Medicine and Health Sciences Commons^™

Automatic Diagnosis Of Late-Life Depression By 3d Convolutional Neural Networks And Cross-Sample Entropy Analysis From Resting-State Fmri, Chemin Lin, Shwu-Hua Lee, Chih-Mao Huang, Guan-Yen Chen, Wei Chang, Ho-Ling Liu, Shu-Hang Ng, Tatia Mei-Chun Lee, Shun-Chi Wu

Faculty, Staff and Student Publications

Resting-state fMRI has been widely used in investigating the pathophysiology of late-life depression (LLD). Unlike the conventional linear approach, cross-sample entropy (CSE) analysis shows the nonlinear property in fMRI signals between brain regions. Moreover, recent advances in deep learning, such as convolutional neural networks (CNNs), provide a timely application for understanding LLD. Accurate and prompt diagnosis is essential in LLD; hence, this study aimed to combine CNN and CSE analysis to discriminate LLD patients and non-depressed comparison older adults based on brain resting-state fMRI signals. Seventy-seven older adults, including 49 patients and 28 comparison older adults, were included for fMRI …

Clinical Features Associated With Outcomes And Biomarker Analysis Of Dabrafenib Plus Trametinib Treatment In Patients With Braf-Mutant Melanoma Brain Metastases, James S Wilmott, Hussein Tawbi, Johnathan A Engh, Nduka M Amankulor, Brindha Shivalingam, Hiya Banerjee, Ismael A Vergara, Hansol Lee, Peter A Johansson, Peter M Ferguson, Philippe Saiag, Caroline Robert, Jean-Jacques Grob, Lisa H Butterfield, Richard A Scolyer, John M Kirkwood, Georgina V Long, Michael A Davies

Faculty, Staff and Student Publications

PURPOSE: This study aimed to identify baseline clinical features associated with the outcomes of patients enrolled in the COMBI-MB phase II study of dabrafenib and trametinib treatment in patients with V600 BRAF-mutant metastatic melanoma with melanoma brain metastases (MBM). Exploratory biomarker analysis was also conducted as part of the synergistic COMBI-BRV trial (BRV116521), to identify molecular and immunologic changes associated with dabrafenib in MBMs and extracranial metastases (ECM).

PATIENTS AND METHODS: Post hoc analysis was performed for baseline features of patients (n = 125) enrolled in COMBI-MB. Analyses were performed to identify baseline clinical features associated with intracranial response rate …

Smart Start: Rituximab, Lenalidomide, And Ibrutinib In Patients With Newly Diagnosed Large B-Cell Lymphoma, Jason Westin, R Eric Davis, Lei Feng, Fredrick Hagemeister, Raphael Steiner, Hun Ju Lee, Luis Fayad, Loretta Nastoupil, Sairah Ahmed, Alma Rodriguez, Michelle Fanale, Felipe Samaniego, Swaminathan P Iyer, Ranjit Nair, Yasuhiro Oki, Nathan Fowler, Michael Wang, Man Chun John Ma, Francisco Vega, Timothy Mcdonnell, Chelsea Pinnix, Donna Griffith, Yang Lu, Sanjit Tewari, Ryan Sun, David W Scott, Christopher R Flowers, Sattva Neelapu, Michael R Green

Faculty, Staff and Student Publications

PURPOSE: Chemoimmunotherapy for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) is largely unchanged for decades. Both preclinical models and clinical data suggest the combination of lenalidomide and ibrutinib may have synergy in DLBCL, particularly in the non-germinal center B-cell-like subset.

METHODS: We enrolled 60 patients with newly diagnosed non-germinal center B-cell-like DLBCL in this investigator-initiated, single-arm phase II trial of rituximab, lenalidomide, and ibrutinib (RLI) with the sequential addition of chemotherapy (ClinicalTrials.gov identifier: NCT02636322). Patients were treated with rituximab 375 mg/m

RESULTS: The median age was 63.5 years (range, 29-83 years) with 28% age 70 years or older. …

A Genome-Wide Association Study Identified Novel Genetic Susceptibility Loci For Oral Cancer In Taiwan, Da-Tian Bau, Ting-Yuan Liu, Chia-Wen Tsai, Wen-Shin Chang, Jian Gu, Jai-Sing Yang, Liang-Chun Shih, Fuu-Jen Tsai

Faculty, Staff and Student Publications

Taiwan has the highest incidence rate of oral cancer in the world. Although oral cancer is mostly an environmentally induced cancer, genetic factors also play an important role in its etiology. Genome-wide association studies (GWAS) have identified nine susceptibility regions for oral cancers in populations of European descent. In this study, we performed the first GWAS of oral cancer in Taiwan with 1529 cases and 44,572 controls. We confirmed two previously reported loci on the 6p21.33 (HLA-B) and 6p21.32 (HLA-DQ gene cluster) loci, highlighting the importance of the human leukocyte antigen and, hence, the immunologic mechanisms in oral carcinogenesis. The …

The Gdf15-Gfral Axis Mediates Chemotherapy-Induced Fatigue In Mice, Brandon Chelette, Chinenye L Chidomere, Robert Dantzer

Faculty, Staff and Student Publications

Cancer-related fatigue is defined as a distressing persistent subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and that interferes with usual functioning. This form of fatigue is highly prevalent during cancer treatment and in some patients, it can persist for years after treatment has ended. An understanding of the mechanisms that drive cancer-related fatigue is still lacking, which hampers the identification of effective treatment options. Various chemotherapeutic agents including cisplatin are known to induce mitochondrial dysfunction and this effect is known to mediate chemotherapy-induced peripheral …

Tissue-Resident Memory T Cells Trigger Rapid Exudation And Local Antibody Accumulation, Pamela C Rosato, Sahar Lotfi-Emran, Vineet Joag, Sathi Wijeyesinghe, Clare F Quarnstrom, Hanna N Degefu, Rebecca Nedellec, Jason M Schenkel, Lalit K Beura, Lars Hangartner, Dennis R Burton, David Masopust

Faculty, Staff and Student Publications

Adaptive immunity is didactically partitioned into humoral and cell-mediated effector mechanisms, which may imply that each arm is separate and does not function together. Here, we report that the activation of CD8+ resident memory T cells (TRM) in nonlymphoid tissues triggers vascular permeability, which facilitates rapid distribution of serum antibodies into local tissues. TRM reactivation was associated with transcriptional upregulation of antiviral signaling pathways as well as Fc receptors and components of the complement cascade. Effects were local, but evidence is presented that TRM in brain and reproductive mucosa are both competent to induce rapid antibody exudation. TRM reactivation in …

Brain Candy: Wayne State University School Of Medicine Journal Of Arts And Culture, 10th Edition, Wayne State University School Of Medicine Gold Humanism Honor Society

Gold Humanism Honor Society

Brain Candy incorporates paintings, written pieces, and poetry from all the medical classes at Wayne State University School of Medicine to shed light on the creative process in medicine, the city of Detroit, and the experiences of health care providers. The first edition of Brain Candy was published online and in print in 2009, produced by a generous grant by the Gold Humanism Honor Society (GHHS). The edition featured poetry, nonfiction, short fiction, and different types of artwork. With generous funding support from alumnus Dr. Tom Janisse, Class of 1975, the journal continues to be in print since 2009.

Effects Of A 12-Week Plant-Based Diet Program On Obese And Overweight Adults In Rural Michigan, Nadine Larcher

Doctor of Nursing Practice Projects

Background

Overweight and obesity among adults are a rising epidemic in the U.S. Obesity is a risk factor for many chronic diseases and impacts morbidity and mortality. Despite our high-tech medical care system in the U.S., we are losing the war on obesity due to not addressing the underlying problems. These include unhealthy lifestyles and an unhealthy diet. A growing body of research studies has shown that adopting a low-fat whole food plant-based diet (WFPBD) regime consisting of whole grains, fruits, vegetables, legumes, and no animal-based products is an effective measure to counteract the rising pandemic of chronic diseases related …

Effects Of A Mindfulness Intervention On Nurse Burnout, Sandra Elanges

Doctor of Nursing Practice Projects

Background

Before the COVID-19 pandemic, nurse retention was a known issue; current nurse retention has worsened. This project examined the burnout of nurses and offered some potential interventions to assist in retaining nurses in the field of nursing.

Purpose

To determine whether a six-week online mindfulness intervention improved the Oldenburg Burnout Inventory (OLBI) scores of nurse participants.

Methods

This project used a convenience snowball sample of participants recruited through social media platforms including Reddit, Twitter, Facebook, TikTok, AllNurses, and word of mouth. This quantitative quasi-experimental design utilized pre- and post-testing to measure baseline burnout and evaluate the intervention’s efficacy. The …

Factors And Behaviors Related To Successful Transition Of Care After Hospitalization For Ischemic Stroke, Chuanhui Dong, Hannah Gardener, Tatjana Rundek, Erika Marulanda, Carolina M Gutierrez, Iszet Campo-Bustillo, Gillian Gordon Perue, Karlon H Johnson, Ralph L Sacco, Jose G Romano, Transitions Of Care Stroke Disparities Study (Tcsd-S) Investigators

Faculty, Staff and Student Publications

BACKGROUND: Our objective is to describe adoption of the posthospitalization behaviors associated with successful transition of care and related baseline characteristics.

METHODS: This study includes 550 participants in the Transition of Care Stroke Disparities Study, a prospective observational cohort derived from the Florida Stroke Registry. Participants had an ischemic stroke (2018-2021), discharged home or to rehabilitation, with modified Rankin Scale score=0-3 (44% women, 24% Black, 48% White, 26% Hispanic, 35% foreign-born). We collected baseline sociodemographic and clinical characteristics. A structured telephone interview at 30-day postdischarge evaluated outcomes including medication adherence, medical appointment attendance, outpatient therapy, exercise, diet modification, toxic habit …

Embracing Heterogeneity In The Multicenter Stroke Preclinical Assessment Network (Span) Trial, Andreia Morais, Joseph J Locascio, Lauren H Sansing, Jessica Lamb, Karisma Nagarkatti, Takahiko Imai, Klaus Van Leyen, Jaroslaw Aronowski, James I Koenig, Francesca Bosetti, Patrick Lyden, Cenk Ayata, Span Investigators

Faculty, Staff and Student Publications

The Stroke Preclinical Assessment Network (SPAN) is a multicenter preclinical trial platform using rodent models of transient focal cerebral ischemia to address translational failure in experimental stroke. In addition to centralized randomization and blinding and large samples, SPAN aimed to introduce heterogeneity to simulate the heterogeneity embodied in clinical trials for robust conclusions. Here, we report the heterogeneity introduced by allowing the 6 SPAN laboratories to vary most of the biological and experimental model variables and the impact of this heterogeneity on middle cerebral artery occlusion (MCAo) performance. We included the modified intention-to-treat population of the control mouse cohort of …

Cognitive Evaluation In Parkinson’S Disease: Applying The Movement Disorder Society Recommendations In A Population With A Low Level Of Formal Education, Natalia Pessoa Rocha, Eduarda Xavier Carreira, Ana Carolina De Almeida Prado, Fabíola Tavares, Mayra Tavares, Francisco Cardoso, Antônio Jaeger, Leonardo Cruz De Souza, Antônio Lucio Teixeira

Faculty, Staff and Student Publications

Background  The diagnosis of cognitive disorders in Parkinson disease (PD) can be very challenging. Aiming at establishing uniform and reliable diagnostic procedures, the International Parkinson's Disease and Movement Disorder Society (MDS) commissioned task forces to delineate diagnostic criteria for mild cognitive impairment (MCI) and dementia in PD.

Objectives  To investigate the applicability of the MDS recommendations for cognitive evaluation in a Brazilian sample of patients with PD with low levels of formal education.

Methods  A total of 41 patients with PD were subjected to a comprehensive neuropsychological evaluation based on tests proposed by the MDS, which included the Mini-Mental State …

A Word From The Writing Team (February 2023), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Writing Retreats on First Fridays
• Faculty Days 2023 Deadline
• On-Demand Workshops

Massage Therapy For Children, Adolescents, And Young Adults: Clinical Delivery And Effectiveness In Hematology And Oncology, Samuel N. Rodgers-Melnick, Mandy Bartolovich, Neha J. Desai, Smitha Hosahalli Vasanna, Amma Owusu-Ansah, Sanjay P. Ahuja, Jeffery A. Dusek, David W. Miller

Student Scholarship

Background: Children, adolescents, and young adults with hematologic and/or oncologic conditions experience multiple, significant symptoms (e.g., pain, stress, and anxiety), which may be addressed by nonpharmacologic approaches such as massage therapy (MT). The purpose of this study was to describe the clinical delivery of MT provided by a certified pediatric massage therapist and assess effectiveness in two patient groups: those with sickle cell disease (SCD) or hematologic and/or oncologic conditions excluding SCD (HemOnc). Methods: Investigators conducted a retrospective review of MT sessions provided to patients 0–39 years with hematologic and/or oncologic conditions at a large pediatric academic medical center. Results: …

A Molecular Signature Defining Exercise Adaptation With Ageing And In Vivo Partial Reprogramming In Skeletal Muscle, Ronald G. Jones Iii, Andrea Dimet-Wiley, Amin Haghani, Francielly Morena Da Silva, Camille R. Brightwell, Seongkyun Lim, Sabin Khadgi, Yuan Wen, Corey M. Dungan, Robert T. Brooke, Nicholas P. Greene, Charlotte A. Peterson, John J. Mccarthy, Steve Horvath, Stanley J. Watowich, Christopher S. Fry, Kevin A. Murach

Health, Human Performance and Recreation Faculty Publications and Presentations

Exercise promotes functional improvements in aged tissues, but the extent to which it simulates partial molecular reprogramming is unknown. Using transcriptome profiling from (1) a skeletal muscle-specific in vivo Oct3/4, Klf4, Sox2 and Myc (OKSM) reprogramming-factor expression murine model; (2) an in vivo inducible muscle-specific Myc induction murine model; (3) a translatable high-volume hypertrophic exercise training approach in aged mice; and (4) human exercise muscle biopsies, we collectively defined exercise-induced genes that are common to partial reprogramming. Late-life exercise training lowered murine DNA methylation age according to several contemporary muscle-specific clocks. A comparison of the murine soleus transcriptome …

Hybrid Epicardial-Endocardial Ablation For Long-Standing Persistent Atrial Fibrillation: A Subanalysis Of The Converge Trial., David B Delurgio, Christopher Blauth, Michael E Halkos, Karl J Crossen, David Talton, Saumil R Oza, Anthony R Magnano, Mark A Mostovych, Sreedhar Billakanty, Steven Duff, Christopher Stees, Jason Sperling, Syed Ahsan, John Yap, Christian Shults, David Pederson, James Garrison, Paul Tabereaux, David M Gilligan, Graham Bundy, Otto Costantini, Eric Espinal, Angelo La Pietra, Felix Yang, Yisachar Greenberg, Israel Jacobowitz, Jaswinder Gill

Heart and Vascular Articles

BACKGROUND: Favorable clinical outcomes are difficult to achieve in long-standing persistent atrial fibrillation (LSPAF) with catheter ablation (CA). The CONVERGE (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent Atrial FIbrillation) trial evaluated the effectiveness of hybrid convergent (HC) ablation vs endocardial CA.

OBJECTIVE: The study sought to evaluate the safety and effectiveness of HC vs CA in the LSPAF subgroup from the CONVERGE trial.

METHODS: The CONVERGE trial was a prospective, multicenter, randomized trial that enrolled 153 patients at 27 sites. A post hoc analysis was performed on LSPAF patients. The primary effectiveness was freedom from …

Glucocorticoid Therapy As First-Line Treatment In Primary Hypophysitis: A Systematic Review And Individual Patient Data Meta-Analysis, Brijesh Krishnappa, Ravikumar Shah, Saba Samad Memon, Chakra Diwaker, Anurag R Lila, Virendra A Patil, Nalini S Shah, Tushar R Bandgar

Faculty, Staff and Student Publications

OBJECTIVES: High-dose glucocorticoids are associated with improved recovery of deficits in primary autoimmune hypophysitis (PAH), but optimal dosing, route, and duration are unclear.

DESIGN: We reviewed literature for first-line glucocorticoid treatment in PAH until December 2021 and performed an individual patient data meta-analysis to analyze clinical, hormonal, and radiological outcomes with respect to route, dose, and duration (12 weeks) of glucocorticoid treatment according to disease severity.

RESULTS: A total of 153 PAH patients from 83 publications were included. The median age at presentation was 41 (32.5-48) years with a female preponderance (70.3%). Visual field recovery was significantly better with i.v. …

Executive Function In Autism: Association With Adhd And Asd Symptoms, Rachel R Lee, Anthony R Ward, David M Lane, Michael G Aman, Katherine A Loveland, Rosleen Mansour, Deborah A Pearson

Faculty, Staff and Student Publications

There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD …

A Rare Case Of Survival After Traumatic Blunt Ventricular Rupture, Ryan Yang, Michael Van Gent, Thomas Clements, Bryan Cotton, Michael Wandling

Faculty, Staff and Student Publications

A male in his 40s presented to the trauma center via air ambulance after colliding with a cement wall at highway speeds. Cross-sectional imaging revealed a right ventricular pseudoaneurysm, confirmed by echocardiography. He was taken emergently to the operating room where he was found to have a pericardial laceration, hemopericardium and a right ventricular rupture, which was primarily repaired. Postoperatively, the patient was transferred to intensive care and after 34 days in the hospital was ultimately discharged home.

Cross-Institutional Virtual Mock Oral Examination: A New Paradigm?, Arvind D Manisundaram, Sairandri Sathyanarayanan, Janhavi V Govande, Erik S Marques, Phuong D Nguyen

Faculty, Staff and Student Publications

Mock oral examinations (MOEs) are shown to be valuable in preparation for national board oral examinations. Although traditionally conducted in-person, improved technological advances have supported exploring virtual alternatives. Furthermore, the cornoavirus disease 2019 pandemic has necessitated virtual learning. We hypothesized that the virtual platform would improve and expand the MOE experience to include collaborative institutions while approximating a board examination environment.

Methods: Sixteen senior plastic surgery residents and 14 faculty from three separate programs participated in a cross-institutional virtual MOE. Over a single day, each trainee was evaluated by two faculty from a separate institution on six scenarios, including digitally …

Clinical Characteristics, Microbiology And Outcomes Of A Cohort Of Patients Treated With Ceftolozane/Tazobactam In Acute Care Inpatient Facilities, Houston, Texas, Usa, Truc T Tran, Nicolo L Cabrera, Anne J Gonzales-Luna, Travis J Carlson, Faris Alnezary, William R Miller, Aki Sakurai, An Q Dinh, Kirsten Rydell, Rafael Rios, Lorena Diaz, Blake M Hanson, Jose M Munita, Claudia Pedroza, Samuel A Shelburne, Samuel L Aitken, Kevin W Garey, Ryan Dillon, Laura Puzniak, Cesar A Arias

Faculty, Staff and Student Publications

BACKGROUND: Ceftolozane/tazobactam is a β-lactam/β-lactamase inhibitor combination with activity against a variety of Gram-negative bacteria, including MDR

METHODS: We conducted a multicentre retrospective study of patients receiving at least 48 h of ceftolozane/tazobactam therapy from January 2016 through to September 2019 at two hospital systems in Houston. Demographic, clinical and microbiological data were collected, including the infecting bacterial isolate, when available. The primary outcome was composite clinical success at hospital discharge. Secondary outcomes included in-hospital mortality and clinical disposition at 14 and 30 days post ceftolozane/tazobactam initiation. Multivariable logistic regression analysis was used to identify predictors of the primary outcome …

Monoclonal Antibody For The Prevention Of Respiratory Syncytial Virus In Infants And Children: A Systematic Review And Network Meta-Analysis, Mingyao Sun, Honghao Lai, Feiyang Na, Sheng Li, Xia Qiu, Jinhui Tian, Zhigang Zhang, Long Ge

Faculty, Staff and Student Publications

IMPORTANCE: Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infection in children younger than 5 years; effective prevention strategies are urgently needed.

OBJECTIVE: To compare the efficacy and safety of monoclonal antibodies for the prevention of RSV infection in infants and children.

DATA SOURCES: In this systematic review and network meta-analysis, PubMed, Embase, CENTRAL, and ClinicalTrials.gov were searched from database inception to March 2022.

STUDY SELECTION: Randomized clinical trials that enrolled infants at high risk of RSV infection to receive a monoclonal antibody or placebo were included. Keywords and extensive vocabulary related to monoclonal antibodies, RSV, …

Public Health Measures And Sars-Cov-2 Cases In The Juvenile Justice System: Implications For Pandemic Response In The Detention Setting, Asha Davidson, Shelley Aggarwal, Mona Eissa, Laura Benjamins, John Will, Rebecca Beyda

Faculty, Staff and Student Publications

OBJECTIVE: The purpose of this study was to examine severe acute respiratory syndrome-coronavirus-2 case positivity in juvenile justice facilities of two different states alongside institutional, local, and state public health policies during the first 6 months of the coronavirus disease 2019 pandemic.

METHODS: This retrospective chart review examined two large, urban juvenile justice centers in California and Texas. Positive intake or day 12 tests were considered suggestive of community-acquired severe acute respiratory syndrome-coronavirus-2 infection. Researchers examined state and county restrictions, closings, and openings. The study included all of the youths 10 to 18 years residing in the facilities between March …

The Alzheimer’S Disease Risk Factor Inpp5d Restricts Neuroprotective Microglial Responses In Amyloid Beta-Mediated Pathology, Mary Claire Tuohy, Elizabeth M C Hillman, Randolph Marshall, Dritan Agalliu

Faculty, Staff and Student Publications

Stroke is a devastating cause of global morbidity and mortality. Ischemic brain injury triggers a profound local and systemic immune response that participates in stroke pathophysiology. In turn, this immune response has emerged as a potential therapeutic target. In order to maximize its therapeutic potential, it is critical to understand how the immune response to ischemic brain injury is affected by age - the strongest non-modifiable risk factor for stroke. The development of multi-omics and single-cell technologies has provided a more comprehensive characterization of transcriptional and cellular changes that occur during aging. In this review, we summarize recent advances in …

The Spatial And Temporal Structure Of Neural Activity Across The Fly Brain, Katherine E Maturen, Cheri L Canon, Joel G Fletcher, Amy K Hara, David H Kim, Jonathan B Kruskal, Frank H Miller, Erick M Remer, Stuart G Silverman

Faculty, Staff and Student Publications

In 2012, the Society of Abdominal Radiology (SAR) was formed by the merger of the Society of Gastrointestinal Radiologists (SGR) and the Society of Uroradiology (SUR). On the occasion of SAR's ten year anniversary, this commentary describes important changes in society structure, the growth and diversity of society membership, new educational and research initiatives, intersociety and international outreach, and plans for the future.

Ct Colonography Is The Perfect Colorectal Screening Test That Unfortunately Few People Use Yet, David H Kim

Faculty, Staff and Student Publications

Take-home points

• • Computed tomography colonography (CTC) is the perfect test among the colorectal cancer screening options.
• • The excellent performance of CTC is on par with colonoscopy for both cancers and precancerous polyps, yet without the risks associated with perforation and sedation.
• • CTC presents an opportunity to serve as an important filter and send the small numbers of high-risk lesions for immediate removal while allowing the identification of the few true precursor targets from the large majority of benign polyps.
• • This selective polypectomy strategy at CTC minimizes complications and waste of resources while maintaining advanced neoplasia detection …

Cross-Institutional Virtual Mock Oral Examination: A New Paradigm?, Arvind D Manisundaram, Sairandri Sathyanarayanan, Janhavi V Govande, Erik S Marques, Phuong D Nguyen

Faculty, Staff and Student Publications

Mock oral examinations (MOEs) are shown to be valuable in preparation for national board oral examinations. Although traditionally conducted in-person, improved technological advances have supported exploring virtual alternatives. Furthermore, the cornoavirus disease 2019 pandemic has necessitated virtual learning. We hypothesized that the virtual platform would improve and expand the MOE experience to include collaborative institutions while approximating a board examination environment.

METHODS: Sixteen senior plastic surgery residents and 14 faculty from three separate programs participated in a cross-institutional virtual MOE. Over a single day, each trainee was evaluated by two faculty from a separate institution on six scenarios, including digitally …

Zone 1 Endovascular Balloon Occlusion Of The Aorta Vs Resuscitative Thoracotomy For Patient Resuscitation After Severe Hemorrhagic Shock, Alexis L Cralley, Navin Vigneshwar, Ernest E Moore, Joseph Dubose, Megan L Brenner, Angela Sauaia, Aast Aorta Study Group

Faculty, Staff and Student Publications

IMPORTANCE: Aortic occlusion (AO) is a lifesaving therapy for the treatment of severe traumatic hemorrhagic shock; however, there remains controversy whether AO should be accomplished via resuscitative thoracotomy (RT) or via endovascular balloon occlusion of the aorta (REBOA) in zone 1.

OBJECTIVE: To compare outcomes of AO via RT vs REBOA zone 1.

DESIGN, SETTING, AND PARTICIPANTS: This was a comparative effectiveness research study using a multicenter registry of postinjury AO from October 2013 to September 2021. AO via REBOA zone 1 (above celiac artery) was compared with RT performed in the emergency department of facilities experienced in both procedures …

Mitochondria-Containing Extracellular Vesicles (Ev) Reduce Mouse Brain Infarct Sizes And Ev/Hsp27 Protect Ischemic Brain Endothelial Cultures, Kandarp M Dave, Donna B Stolz, Venugopal R Venna, Victoria A Quaicoe, Michael E Maniskas, Michael John Reynolds, Riyan Babidhan, Duncan X Dobbins, Maura N Farinelli, Abigail Sullivan, Tarun N Bhatia, Hannah Yankello, Rohan Reddy, Younsoo Bae, Rehana K Leak, Sruti S Shiva, Louise D Mccullough, Devika S Manickam

Faculty, Staff and Student Publications

Ischemic stroke causes brain endothelial cell (BEC) death and damages tight junction integrity of the blood-brain barrier (BBB). We harnessed the innate mitochondrial load of BEC-derived extracellular vesicles (EVs) and utilized mixtures of EV/exogenous 27 kDa heat shock protein (HSP27) as a one-two punch strategy to increase BEC survival (via EV mitochondria) and preserve their tight junction integrity (via HSP27 effects). We demonstrated that the medium-to-large (m/lEV) but not small EVs (sEV) transferred their mitochondrial load, that subsequently colocalized with the mitochondrial network of the recipient primary human BECs. Recipient BECs treated with m/lEVs showed increased relative ATP levels and …

Upregulation Of Pd-L1 By Sars-Cov-2 Promotes Immune Evasion, Hsiang-Chi Huang, Shih-Han Wang, Guo-Chen Fang, Wen-Cheng Chou, Chun-Che Liao, Cheng-Pu Sun, Jia-Tsrong Jan, Hsiu-Hua Ma, Hui-Ying Ko, Yi-An Ko, Ming-Tsai Chiang, Jian-Jong Liang, Chun-Tse Kuo, Te-An Lee, Diego Morales-Scheihing, Chen-Yang Shen, Shih-Yu Chen, Louise D Mccullough, Lu Cui, Gerlinde Wernig, Mi-Hua Tao, Yi-Ling Lin, Yao-Ming Chang, Shu-Ping Wang, Yun-Ju Lai, Chia-Wei Li

Faculty, Staff and Student Publications

Patients with severe COVID-19 often suffer from lymphopenia, which is linked to T-cell sequestration, cytokine storm, and mortality. However, it remains largely unknown how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces lymphopenia. Here, we studied the transcriptomic profile and epigenomic alterations involved in cytokine production by SARS-CoV-2-infected cells. We adopted a reverse time-order gene coexpression network approach to analyze time-series RNA-sequencing data, revealing epigenetic modifications at the late stage of viral egress. Furthermore, we identified SARS-CoV-2-activated nuclear factor-κB (NF-κB) and interferon regulatory factor 1 (IRF1) pathways contributing to viral infection and COVID-19 severity through epigenetic analysis of H3K4me3 chromatin …