literature review was conducted to describe cSDH pathophysiology, the therapeutic mechanisms of LD-RT, and any clinical evidence supporting the efficacy of LD-RT for cSDH.
• Based on these findings, a randomized controlled trial design and …