Medicine and Health Sciences Commons^™

Risk Assessment Of Blood-Borne Pathogen Exposure For Emergency Responders, Jill A. Ireland

USF Tampa Graduate Theses and Dissertations

Emergency responders face a significant risk of exposure to blood-borne pathogens (BBPs), such as HIV and hepatitis, due to the nature of their work environment. This study investigates this issue utilizing a dual approach of data analysis and online surveys to assess exposure rates, risk perceptions, factors that contribute to risk and prevention practices. In addressing issues ranging from personal protective equipment (PPE) usage to levels of concern surrounding blood and bodily fluid contact, the findings underscore the need for tailored safety measures, comprehensive education, and improved prevention strategies.

The examination of 346 worker's compensation exposure claims highlighted a significant …

Deep Learning Approaches For Cancer Prognosis Prediction Using Histopathological, Omics, And Clinical Data, Shuai Jiang

Dartmouth College Ph.D Dissertations

Accurate prediction of patient outcomes is crucial for shared clinical decision-making, treatment planning, and patients' psychological adjustment. Histopathological features of cancer, including tumor size, lymph node involvement, and metastasis, are commonly incorporated into survival prediction models, underscoring the prognostic value of whole slide images (WSIs). Concurrently, studies have highlighted the significance of omics data, such as transcriptomics, in providing valuable insights into cancer prognosis.

The emerging deep learning methods have brought new opportunities in biomedical informatics. Despite a growing body of studies on the application of deep learning methods for predicting prognosis using WSIs, the results are varied, primarily due …

Resolution Of Severe Portopulmonary Hypertension With Inhaled Treprostinil And Liver Transplantation, Alex J Chang, Choon Hwa Goh

The Texas Heart Institute Journal

Portopulmonary hypertension is a rare condition with a poor prognosis. Prompt management is essential for liver transplantation eligibility, a potentially curative option. This report presents a case of severe portopulmonary hypertension that resolved with a conservative therapeutic regimen of tadalafil, macitentan, and inhaled treprostinil, which ultimately enabled successful liver transplantation. There was no recurrence of pulmonary hypertension after transplantation, and the patient was weaned off most pulmonary arterial hypertension therapies. This case report is the first to provide evidence that inhaled treprostinil is a safe and effective alternative to continuous intravenous prostacyclins in portopulmonary hypertension.

Metabolic Syndrome Traits Exhibit Genotype-By-Environment Interaction In Relation To Socioeconomic Status In The Mexican American Family Heart Study, Vincent P. Diego, Eron G. Manusov, Xi Mao, Marcio A. Almeida, Juan M. Peralta, Joanne E. Curran, Michael C. Mahaney, Harald H. H. Goring, John Blangero, Sarah Williams-Blangero

School of Medicine Publications

Background: Socioeconomic Status (SES) is a potent environmental determinant of health. To our knowledge, no assessment of genotype-environment interaction has been conducted to consider the joint effects of socioeconomic status and genetics on risk for metabolic disease. We analyzed data from the Mexican American Family Studies (MAFS) to evaluate the hypothesis that genotype-by-environment interaction (GxE) is an essential determinant of variation in risk factors for metabolic syndrome (MS).

Methods: We employed a maximum likelihood estimation of the decomposition of variance components to detect GxE interaction. After excluding individuals with diabetes and individuals on medication for diabetes, hypertension, or dyslipidemia, we …

A Road Map Of Relapse In Mds After Allo-Hsct, Juan Jose Rodriguez-Sevilla, Simona Colla

Faculty, Staff and Student Publications

No abstract provided.

Dining Patterns At Campus Food Venues: University Employees’ Perspectives, Kritika Gupta, Jangwoo Jo, Laurel Lambert, Georgianna Mann, Selby Rebecca Entrekin

Journal of Public Health in the Deep South

Background: Few studies exist concerning university employees’ on-campus dining patterns patronage with regard to healthy eating principles. Purpose: To understand the importance that faculty/staff (F/S) place on healthy eating principles and the influence it may have on satisfaction and dining patterns at campus food venues. Methods: A validated online survey was used to collect data on F/S’s perspectives. The survey was distributed through a survey panel group, offered through the University’s Office of Research. Results: Responses on the importance of healthy eating principles showed a severe skewness towards high importance. Younger F/S placed higher importance on …

Deep Learning-Based Predictive Classification Of Functional Subpopulations Of Hematopoietic Stem Cells And Multipotent Progenitors., Shen Wang, Jianzhong Han, Jingru Huang, Khayrul Islam, Yuheng Shi, Yuyuan Zhou, Dongwook Kim, Jane Zhou, Zhaorui Lian, Yaling Liu, Jian Huang

Cooper Medical School of Rowan University Departmental Research

BACKGROUND: Hematopoietic stem cells (HSCs) and multipotent progenitors (MPPs) play a pivotal role in maintaining lifelong hematopoiesis. The distinction between stem cells and other progenitors, as well as the assessment of their functions, has long been a central focus in stem cell research. In recent years, deep learning has emerged as a powerful tool for cell image analysis and classification/prediction.

METHODS: In this study, we explored the feasibility of employing deep learning techniques to differentiate murine HSCs and MPPs based solely on their morphology, as observed through light microscopy (DIC) images.

RESULTS: After rigorous training and validation using extensive image …

Multispecies Comparative Prostate Anatomy By Imaging: Implications For Experimental Models Of Prostatic Disease, Felipe M. Berg, Eduardo T.O. Correia, Eric C. Abenojar, James P. Basilion, Agata A. Exner, Leonardo K. Bittencourt

Faculty Scholarship

Background: There is an increasing interest in using preclinical models for development and assessment of medical devices and imaging techniques for prostatic disease care. Still, a comprehensive assessment of the prostate's radiological anatomy in primary preclinical models such as dogs, rabbits, and mice utilizing human anatomy as a reference point remains necessary with no optimal model for each purpose being clearly defined in the literature. Therefore, this study compares the anatomical characteristics of different animal models to the human prostatic gland from the imaging perspective. Methods: We imaged five Beagle laboratory dogs, five New Zealand White rabbits, and five mice, …

Contraception Methods And Varying Ovarian Cancer Risk, Caroline Veltri

D.U.Quark

Ovarian cancer (OC) is one of the most common, yet deadly, cancers women face. There are multiple ways it can be treated, such as hysterectomy, cytoreductive surgery, and/or chemotherapy, depending on the grade of the cancer. Important risk factors to note are genetics, talc usage, endometriosis, obesity, gene mutations, and cigarette smoking. Non-oral, long-acting contraception (LARC), such as IUDs (intrauterine device) and implants, are the most effective methods of pregnancy prevention. It is uncertain that they can protect against OC like oral contraceptives can. If LARCs can be proven useful in preventing OC, the mortality rate of OC will decrease, …

The Phenomenon Of False Memory And Its Correlation To Mental Health, Kelsey Christianson

D.U.Quark

Memory has always been important for humans. Whether it is remembering the location of one’s car in a crowded parking lot or giving an eye-witness testimony, memory is instrumental in every part of society. False memory is a situation where one incorrectly believes or recalls an event. This review is about false memory and how mental disorders may or may not increase the capacity for false memory. Previous studies have found correlations between false memory and specific mental health disorders. Additional research is needed in patients with post-traumatic stress disorder (PTSD), substance abuse, and schizophrenia. The benefits of future research …

Introduction: Medical-Legal Partnerships: Equity, Evolution, And Evaluation., Katherine L. Kraschel, James Bhandary-Alexander, Yael Z. Cannon, Vicki W. Girard, Abbe R. Gluck, Jennifer L. Huer, Medha D. Makhlouf

Faculty Scholarly Works

The COVID-19 pandemic laid bare systemic inequities shaped by social determinants of health (SDoH). Public health agencies, legislators, health systems, and community organizations took notice, and there is currently unprecedented interest in identifying and implementing programs to address SDoH. This special issue focuses on the role of medical-legal partnerships (MLPs) in addressing SDoH and racial and social inequities, as well as the need to support these efforts with evidence-based research, data, and meaningful partnerships and funding.

Short Cell Cycle Duration Is A Phenotype Of Human Epidermal Stem Cells, Tong Xiao, Ugomma C Eze, Alex Charruyer-Reinwald, Tracy Weisenberger, Ayman Khalifa, Brook Abegaze, Gabrielle K Schwab, Rasha H Elsabagh, T Richard Parenteau, Karl Kochanowski, Merisa Piper, Yumin Xia, Jeffrey B Cheng, Raymond J Cho, Ruby Ghadially

Staff and Researcher Publications

Background: A traditional view is that stem cells (SCs) divide slowly. Meanwhile, both embryonic and pluripotent SCs display a shorter cell cycle duration (CCD) in comparison to more committed progenitors (CPs).

Methods: We examined the in vitro proliferation and cycling behavior of somatic adult human cells using live cell imaging of passage zero keratinocytes and single-cell RNA sequencing.

Results: We found two populations of keratinocytes: those with short CCD and protracted near exponential growth, and those with long CCD and terminal differentiation. Applying the ergodic principle, the comparative numbers of cycling cells in S phase in an enriched population of …

The Impact Of Robotic Assistance For Lumbar Fusion Surgery On 90-Day Surgical Outcomes And 1-Year Revisions, Jeremy Heard, Yunsoo Lee, Nicholas D D'Antonio, Rajkishen Narayanan, Mark Lambrechts, John Bodnar, Caroline Purtill, Joshua Pezzulo, Dominic Farronato, Pat Fitzgerald, Jose Canseco, Ian Kaye, Alan Hilibrand, Alex Vaccaro, Christopher Kepler, Gregory Schroeder

Department of Orthopaedic Surgery Faculty Papers

Objectives: To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery. Methods: Patients >18 years of age who underwent primary lumbar fusion surgery at our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected. Multivariable regression analysis was performed. Significance was set to P < 0.05. Results: Four hundred and fifteen patients were identified as having robotic lumbar fusion and were matched to a control group. Bivariant analysis revealed no significant difference in total 90-day surgical complications (P = 0.193) or 1-year revisions (P = 0.178). The operative duration was longer in robotic surgery (287 + 123 vs. 205 + 88.3, P ≤ 0.001). Multivariable analysis revealed that robotic fusion was not a significant predictor of 90-day surgical complications (odds ratio [OR] = 0.76 [0.32-1.67], P = 0.499) or 1-year revisions (OR = 0.58 [0.28-1.18], P = 0.142). Other variables identified as the positive predictors of 1-year revisions included levels fused (OR = 1.26 [1.08-1.48], P = 0.004) and current smokers (OR = 3.51 [1.46-8.15], P = 0.004). Conclusion: Our study suggests that robotic-assisted and nonrobotic-assisted lumbar fusions are associated with a similar risk of 90-day surgical complications and 1-year revision rates; however, robotic surgery does increase time under anesthesia.

Viral Epitope Scanning Reveals Correlation Between Seasonal Hcovs And Sars-Cov-2 Antibody Responses Among Cancer And Non-Cancer Patients, Salum J. Lidenge, Dicle Yalcin, Sydney J. Bennett, Owen Ngalamika, Brenda B. Kweyamba, Chacha J. Mwita, For Yue Tso, Julius Mwaiselage, John T. West, Charles Wood

School of Medicine Faculty Publications

Seasonal coronaviruses (HCoVs) are known to contribute to cross-reactive antibody (Ab) responses against SARS-CoV-2. While these responses are predictable due to the high homology between SARS-CoV-2 and other CoVs, the impact of these responses on susceptibility to SARS-CoV-2 infection in cancer patients is unclear. To investigate the influence of prior HCoV infection on anti-SARS-CoV-2 Ab responses among COVID-19 asymptomatic individuals with cancer and controls without cancers, we utilized the VirScan technology in which phage immunoprecipitation and sequencing (PhIP-seq) of longitudinal plasma samples was performed to investigate high-resolution (i.e., epitope level) humoral CoV responses. Despite testing positive for anti-SARS-CoV-2 Ab in …

Border-Associated Macrophages In The Central Nervous System, Rui Sun, Haowu Jiang

2020-Current year OA Pubs

Tissue-resident macrophages play an important role in the local maintenance of homeostasis and immune surveillance. In the central nervous system (CNS), brain macrophages are anatomically divided into parenchymal microglia and non-parenchymal border-associated macrophages (BAMs). Among these immune cell populations, microglia have been well-studied for their roles during development as well as in health and disease. BAMs, mostly located in the choroid plexus, meningeal and perivascular spaces, are now gaining increased attention due to advancements in multi-omics technologies and genetic methodologies. Research on BAMs over the past decade has focused on their ontogeny, immunophenotypes, involvement in various CNS diseases, and potential …

Calpain-2 Mediates Sars-Cov-2 Entry Via Regulating Ace2 Levels, Qiru Zeng, Avan Antia, Luis Alberto Casorla-Perez, Maritza Puray-Chavez, Sebla B Kutluay, Matthew A Ciorba, Siyuan Ding

2020-Current year OA Pubs

UNLABELLED: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, much effort has been dedicated to identifying effective antivirals against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A number of calpain inhibitors show excellent antiviral activities against SARS-CoV-2 by targeting the viral main protease (M

IMPORTANCE: Many efforts in small-molecule screens have been made to counter SARS-CoV-2 infection by targeting the viral main protease, the major element that processes viral proteins after translation. Here, we discovered that calpain inhibitors further block SARS-CoV-2 infection in a main protease-independent manner. We identified the host cysteine protease calpain-2 as an important positive …

The Identification Of Small Molecule Inhibitors With Anthelmintic Activities That Target Conserved Proteins Among Ruminant Gastrointestinal Nematodes, Hyeim Jung, Dante Zarlenga, John C Martin, Peter Geldhof, Kymberlie Hallsworth-Pepin, Makedonka Mitreva

2020-Current year OA Pubs

Gastrointestinal nematode (GIN) infections are a major concern for the ruminant industry worldwide and result in significant production losses. Naturally occurring polyparasitism and increasing drug resistance that potentiate disease outcomes are observed among the most prevalent GINs of veterinary importance. Within the five major taxonomic clades, clade Va represents a group of GINs that predominantly affect the abomasum or small intestine of ruminants. However, the development of effective broad-spectrum anthelmintics against ruminant clade Va GINs has been challenged by a lack of comprehensive druggable genome resources. Here, we first assembled draft genomes for three clade Va species (

Inducing Vulnerability To Inha Inhibition Restores Isoniazid Susceptibility In Drug-Resistant Mycobacterium Tuberculosis, Gregory A Harrison, Erin R Wang, Kevin Cho, Yassin Mreyoud, Souvik Sarkar, Fredrik Almqvist, Gary J Patti, Christina L Stallings

2020-Current year OA Pubs

Of the approximately 10 million cases of

Genomic Surveillance Of Clostridioides Difficile Transmission And Virulence In A Healthcare Setting, Erin P Newcomer, Skye R S Fishbein, Kailun Zhang, Tiffany Hink, Kimberly A Reske, Candice Cass, Zainab H Iqbal, Emily L Struttmann, Carey-Ann D Burnham, Erik R Dubberke, Gautam Dantas

2020-Current year OA Pubs

UNLABELLED:

IMPORTANCE:

A Phase I Trial Of Pevonedistat In Combination With Ruxolitinib For The Treatment Of Myelofibrosis, Tim Kong, Nicole Gaudin, Karyn Gordon, Maggie J Cox, Amy W Zhou, Stephen T Oh

2020-Current year OA Pubs

Janus kinase 2 (JAK2) inhibitors such as ruxolitinib have become standard-of-care therapy for patients with myeloproliferative neoplasms (MPNs); however, activation of alternate oncogenic pathways including nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) has limited durable response as single-agent therapy. With the rationale of targeting both pathways, we conducted a phase I dose escalation trial of pevonedistat in combination with ruxolitinib for the treatment of patients with myelofibrosis (NCT03386214). The primary objective was to assess the safety and tolerability of combination therapy with additional objectives of treatment efficacy and alterations of biomarkers. There were no dose-limiting toxicities observed with most …

A Comparative Review Of Typical And Atypical Optic Neuritis: Advancements In Treatments, Diagnostics, And Prognosis, Noah J. Spillers, Patrick M. Luther, Norris C. Talbot, Evan J. Kidder, Connor A. Doyle, Salim C. Lutfallah, Alyssa G. Derouen, Sridhar Tirumala, Shahab Ahmadzadeh, Sahar Shekoohi, Alan D. Kaye, Giustino Varrassi

School of Medicine Faculty Publications

Optic neuritis (ON) is a debilitating condition that through various mechanisms, including inflammation or demyelination of the optic nerve, can result in partial or total permanent vision loss if left untreated. Accurate diagnosis and promptly initiated treatment are imperative related to the potential of permanent loss of vision if left untreated, which can lead to a significant reduction in the quality of life in affected patients. ON is subtyped as "typical" or "atypical" based on underlying causative etiology. The etiology of ON can be differentiated when appropriate diagnostic testing is performed. Using history taking, neuroimaging, and visual testing to localize …

Effectiveness Of The Introduction To Critical Care In Emergency Medicine Curriculum's Implementation Among Trainees Interested In Intensive Care, Matthew M.T. Carvey

Researchers, Instructors, & Staff Scholarship

Background: Emergency physicians and trainees provide the initial care for critically ill patients. In times of emergency department boarding, this care may extend beyond the first few hours. To meet the needs of this population, a standardized novel critical care curriculum targeting third- and fourth-year medical students was developed. Objectives: We hypothesized that the institution of such a curriculum is feasible and will provide an increased understanding of the underlying critical care principles within this learner population. Methods: We developed a 2-month-long critical care curriculum (February–April) and carried out the course twice from 2022–2023. Our pilot study deployed this curriculum …

Interrelationships Among Local Values Of Wet Bulb Globe Temperature, Heat Index, And Adjusted Temperature, Andrea Giraldo

USF Tampa Graduate Theses and Dissertations

Occupational heat stress significantly affects outdoor workers who face challenges due to increased heat exposure. Because of the prevalence of heat illness, it is important to measure heat stress for outdoor workers. Monitoring occupational heat stress most often relies on the Wet Bulb Globe Temperature (WBGT) measure. Heat Index (HI) is a widely used measure to account for air temperature and humidity. Adjusted Temperature (Tadj) considers air temperature, humidity and estimates radiant heat. There is interest in predicting WBGT from HI and HI from WBGT. This study builds on previous USF research by Bernard and Iheanacho and Irvin to evaluate …

Dysregulated Creb3 Cleavage At The Nuclear Membrane Induces Karyoptosis-Mediated Cell Death, Ga-Eun Lee, Geul Bang, Jiin Byun, Cheol-Jung Lee, Weidong Chen, Dohyun Jeung, Hyun-Jung An, Han Chang Kang, Dae Joon Kim, Megan Keniry

School of Medicine Publications

Cancer cells often exhibit resistance to apoptotic cell death, but they may be vulnerable to other types of cell death. Elucidating additional mechanisms that govern cancer cell death is crucial for developing new therapies. Our research identified cyclic AMP-responsive element-binding protein 3 (CREB3) as a crucial regulator and initiator of a unique cell death mechanism known as karyoptosis. This process is characterized by nuclear shrinkage, deformation, and the loss of nuclear components following nuclear membrane rupture. We found that the N-terminal domain (aa 1-230) of full-length CREB3 (CREB3-FL), which is anchored to the nuclear inner membrane (INM), interacts with lamins …

Ways To Improve Uptake Of Tier 2 Weight Management Programmes In Bame Communities In Medway: A Qualitative Study, Jennifer A. Teke, Johnson Mbabazi, Emma Giles, Scott Elliot, Louisa Ells, Lawrence Achilles Nnyanzi

International Journal of Physical Activity and Health

Overweight and obesity is usually determined by Body Mass Index (BMI). Twelve BAME adults participated in the interviews: six were female, ten were first-generation migrants, three were retirees, none lived with a disability, and all were concerned about their excess weight. There were four themes from the data and eight subthemes obtained. To improve the uptake of the weight management service provided in Medway, the participants recommended the use of strategies such as indigenous food labelling, BAME-led clinics, the use of translated leaflets, the recruitment of local weight management champions, better coordination of services, appropriate communication strategies, and further research. …

Strabismus Management In Retinoblastoma Survivors, Babak Masoomian, Carol L. Shields, Hamid Riazi Esfahani, Atefeh Khalili, Fariba Ghassemi, Pukhraj Rishi, Mohammad Reza Akbari, Masoud Khorrami-Nejad

Wills Eye Hospital Papers

PURPOSE: To report the result of strabismus surgery in eye-salvaged retinoblastoma (Rb) patients.

METHODS: A retrospective case series including 18 patients with Rb and strabismus who underwent strabismus surgery after completing tumor treatment by a single pediatric ophthalmologist.

RESULTS: A total of 18 patients (10 females and 8 males) were included with a mean age of 13.3 ± 3.0 (range, 2-39) months at the time tumor presentation and 6.0 ± 1.5 (range, 4-9) years at the time of strabismus surgery. Ten (56%) patients had unilateral and 8(44%) had bilateral involvement and the most common worse eye tumor's group was D …

Β-Sheets Mediate The Conformational Change And Allosteric Signal Transmission Between The Aslov2 Termini, Sian Xiao, Mayar Terek Ibrahim, Gennady M. Verkhivker, Brian D. Zoltowski, Peng Tao

Mathematics, Physics, and Computer Science Faculty Articles and Research

Avena sativa phototropin 1 light-oxygen-voltage 2 domain (AsLOV2) is a model protein of Per-Arnt-Sim (PAS) superfamily, characterized by conformational changes in response to external environmental stimuli. This conformational change begins with the unfolding of the N-terminal A'α helix in the dark state followed by the unfolding of the C-terminal Jα helix. The light state is characterized by the unfolded termini and the subsequent modifications in hydrogen bond patterns. In this photoreceptor, β-sheets are identified as crucial components for mediating allosteric signal transmission between the two termini. Through combined experimental and computational investigations, the Hβ …

Unraveling Trends In Schistosomiasis: Deep Learning Insights Into National Control Programs In China, Qing Su, Cici Xi Chen Bauer, Robert Bergquist, Zhiguo Cao, Fenghua Gao, Yi Hu, Zhijie Zhang

Faculty, Staff and Student Publications

OBJECTIVES: to achieve the ambitious goal of eliminating schistosome infections, the Chinese government has implemented diverse control strategies. This study explored the progress of the 2 most recent national schistosomiasis control programs in an endemic area along the Yangtze River in China.

METHODS: We obtained village-level parasitological data from cross-sectional surveys combined with environmental data in Anhui Province, China from 1997 to 2015. A convolutional neural network (CNN) based on a hierarchical integro-difference equation (IDE) framework (i.e., CNN-IDE) was used to model spatio-temporal variations in schistosomiasis. Two traditional models were also constructed for comparison with 2 evaluation indicators: the mean-squared …

Facile Synthesis Of Fe2o3, Fe2o3@ Cuo And Wo3 Nanoparticles: Characterization, Structure Determination And Evaluation Of Their Biological Activity, Asmaa Taha

Nanotechnology Research Centre

Due to their high specific surface area and its characteristic’s functionalized nanomaterials have great potential in medical applications specialty, as an anticancer. Herein, functional nanoparticles (NPs) based on iron oxide Fe2O3, iron oxide modified with copper oxide Fe2O3@ CuO, and tungsten oxide WO3 were facile synthesized for biomedical applications. The obtained nanomaterials have nanocrystal sizes of 35.5 nm for Fe2O3, 7 nm for Fe2O3@ CuO, and 25.5 nm for WO3. In addition to octahedral and square nanoplates for Fe2O3, and WO3; respectively. Results revealed that Fe2O3, Fe2O3@ CuO, and WO3 NPs showed remarked anticancer effects versus a safe effect on …

Safety And Efficacy Of Dynamic Catheter-Directed Cerebral Digital Subtraction Angiography For Diagnosis Of Bowhunter Syndrome Spectrum Disorders: A Systematic Review Of The Literature, Joo Won Choi, Yang Qiao, Tej I Mehta, Jessica N Wilson, Trevor H Torigoe, Samuel Tsappidi, Y Jonathan Zhang, Stacy C Brown, Ferdinand K Hui, Todd Abruzzo

Faculty, Staff and Student Publications

Introduction: Dynamic catheter-directed cerebral digital subtraction angiography (dcDSA) is the gold standard for diagnosing dynamic vascular occlusion syndromes such as bowhunter syndrome (BHS). Nonetheless, concerns about its safety exist and no standardized protocols have been published to date.

Methods: We describe our methodology and insights regarding the use of dcDSA in patients with BHS. We also perform a systematic literature review to identify cases of typical and atypical presentations of BHS wherein dcDSA was utilized and report on any procedural complications related to dcDSA.

Results: Our study included 104 cases wherein dcDSA was used for the diagnosis of BHS. There …