Medicine and Health Sciences Commons^™

Project Prevent: A Randomized Controlled Trial Of Preoperative Vaginal Metronidazole To Decrease Patient Issues And Infections After Hysterectomy, Tana Pradhan, Helen Zhang, Amanda Kadesh, Ama Buskwofie, Sonali Patankar, Sharifa Menon, Timothy Ryntz, Cara Grimes

Abington Jefferson Health Papers

OBJECTIVES: To evaluate if vaginal metronidazole for 5 days before hysterectomy decreases postoperative infections and patient issues.

DESIGN: This randomized trial compared vaginal metronidazole for 5 days before a scheduled hysterectomy to no intervention. Sample size calculation was based on a 20% difference in issues and infection (30% incidence and 10% in the intervention arm) with 80% power and an alpha error of 0.05 and indicated 62 subjects needed in each arm.

SETTING: Outpatient gynecology clinics at a single academic institution.

PARTICIPANTS: 154 subjects were screened for eligibility between July 2020 and September 2022. 133 underwent hysterectomy including 68 subjects …

Green Oxidation Of Aromatic Hydrazide Derivatives Using An Oxoammonium Salt, Nidheesh Phadnis, Jessica A. Molen, Shannon M. Stephens, Shayne M. Weierbach, Kyle M. Lambert, John A. Milligan

College of Life Sciences Faculty Papers

Aromatic diazenes are often prepared by oxidation of the corresponding hydrazides using stoichiometric quantities of nonrecyclable oxidants. We developed a convenient alternative protocol for the oxidation of aromatic hydrazides using Bobbitt's salt (1), a metal-free, recyclable, and commercially available oxoammonium reagent. A variety of aryl hydrazides were oxidized within 75 min at room temperature using the developed protocol. Computational insight suggests that this oxidation occurs by a polar hydride transfer mechanism.

Increased Cardiovascular Risk In Epilepsy, Mark Gaertner, Scott Mintzer, Christopher Degiorgio

Department of Neurology Faculty Papers

Epilepsy is associated with increased mortality. Cardiovascular disease confers a significant portion of this increased risk. Recently there is increased interest in the burden of cardiovascular mortality in people with epilepsy. This review discusses the most common cardiovascular risk factors and their association with epilepsy including obesity, diabetes mellitus, and hyperlipidemia. Hyperlipidemia related to the use of enzyme inducing anti-seizure medications is also discussed as a topic that is of particular importance to prescribers that have patients with comorbid cardiovascular risk and epilepsy. Heart rate variability (HRV) and its association with SUDEP is discussed as well as a contributor to …

Association Of Multiple Metabolic And Cardiovascular Markers With The Risk Of Cognitive Decline And Mortality In Adults With Alzheimer’S Disease And Ad-Related Dementia Or Cognitive Decline: A Prospective Cohort Study, Longjian Liu, Edward Gracely, Xiaopeng Zhao, Gediminas Gliebus, Nathalie May, Stella Volpe, Jingyi Shi, Rose Ann Dimaria-Ghalili, Howard Eisen

Division of Cardiology Faculty Papers

BACKGROUND AND OBJECTIVES: There is a scarcity of data stemming from large-scale epidemiological longitudinal studies focusing on potentially preventable and controllable risk factors for Alzheimer's disease (AD) and AD-related dementia (ADRD). This study aimed to examine the effect of multiple metabolic factors and cardiovascular disorders on the risk of cognitive decline and AD/ADRD.

METHODS: We analyzed a cohort of 6,440 participants aged 45-84 years at baseline. Multiple metabolic and cardiovascular disorder factors included the five components of the metabolic syndrome [waist circumference, high blood pressure (HBP), elevated glucose and triglyceride (TG) concentrations, and reduced high-density lipoprotein cholesterol (HDL-C) concentrations], C-reactive …

Deep-Learning-Based Group Pointwise Spatial Mapping Of Structure To Function In Glaucoma, Zhiqi Chen, Hiroshi Ishikawa, Yao Wang, Gadi Wollstein, Joel Schuman

Wills Eye Hospital Papers

PURPOSE: To establish generalizable pointwise spatial relationship between structure and function through occlusion analysis of a deep-learning (DL) model for predicting the visual field (VF) sensitivities from 3-dimensional (3D) OCT scan.

DESIGN: Retrospective cross-sectional study.

PARTICIPANTS: A total of 2151 eyes from 1129 patients.

METHODS: A DL model was trained to predict 52 VF sensitivities of 24-2 standard automated perimetry from 3D spectral-domain OCT images of the optic nerve head (ONH) with 12 915 OCT-VF pairs. Using occlusion analysis, the contribution of each individual cube covering a 240 × 240 × 31.25 μm region of the ONH to the model's …

Gibbon Surgical Review, Volume 7, Issue 1, 2024

Gibbon Surgical Review

Table of Contents

6 - Socially Responsible Surgery: Better Practices for Better Outcomes

8 - Interview with Dr. Talar Tatarian - Assistant Professor

10 - Global Surgery : Current State and Involvement as a Trainee

12 - Interview with Dr. Ibnouf Sulieman - Transplant Surgery Fellow

14 - Resident Spotlight - Dr. Sam Nasser - PGY3

16 - A Review of the FIRST and SECOND Trials

18 - Residency Signaling in General Surgery

20 - Navigating Competency: Entrustable Professional Activities (EPAs)

22 - The Effect of Language Barriers on Surgical Outcomes

24 - Research Spotlight: The First Complete Human Eye …

Delayed Onset Of Neonatal Compartment Syndrome Associated With Compound Fetal Presentation, Nicholas Manini, Hayato Unno

Department of Medicine Faculty Papers

Neonatal compartment syndrome, although rare, has a classic presentation with sentinel skin findings and development of swelling, erythema, and tenderness of the affected extremity. Neonatal compartment syndrome requires prompt surgical intervention to preserve the affected limb and ensure its normal growth and development. Our patient was born at term via vaginal delivery complicated by a compound presentation involving the left upper extremity. No physical exam abnormalities were noted at birth, but she developed signs of neonatal compartment syndrome by 15 h of life. She was surgically treated at 22 h of life and recovered well. At one year of age, …

The Role Of Acgme-International In Enhancing Opportunities Of Residents For Advanced Subspecialty Training, James A. Arrighi, Lorraine C. Lewis, Thomas J. Nasca

Department of Medicine Faculty Papers

No abstract provided.

Role Of Mechanoregulation In Mast Cell-Mediated Immune Inflammation Of The Smooth Muscle In The Pathophysiology Of Esophageal Motility Disorders, Raj Goyal, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

Major esophageal disorders involve obstructive transport of bolus to the stomach, causing symptoms of dysphagia and impaired clearing of the refluxed gastric contents. These may occur due to mechanical constriction of the esophageal lumen or loss of relaxation associated with deglutitive inhibition, as in achalasia-like disorders. Recently, immune inflammation has been identified as an important cause of esophageal strictures and the loss of inhibitory neurotransmission. These disorders are also associated with smooth muscle hypertrophy and hypercontractility, whose cause is unknown. This review investigated immune inflammation in the causation of smooth muscle changes in obstructive esophageal bolus transport. Findings suggest that …

Ic3d Classification Of Corneal Dystrophies-Edition 3, Jayne Weiss, Christopher Rapuano, Berthold Seitz, Massimo Busin, Tero Kivelä, Nacim Bouheraoua, Cecilie Bredrup, Ken Nischal, Harshvardhan Chawla, Vincent Borderie, Kenneth Kenyon, Eung Kweon Kim, Hans Ulrik Møller, Francis Munier, Tim Berger, Walter Lisch

Wills Eye Hospital Papers

PURPOSE: The International Committee for the Classification of Corneal Dystrophies (IC3D) was created in 2005 to develop a new classification system integrating current information on phenotype, histopathology, and genetic analysis. This update is the third edition of the IC3D nomenclature.

METHODS: Peer-reviewed publications from 2014 to 2023 were evaluated. The new information was used to update the anatomic classification and each of the 22 standardized templates including the level of evidence for being a corneal dystrophy [from category 1 (most evidence) to category 4 (least evidence)].

RESULTS: Epithelial recurrent erosion dystrophies now include epithelial recurrent erosion dystrophy, category 1 ( …

The Design Of A Quality Improvement Dashboard For Monitoring Spinal Cord And Column Injuries, Zahra Azadmanjir, Mohsen Sadeghi-Naini, Mohammad Dashtkoohi, Maziar Moradi-Lakeh, Jalil Arabkheradmand, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

Background: Interactive dashboards are a powerful tool for dynamic visualization and monitoring of patient performance and serve as a useful to for optimal decision-making. The National Spinal Column and Cord Injury Registry of Iran (NSCIR-IR) was designed to efficiently display and broadcast important patient care data. This has been achieved through an electronic dashboard display (graph and visual displays), rather than traditional static paper reports (text). Objectives: The objective of this study was to design and develop an electronic visual dashboard as a display system to monitor the quality of care in the NSCIR-IR collaborating centers. Methods: The indicators chosen …

A Word From The Writing Team (April 2024), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Join Us for Our Virtual Writing Retreat on April 5th
• Attend a Packback Workshop
• Check Out the Spring 2024 Research Support Newsletter
• Learn about the Ethics of AI at Jefferson's Research Compliance Symposium
• Attend a Reception for the Drs. Theresa and Charles Yeo Writing Prize Winners on April 25th
• Publication Spotlight
• Jefferson's AI Library Guide is Available on the Library Website
• The OPWPC Canvas Page Offers Helpful Tools
• Scott Memorial Library Archive Renovations are Almost Done!
• Wiley Open Access Fees Waived for Jefferson Authors

Icnirp Statement On Short Wavelength Light Exposure From Indoor Artificial Sources And Human Health, Sharon Miller, Christian Cajochen, Adele Green, John Hanifin, Anke Huss, Ken Karipidis, Sarah Loughran, Gunnhild Oftedal, John O'Hagan, David H Sliney, Rodney Croft, Eric Van Rongen, Nigel Cridland, Guglielmo D'Inzeo, Akimasa Hirata, Carmela Marino, Martin Röösli, Soichi Watanabe

Department of Neuroscience Faculty Papers

Concerns have been raised about the possibility of effects from exposure to short wavelength light (SWL), defined here as 380-550 nm, on human health. The spectral sensitivity of the human circadian timing system peaks at around 480 nm, much shorter than the peak sensitivity of daytime vision (i.e., 555 nm). Some experimental studies have demonstrated effects on the circadian timing system and on sleep from SWL exposure, especially when SWL exposure occurs in the evening or at night. The International Commission on Non-Ionizing Radiation Protection (ICNIRP) has identified a lack of consensus among public health officials regarding whether SWL from …

Proteoglycan Dysfunction: A Common Link Between Intervertebral Disc Degeneration And Skeletal Dysplasia, Kimheak Sao, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Proteoglycans through their sulfated glycosaminoglycans regulate cell-matrix signaling during tissue development, regeneration, and degeneration processes. Large extracellular proteoglycans such as aggrecan, versican, and perlecan are especially important for the structural integrity of the intervertebral disc and cartilage during development. In these tissues, proteoglycans are responsible for hydration, joint flexibility, and the absorption of mechanical loads. Loss or reduction of these molecules can lead to disc degeneration and skeletal dysplasia, evident from loss of disc height or defects in skeletal development respectively. In this review, we discuss the common proteoglycans found in the disc and cartilage and elaborate on various murine …

Real World Clinical Experience Using Daily Intelligence-Assisted Online Adaptive Radiotherapy For Head And Neck Cancer, Philip Blumenfeld, Eduard Arbit, Robert Den, Ayman Salhab, Tal Falick Michaeli, Marc Wygoda, Yair Hillman, Raphael Pfeffer, Marcel Fang, Yael Misrati, Noam Weizman, Jon Feldman, Aron Popovtzer

Department of Radiation Oncology Faculty Papers

Background

Adaptive radiation therapy (ART) offers a dynamic approach to address structural and spatial changes that occur during radiotherapy (RT) for locally advanced head and neck cancers. The integration of daily ART with Cone-Beam CT (CBCT) imaging presents a solution to enhance the therapeutic ratio by addressing inter-fractional changes.

Methods

We evaluated the initial clinical experience of daily ART for patients with head and neck cancer using an online adaptive platform with intelligence-assisted workflows on daily CBCT. Treatment included auto-contour and structure deformation of Organs at Risk (OARs) and target structures, with adjustments by the treating physician. Two plans were …

The Effect Of Cervical Pessary On Increasing Gestational Age At Delivery In Twin Pregnancies With Asymptomatic Short Cervix: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Amir Hossein Norooznezhad, Nikan Zargarzadeh, Ali Javinani, Seyedeh Maedeh Nabavian, Shohra Qaderi, Shayan Mostafaei, Vincenzo Berghella, Yinka Oyelese, Alireza A. Shamshirsaz

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The incidence of preterm delivery is much higher in twin pregnancies than in singletons and even higher if a short cervical length is detected in the second trimester. Studies are contradictory regarding the efficacy of a cervical pessary to decrease preterm birth in twin pregnancies and short cervical length. To conduct a systematic review and meta-analysis investigating the efficacy of cervical pessary in prolonging gestation, preventing preterm birth, and reducing adverse neonatal outcomes in twin pregnancies with an asymptomatic short cervix.

DATA SOURCES: PubMed, Scopus, Web of Science, and ClinicalTrials.org were searched for randomized controlled trials from inception to …

The Psychological Burden Of Nmosd - A Mixed Method Study Of Patients And Caregivers, Darcy C. Esiason, Nicole Ciesinski, Chelsi N. Nurse, Wendy Erler, Tom Hattrich, Ankita Deshpande, C. Virginia O'Hayer

Department of Psychiatry and Human Behavior Faculty Papers

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system with common symptoms of rapid onset of eye pain, loss of vision, neck/back pain, paralysis, bowel and bladder dysfunction and heat sensitivity. The rare, unpredictable, and debilitating nature of NMOSD constitutes a unique psychological burden for patients and their caregivers, the specific nature and extent of which is not yet known. This mixed methods study, informed by both quantitative and qualitative data collected via self-report measures, focus groups, and in-depth interviews, aims to investigate and understand the psychological burden of patients with NMOSD and their caregiver/loved …

Non-Thermal Plasma Reduces Hsv-1 Infection Of And Replication In Hacat Keratinocytes In Vitro, Julia Sutter, Jascha Brettschneider, Brian Wigdahl, Peter Bruggeman, Fred Krebs, Vandana Miller

Kimmel Cancer Center Faculty Papers

Herpes simplex virus type 1 (HSV-1) is a lifelong pathogen characterized by asymptomatic latent infection in the trigeminal ganglia (TG), with periodic outbreaks of cold sores caused by virus reactivation in the TG and subsequent replication in the oral mucosa. While antiviral therapies can provide relief from cold sores, they are unable to eliminate HSV-1. We provide experimental results that highlight non-thermal plasma (NTP) as a new alternative therapy for HSV-1 infection that would resolve cold sores faster and reduce the establishment of latent infection in the TG. Additionally, this study is the first to explore the use of NTP …

Devimistat Plus Chemotherapy Vs Chemotherapy Alone For Older Relapsed Or Refractory Patients With Aml: Results Of The Armada Trial, Timothy Pardee, Bayard Powell, Richard Larson, Joseph Maly, Michael Keng, Matthew Foster, Eun-Ji Choi, Heinz Sill, Thomas Cluzeau, Deepa Jeyakumar, Olga Frankfurt, Prapti Patel, Michael Schuster, Elisabeth Koller, Regis Costello, Uwe Platzbecker, Pau Montesinos, Susana Vives, Aziz Nazha, Rachel Cook, Carlos Vigil-Gonzales, Sylvain Chantepie, Sanjeev Luther, Jorge Cortes

Department of Medical Oncology Faculty Papers

Acute myeloid leukemia (AML) is an aggressive cancer of the myeloid lineage. Outcomes in older patients are poor, with high rates of resistant and relapsed disease. Devimistat is a lipoic acid analog that inhibits mitochondrial metabolism. Devimistat combined with high-dose cytarabine and mitoxantrone resulted in promising phase 1 and 2 response rates especially in older patients. Therefore, the phase 3 ARMADA 2000 trial was conducted in patients aged ≥50 years with relapsed or refractory AML. The study randomized patients between devimistat combined with high-dose cytarabine and mitoxantrone (CHAM) or 1 of 3 control treatment regimens without devimistat: high-dose cytarabine and …

Sans-Cnn: An Automated Machine Learning Technique For Spaceflight Associated Neuro-Ocular Syndrome With Astronaut Imaging Data, Sharif Amit Kamran, Khondker Fariha Hossain, Joshua Ong, Nasif Zaman, Ethan Waisberg, Phani Paladugu, Andrew Lee, Alireza Tavakkoli

SKMC Student Presentations and Publications

Spaceflight associated neuro-ocular syndrome (SANS) is one of the largest physiologic barriers to spaceflight and requires evaluation and mitigation for future planetary missions. As the spaceflight environment is a clinically limited environment, the purpose of this research is to provide automated, early detection and prognosis of SANS with a machine learning model trained and validated on astronaut SANS optical coherence tomography (OCT) images. In this study, we present a lightweight convolutional neural network (CNN) incorporating an EfficientNet encoder for detecting SANS from OCT images titled "SANS-CNN." We used 6303 OCT B-scan images for training/validation (80%/20% split) and 945 for testing …

Frailty Assessment In Prospective Lvad Candidates: An International Survey, Malachy Clancy, Phd, Otr/L, Bcpr, Sarah Schroeder, Phd, Acpn-Bc, Msn, Rn, Aacc, Yu Wu, Dnp, Agacnp

Department of Occupational Therapy Posters and Presentations

Introduction

• The concept of frailty, initially developed in geriatrics, has recently been applied to individuals with heart failure (HF) and is recognized as an essential measure for prognostication of health status and predicting health outcomes
• Frailty remains highly prevalent, ranging between 56-79% in those undergoing left ventricular assist device (LVAD) evaluation¹ and is associated with poor postoperative outcomes.²
• Since little is known about frailty assessment and instruments used, this study aimed to evaluate institutional assessment processes of frailty during evaluation and the implications of frailty in LVAD eligibility.

S100a8/A9 As A Prognostic Biomarker With Causal Effects For Post-Acute Myocardial Infarction Heart Failure, Jie Ma, Yang Li, Ping Li, Xinying Yang, Shuolin Zhu, Ke Ma, Fei Gao, Hai Gao, Hui Zhang, Xin-Liang Ma, Jie Du, Yulin Li

Department of Emergency Medicine Faculty Papers

Heart failure is the prevalent complication of acute myocardial infarction. We aim to identify a biomarker for heart failure post-acute myocardial infarction. This observational study includes 1062 and 1043 patients with acute myocardial infarction in the discovery and validation cohorts, respectively. The outcomes are in-hospital and long-term heart failure events. S100A8/A9 is screened out through proteomic analysis, and elevated circulating S100A8/A9 is independently associated with heart failure in discovery and validation cohorts. Furthermore, the predictive value of S100A8/A9 is superior to the traditional biomarkers, and the addition of S100A8/A9 improves the risk estimation using traditional risk factors. We finally report …

Biomarkers For Managing Neurodegenerative Diseases, Lara Cheslow, Adam E. Snook, Scott A. Waldman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Neurological disorders are the leading cause of cognitive and physical disability worldwide, affecting 15% of the global population. Due to the demographics of aging, the prevalence of neurological disorders, including neurodegenerative diseases, will double over the next two decades. Unfortunately, while available therapies provide symptomatic relief for cognitive and motor impairment, there is an urgent unmet need to develop disease-modifying therapies that slow the rate of pathological progression. In that context, biomarkers could identify at-risk and prodromal patients, monitor disease progression, track responses to therapy, and parse the causality of molecular events to identify novel targets for further clinical investigation. …

Novel Frameless Linac Radiosurgery Solution For Uveal Melanoma, Louis Cappelli, Mehak Khan, Sudheshna Vemula, Christina Hum, Haisong Lui, Yan Yu, Yingxuan Chen, Yechi Zhang, Muhammad Sharif, Wenyin Shi

Department of Radiation Oncology Faculty Papers

INTRODUCTION: Radiation treatment has replaced enucleation as an organ-preservation treatment for patients with uveal melanoma (UM). We developed a novel non-invasive, frameless LINAC based solution for fractionated stereotactic radiosurgery (fSRS) treatment.

METHODS: We designed and constructed the a stereotactic ocular localization box that can be attached and indexed to a stereotactic LINAC tabletop. It contains adjustable LED lights as a gaze focus point and CCD camera for monitoring of the patient's eye position. The device also has 6 infrared spheres compatible with the ExacTRAC IGRT system. Treatment plans were developed using iPLAN Dose version 4.5, with conformal dynamic arcs and …

Advocacy Connection Team-Now Educational Program For Headache Fellows And Patients/Caregivers: Assessment Of Educational Objectives, Courtney Seebadri-White, Hsiangkuo Yuan, William B. Young, Karissa N. Arca

Department of Neurology Faculty Papers

OBJECTIVE: To assess for improvement in comfort in participating in advocacy for migraine and headache disorders and knowledge needed for successful advocacy.

BACKGROUND: The Advocacy Connection Team (ACT)-Now program is an educational program offered through Miles for Migraine, a non-profit advocacy organization. It is designed to teach headache fellows and patients advocacy skills.

METHODS: In a cross-sectional pre-test-post-test design, the 2021 ACT-Now cohort of 98 participants were administered a set of 11 pre-course survey questions identifying their role (healthcare provider/headache fellow or patient/caregiver), baseline knowledge of migraine-related disability and stigma, and baseline engagement and comfort with advocating. The post-course survey …

A Clinical Practice Guideline For The Management Of Patients With Acute Spinal Cord Injury: Recommendations On Hemodynamic Management, Brian K. Kwon, Lindsay A. Tetreault, Allan R. Martin, Paul M. Arnold, Rex A.W. Marco, Virginia F.J Newcombe, Carl M. Zipser, Stephen L. Mckenna, Radha Korupolu, Chris J. Neal, Rajiv Saigal, Nina E. Glass, Sam Douglas, Mario Ganau, Vafa Rahimi-Movaghar, James S. Harrop, Bizhan Aarabi, Jefferson R. Wilson, Nathan Evaniew, Andrea C. Skelly, Michael G. Fehlings

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Clinical practice guideline development following the GRADE process.

OBJECTIVES: Hemodynamic management is one of the only available treatment options that likely improves neurologic outcomes in patients with acute traumatic spinal cord injury (SCI). Augmenting mean arterial pressure (MAP) aims to improve blood perfusion and oxygen delivery to the injured spinal cord in order to minimize secondary ischemic damage to neural tissue. The objective of this guideline was to update the 2013 AANS/CNS recommendations on the hemodynamic management of patients with acute traumatic SCI, acknowledging that much has been published in this area since its publication. Specifically, we sought …

Risk Of Secondary Malignancies After Pelvic Radiation: A Population-Based Analysis, Connor Mcpartland, Andrew Salib, Joshua Banks, James R. Mark, Costas D. Lallas, Edouard J. Trabulsi, Leonard G. Gomella, Hannan Goldberg, Benjamin Leiby, Robert Den, Thenappan Chandrasekar

Department of Urology Faculty Papers

Background and objective

Radiation therapy has increasingly been used in the management of pelvic malignancies. However, the use of radiation continues to pose a risk of a secondary malignancy to its recipients. This study investigates the risk of secondary malignancy development following radiation for primary pelvic malignancies.

Methods

A retrospective cohort review of the Surveillance, Epidemiology, and End Results database from 1975 to 2016 was performed. Primary pelvic malignancies were subdivided based on the receipt of radiation, and secondary malignancies were stratified as pelvic or nonpelvic to investigate the local effect of radiation.

Key findings and limitations

A total of …

Discordance Interpretation Of Left Ventricular Size Between Echocardiography And Cardiac Magnetic Resonance In Pediatric Patients With Aortic/Mitral Regurgitation, Anastasia Barros, Michelle Udine, Chris Spurney, Laura Olivieri, Yue-Hin Loke

Jefferson Hospital Staff Papers and Presentations

PURPOSE: This study investigated discordance between echocardiography (echo) and cardiac magnetic resonance (CMR) measurements of the left ventricle (LV) in pediatric patients with aortic and/or mitral regurgitation (AR/MR).

METHODS: Retrospective cohort study of pediatric patients. The cohorts were comprised of patients with AR/MR vs. non-AR/MR. Left ventricular end diastolic volume (LVEDV) by CMR and left ventricular internal diameter diastolic (LVIDd) by echo were obtained from clinical reports then echo images were reviewed to remeasure LVEDV by bullet method. Left ventricular internal diameter systolic (LVIDs) and left ventricular ejection fraction (LVEF) measurements by echo and LVEF by CMR were obtained from …

Edge-Wise Analysis Reveals White Matter Connectivity Associated With Focal To Bilateral Tonic-Clonic Seizures, Sam S. Javidi, Xiaosong He, Ankeeta Ankeeta, Qirui Zhang, Salvatore Citro, Michael R. Sperling, Joseph I. Tracy

Farber Institute for Neuroscience Faculty Papers

OBJECTIVE: Focal to bilateral tonic-clonic seizures (FBTCS) represent a challenging subtype of focal temporal lobe epilepsy (TLE) in terms of both severity and treatment response. Most studies have focused on regional brain analysis that is agnostic to the distribution of white matter (WM) pathways associated with a node. We implemented a more selective, edge-wise approach that allowed for identification of the individual connections unique to FBTCS.

METHODS: T1-weighted and diffusion-weighted images were obtained from 22 patients with solely focal seizures (FS), 43 FBTCS patients, and 65 age/sex-matched healthy participants (HPs), yielding streamline (STR) connectome matrices. We used diffusion tensor-derived STRs …

Temporal Considerations In Brain Metastases Radiation Therapy: The Intersection Of Chronobiology And Patient Profiles, Nicolas Nelson, Sara Burke, Louis Cappelli, Lauren Matlack, Alexandria Smith, Noelle Francois, Joseph Lombardo, Yash Shah, Kuang-Yi Wen, Ayesha A Shafi, Nicole Simone

Department of Radiation Oncology Faculty Papers

The circadian system, a vital temporal regulator influencing physiological processes, has implications for cancer development and treatment response. Our study assessed circadian timing’s impact on whole-brain radiotherapy outcomes in brain metastases for personalized cancer therapy insights. The aim of the study was to evaluate circadian influence on radiation treatment timing and its correlation with clinical outcomes and to identify patient populations benefiting from interventions synchronizing circadian rhythms, considering subgroup differences and potential disparities. An IRB-approved retrospective analysis of 237 patients undergoing whole-brain radiotherapy for brain metastases (2017–2021), receiving over 80% of treatments in the morning or afternoon, was performed. Survival …