Medicine and Health Sciences Commons^™

Information Seeking Behaviors And Attitudes Of Wives Of Former Football Players Regarding Chronic Traumatic Encephalopathy, Summer D Ott, Sukhnandan K Cheema, Alexa Ryder, Philip Schatz, Lorie A Gonzalez, Jecenia Duran, Paul E Schulz

Faculty, Staff and Student Publications

This study examines CTE-related knowledge and information-seeking behaviors of caregivers of persons who are at high risk of CTE. Online survey responses were collected from 64 females, ages 18-74, who were married to former college, semiprofessional, or professional football players and were fluent in English. Ranging from 0 to 18, a score was calculated to represent level of CTE knowledge. Participants were classified into groups based on their spouse's reported symptoms and diagnosis. Approximately 87% of participants reported that their spouses have been diagnosed with a football-related concussion and were significantly more likely to seek out information from a healthcare …

Professional Baseball Pitchers Use Of Weighted Ball Training, Injury Incidence, And Time Loss: A Preliminary Study, Ellen Shanley, Thomas J Noonan, Michael J Kissenberth, Daniel Kline, Charles A Thigpen, Garrett S Bullock

Faculty, Staff and Student Publications

Background: Little is known about the injury risk associated with weighted ball use by professional baseball pitchers. The purpose of this study was to describe weighted ball training and injuries and compare injury rates between those professional pitchers using weighted ball training and those that did not use weighted ball training during the 2023 pre- and regular season.

Methods: This study, intended as a multi-year project, serves as an interim safety analysis after one year of follow up. Pitchers underwent routine physical examination and injury screening and were surveyed about their use of weighted baseball training. Throughout spring training and …

Effect Of Palatoplasty Technique On Otologic Outcomes In Children With Cleft Palate, Shaina W Gong, Paul Hung, Chioma G Obinero, Jose Barrera, Zi Yang Jiang, Matthew R Greives, Zhen Huang

Faculty, Staff and Student Publications

Background: In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.

Objective: We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.

Methods: A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic …

Transnasal Humidified Rapid Insufflation Ventilatory Exchange (Thrive) For The Operative Management Of Retrograde Cricopharyngeus Dysfunction, Amy B Leming, Dylan G Vance, Andrew G Tritter, Zao Mike Yang

Faculty, Staff and Student Publications

Objective: Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is a method of apneic oxygenation gaining popularity in upper aerodigestive surgery. Retrograde cricopharyngeus muscle dysfunction (RCPD) is characterized by the inability to belch, managed by intraoperative injection of botulinum toxin to the cricopharyngeus muscle (CPBI), often performed under general anesthesia with endotracheal intubation. We sought to assess the safety and efficacy of THRIVE when performing CPBI for RCPD.

Study design: We conducted a retrospective review of adult RCPD patients undergoing CPBI under general anesthesia with THRIVE.

Setting: The study was conducted at both the University of Texas Health Science Centers in …

Molecular, Histologic, And Clinical Characterization Of Methylation Class Pleomorphic Xanthoastrocytoma: An Analysis Of 469 Tumors, Christopher H Dampier, Niharika Shah, Kristyn Galbraith, Azadeh Ebrahimi, Osorio Lopes Abath Neto, Zied Abdullaev, Sanda Alexandrescu, Felipe Andreiuolo, Terri Armstrong, Tiffany Baker, Sahara Cathcart, Hye-Jung Chung, Patrick J Cimino, Kyle S Conway, Jennifer Cotter, Felipe D'Almeida Costa, Karen Dazelle, Nima Etminam, Sima Esther Ferman, Igor Fernandes, Christina K Ferrone, Ahmed Gilani, Mark Gilbert, Jason Gregory, Courtney Ketchum, Han Sung Lee, Ina Lee, Maria Beatriz S Lopes, Qinwen Mao, Michael S Marshall, Matthew Mccord, Stewart G Neill, Jeffrey J Nirschl, Byram H Ozer, Werner Paulus, Marta Penas-Prado, Marco Prinz, Peter Pytel, Martha Quezado, Mark Raffeld, Sharika Rajan, Miriam Ratliff, Guido Reifenberger, Lorraina Robinson, Jens Schittenhelm, Daniel Schrimpf, Omkar Singh, Christian Thomas, Diana Thomas, Jaiyeola Thomas-Ogunniyi, Angus Toland, Rust Turakulov, Rachael Vaubel, Nitin Wadhwani, Jing Wu, Caterina Giannini, Matija Snuderl, Sebastian Brandner, Andreas Von Deimling, Kenneth Aldape

Faculty, Staff and Student Publications

Background: Methylation class pleomorphic xanthoastrocytoma (mcPXA) comprises tumors with the DNA methylation signature of classical PXA but with a wider histologic spectrum, including overlap with glioblastoma (GBM).

Methods: To clarify the histologic and molecular scope of mcPXA and characterize its clinical behavior, a cohort of 469 tumor samples from 458 patients matching to mcPXA by the DKFZ classifier (v12.6 score ≥0.85) was interrogated.

Results: Patient median age was 23 years (range 1-73 years) with a female predominance (259 female/199 male). CDKN2A/B homozygous deletion was observed in 406 of 469 (87%) samples. In samples tested for BRAF p.V600E mutations (n …

Safety Of Indocyanine Green Microdosing For Clinical Imaging Of Csf Ventricular Dynamics And Extracranial Outflow, Miriam Zamorano, Banghe Zhu, Ahmed T Massoud, Jonathan Hendricks, H Alex Choi, Pedram Peesh, Brandon A Miller, Xinhai Robert Zhang, Manish N Shah, Eva M Sevick-Muraca

Faculty, Staff and Student Publications

Background and purpose: Intravenous administration of indocyanine green (ICG) has been approved in brain surgeries for decades, yet concerns about neurotoxicity prevent its direct administration into the cerebrospinal fluid (CSF). Armed with prior animal studies demonstrating the feasibility of using ICG microdosing into the CSF, we sought to evaluate its nonclinical safety profile and obtain surrogate measures in adults prior to its use in human neonates.

Methods: Evaluation of ICG toxicity was conducted in mixed primary CNS cell cultures and in an extended safety study of juvenile rat pups deploying intraventricular injections of saline (as control) or ICG. Analysis of …

Advancing Randomized Clinical Trials In Surgery: Role Of Exception From Informed Consent, Central Institutional Review Board, And Bayesian Approaches, Amelia W Maiga, Rebecca A Snyder, Lillian S Kao, Mehul V Raval, Mayur B Patel, Martin L Blakely

Faculty, Staff and Student Publications

No abstract provided.

Reducing Computed Tomography Use For Appendicitis Evaluation In A Pediatric Emergency Department: A Multidisciplinary Quality Improvement Initiative, Jennifer Hockenbury, Monica E Lopez, Caroline M Godfrey, Martin L Blakely, Melissa Danko, Marta Hernanz-Schulman, S Barron Frazier

Faculty, Staff and Student Publications

Introduction: Appendicitis is the most common pediatric surgical emergency, and computed tomography (CT) remains an overused diagnostic test for appendicitis. Our institutional rate of CT utilization for suspected appendicitis was higher than in peer children's hospitals, so we aimed to reduce CT utilization during the evaluation of pediatric appendicitis from 31.3% to 15% within 12 months.

Methods: From September 2021 to October 2022, we conducted a multidisciplinary quality improvement initiative among patients evaluated for appendicitis in the pediatric emergency department (PED). Interventions included standardizing evaluation with a clinical practice guideline, an order set in the electronic medical record for clinical …

Moving From Prognostication To Prevention Of Ssis In Lmics, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Lillian S Kao

Faculty, Staff and Student Publications

No abstract provided.

Case Report: Successful Delivery Following Chemotherapy In A Pregnant Patient With Metastatic Smarcb1-Deficient Renal Medullary Carcinoma, Panayiotis D Kontoyiannis, Adam Kuykendal, Chad Tang, Jessica P Cheng, Beei Chan, Susan S Thomas, Priya Rao, Bora Lim, Pavlos Msaouel

Faculty, Staff and Student Publications

SMARCB1-deficient renal medullary carcinoma (RMC) is a rare and aggressive kidney cancer defined by the loss of SMARCB1 tumor suppressor and primarily affecting adolescents and young adults with sickle hemoglobinopathies. Approximately 7% of RMC cases, known as renal cell carcinoma unclassified with medullary phenotype (RCCU-MP), lack sickle hemoglobinopathy. RMC does not respond to immune checkpoint inhibitors and antiangiogenic tyrosine kinase inhibitors, with chemotherapy being the main treatment. Here we present the first documented case of RMC diagnosed during pregnancy. A 24-year-old woman presented with right-sided back pain, leading to the discovery of a 6-cm right renal mass. Pathology confirmed RCCU-MP …

Comb-Boin12: A Utility-Based Bayesian Optimal Interval Design For Dose Optimization In Cancer Drug-Combination Trials, Mengyi Lu, Jingyi Zhang, Ying Yuan, Ruitao Lin

Faculty, Staff and Student Publications

Drug combinations are increasingly utilized in cancer treatment to enhance drug effectiveness through synergistic therapeutic effects. However, determining the optimal biological dose combination (OBDC) in small-scale drug combination trials presents challenges due to the increased complexity of the dose space. To effectively optimize the dose combination of combined drugs, we propose a model-assisted design by extending the single-agent Bayesian optimal interval phase I/II (BOIN12) design. Our approach incorporates a utility function to balance the trade-off between risk and benefit and directly models the utility of each dose by constructing a quasi-beta-binomial model. A key advantage of our design is the …

Consolidation Alk Tyrosine Kinase Inhibitors Versus Durvalumab Or Observation After Chemoradiation In Unresectable Stage Iii Alk-Positive Nsclc, Amin H Nassar, Ritujith Jayakrishnan, Jamie Feng, Frances Shepherd, Elio Adib, Justin M Cheung, Jessica J Lin, Yufei Liu, Steven H Lin, Kaushal Parikh, Arthi Sridhar, Purnima Shakya, Thomas J Dilling, David Kaldas, Jhanelle E Gray, Anastasiya Lobachov, Jair Bar, Heike Luders, Christian Grohe, Shruti Gupta, Ticiana Leal, Bailey Fitzgerald, Fionnuala Crowley, Yu Fujiwara, Thomas U Marron, Molly Wilgucki, Joshua Reuss, Luxi Chen, Kamya Sankar, Jacqueline V Aredo, Joel W Neal, Heather A Wakelee, Rohit Thummalapalli, Helena Yu, Ryan Whitaker, Ana Velazquez, Meera Ragavan, Alessio Cortellini, David J Kwiatkowski, Abdul Rafeh Naqash, Sarah B Goldberg, So Yeon Kim

Faculty, Staff and Student Publications

Introduction: Patients with advanced ALK-positive NSCLC typically have poor response to immunotherapy; the benefit of consolidation durvalumab in patients with unresectable stage III ALK-positive NSCLC remains unclear. Herein, we compare the efficacy and safety of consolidation ALK tyrosine kinase inhibitor (TKI) versus durvalumab or observation after concurrent chemoradiation.

Methods: We conducted a retrospective study using a multicenter study of 17 institutions globally. Patients with unresectable stage III ALK-positive NSCLC treated between 2015 and 2022 were included. Patients received ALK TKI, durvalumab, or observation after concurrent chemoradiation. Real-world progression-free survival (rwPFS) and overall survival (OS) were estimated using Kaplan-Meier method. Treatment-related …

Correlation Of Pancreatic Laminin Alpha 5 Expression With Clinical Outcomes In Total Pancreatectomy With Islet Autotransplantation, Jayachandra Kuncha, Carly M Darden, Yang Liu, Michael Lawrence, J Sebastian Danobeitia, Bashoo Naziruddin

Faculty, Staff and Student Publications

This study examines extracellular matrix (ECM) protein (ECM) expression in chronic pancreatitis (CP) patients and its correlation with graft function after total pancreatectomy with islet autologous transplantation (TPIAT). Pancreatic sections from 29 CP patients undergoing TPIAT were analyzed for ECM including pan-laminin, laminin alpha 5 (LAMA5), collagen IV, and Perlecan by immunohistochemistry and scored by the percentage positive staining area within the whole tissue area. Graft function was monitored by blood glucose and C-peptide levels. Laminin alpha 5 levels in blood plasma were greater in CP. Laminin alpha 5 expression was significantly higher in all CP patient etiological categories including …

Stim1 And Lipid Interactions At Er-Pm Contact Sites, Yuepeng Ke, Ritchel Gannaban, Junchen Liu, Yubin Zhou

Faculty, Staff and Student Publications

Store-operated calcium (Ca2+) entry (SOCE) represents a major route of Ca2+ permeation across the plasma membrane (PM) in non-excitable cells, which plays an indispensable role in maintaining intracellular Ca2+ homeostasis. This process is orchestrated through the dynamic coupling between the endoplasmic reticulum (ER)-localized Ca2+ sensor stromal interaction molecule 1 (STIM1) and the PM-resident ORAI1 channel. Upon depletion of ER Ca2+ stores, STIM1 undergoes conformational rearrangements and oligomerization, leading to translocation of STIM1-containing ER membrane towards the PM. This movement is facilitated by the physical interaction between positively charged cytosolic domains within STIM1 and negatively charged phospholipids embedded in the PM, …

Combining Biology-Based And Mri Data-Driven Modeling To Predict Response To Neoadjuvant Chemotherapy In Patients With Triple-Negative Breast Cancer, Casey E Stowers, Chengyue Wu, Zhan Xu, Sidharth Kumar, Clinton Yam, Jong Bum Son, Jingfei Ma, Jonathan I Tamir, Gaiane M Rauch, Thomas E Yankeelov

Faculty, Staff and Student Publications

Purpose

To combine deep learning and biology-based modeling to predict the response of locally advanced, triple-negative breast cancer before initiating neoadjuvant chemotherapy (NAC).

Materials and Methods

In this retrospective study, a biology-based mathematical model of tumor response to NAC was constructed and calibrated on a patient-specific basis using imaging data from patients enrolled in the MD Anderson A Robust TNBC Evaluation FraMework to Improve Survival trial (ARTEMIS; ClinicalTrials.gov registration no. NCT02276443) between April 2018 and May 2021. To relate the calibrated parameters in the biology-based model and pretreatment MRI data, a convolutional neural network (CNN) was employed. The CNN …

Early Diagnosis Of Vascular Ehlers-Danlos Syndrome Through Ai-Powered Facial Analysis: Results From The Montalcino Aortic Consortium, David R Murdock, Adarsh Suresh, Ernesto Calderon Martinez, Isabella Marin, Frances Marin, Alan C Braverman, Angela T Yetman, Shaine A Morris, Dianna M Milewicz

Faculty, Staff and Student Publications

Purpose: Vascular Ehlers-Danlos syndrome (vEDS), which is caused by COL3A1 pathogenic variants, is a rare heritable aortic and arterial disorder associated with early mortality, mainly due to spontaneous vascular dissections and ruptures. Improved methods for diagnosing vEDS are needed for guideline-based management to be initiated for preventing deadly complications and differentiating vEDS from overlapping conditions, such as hypermobile EDS (hEDS).

Methods: We implemented an artificial intelligence (AI) facial analysis model based on the PhenoScore framework using a support vector machine trained on facial images of 30 individuals, aged 6 to 65 years, with vEDS from the Montalcino Aortic Consortium, control …

Integrative Multi-Omics Approach For Improving Causal Gene Identification, Austin King, Chong Wu

Faculty, Staff and Student Publications

Transcriptome-wide association studies (TWAS) have been widely used to identify thousands of likely causal genes for diseases and complex traits using predicted expression models. However, most existing TWAS methods rely on gene expression alone and overlook other regulatory mechanisms of gene expression, including DNA methylation and splicing, that contribute to the genetic basis of these complex traits and diseases. Here we introduce a multi-omics method that integrates gene expression, DNA methylation, and splicing data to improve the identification of associated genes with our traits of interest. Through simulations and by analyzing genome-wide association study (GWAS) summary statistics for 24 complex …

Chronic Circadian Misalignment Accelerates Sarcopenia Progression In Mice, Takashi Seya, Nobuya Koike, Naoki Okubo, Yasuhiro Umemura, Yoshiki Tsuchiya, Kazuya Yabumoto, Yasuhiro Endo, Kanako Iinuma, Akiyo Kakibuchi, Akira Sugimoto, Kenji Takahashi, Seung-Hee Yoo, Zheng Chen, Kazuhiro Yagita

Faculty, Staff and Student Publications

Introduction: In today's 24/7 society, circadian misalignment caused by environmental and lifestyle factors is associated with various adverse health consequences. Understanding tissue-specific pathology is required to counter this growing public health challenge. A potential association of environmental circadian misalignment with sarcopenia, or accelerated loss of skeletal muscle strength and mass, is poorly documented.

Methods: 14-week-old wild-type C57BL/6J male mice were exposed to a chronic jet lag (CJL) paradigm consisting of an 8-h phase advance every 4 days (the ADV group) or a fixed light-dark cycle (the LD group) for 64 weeks. Grip strength was measured during the experiment, and hindlimb …

Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Pilot Infection Control Lecture Series, Kayla E Ruch, Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, Eric L Brown

Faculty, Staff and Student Publications

Introduction: The Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI's Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.

Methods: Data from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to …

Virtually Assisted Home Rehabilitation After Acute Stroke (Vast-Rehab): A Descriptive Pilot Study For Young And Underserved Stroke Survivors, Emily A Stevens, Neha Muraly, Carolyn P Da Silva, Lorie Richards, Aylen Sosa, Heather Smith, Allyson Seals Richard, Shehzeen Manji, Mary E Russell, Sean I Savitz

Faculty, Staff and Student Publications

Introduction: The objective of Virtually Assisted home rehabilitation after acute STroke was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic.

Methods: Participants were recruited from acute care, inpatient rehab, or provider/self-referral if they had a stroke within the previous year, prestroke modified Rankin Scale < 3, were recommended to participate in rehab, and had internet access. Exclusions were: prior injury/diagnoses that impacted functional level, life expectancy of less than six months, or safety concerns. Outcomes were within one week prior to initiation and within one week after completion of telerehabilitation sessions. Video call sessions were completed 1-2 times a week for 12 weeks. Occupational therapy, physical therapy, and/or speech therapy were provided. Analyses involved descriptive statistics; qualitative comments were aggregated and analyzed for broader themes. Twenty participants were consented.

Results: Of the 20 participants (39-71 years old, 35% White, 50% female), 12 completed study activities, five completed exit interview; 10 demonstrated improvement on National Institute of Health Stroke Scale from a mean of 5.6 at baseline to 2.7 at end of study, six demonstrated improvement in modified Rankin Score …

Case Report: Rare Intraventricular H3 K27-Altered Diffuse Midline Glioma In An Adult, Merari Jasso, Jay-Jiguang Zhu, Meenakshi B Bhattacharjee, Georgene W Hergenroeder

Faculty, Staff and Student Publications

H3 K27-Altered Diffuse Midline Gliomas are commonly found in children and adolescents in midline locations such as the thalamus, brain stem, and spinal cord. It is rare for these tumors to affect adults and to occur in locations like the lateral ventricles. Despite aggressive treatment methodologies, there is no cure for this disease. The median survival is between 8-12 months. A 24-year-old white male presented to the emergency department due to severe headache refractory to pain medications with a 2-month history of progressive headaches and eventual memory problems. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an intraventricular enhancing …

Re-Stenting Following Recurrence After Successful Venous Sinus Stenosis Stenting For Idiopathic Intracranial Hypertension, Salvatore A D'Amato, Juan Carlos Martinez Gutierrez, Hussein A Zeineddine, Eric Claude Mohan, Tien Nguyen, Cybele Woon, Rosa Tang, Peng Roc Chen

Faculty, Staff and Student Publications

Objective: In medically refractory idiopathic intracranial hypertension (IIH), venous sinus stenosis (VSS) stenting has been an effective treatment modality. Among patients who experience recurrent symptoms and develop new stenosis, the optimal treatment strategy is unknown. The aim of this study was to investigate the role of rescue re-stenting in patients with recurrence after prior successful stenting.

Methods: This was a single center, retrospective review from a prospectively maintained IIH registry. Between 2012 and 2023, patients who underwent interventions for confirmed IIH and angiographically demonstrable VSS were included. The cohort was divided into those who underwent a single stenting procedure (single …

Prenatal Alcohol Exposure Inhibits Transient Expression Of Autophagy And Synaptic Proteins In Developing Brain, Monica Hampe, Nune Darbinian, Nana Merabova, Armine Darbinyan, Jamal Hamze, Uday Bharai, Yuri Persidsky, Mary F Morrison, Shohreh Amini, Laura Goetzl, Michael E Selzer

Faculty, Staff and Student Publications

Introduction: Neuronal apoptosis and consequent inhibition of autophagy, with loss of synaptic connections are central events in the genesis of fetal alcohol spectrum disorders (FASD). However, studies of molecular mechanisms of autophagy in human fetal brain are limited. Recently, prenatal exposure to EtOH was associated with reduced miRNA-9 levels in fetal brain-derived exosomes (FB- Es) isolated from maternal plasma, which correlated with small eyes, an anatomical hallmark of fetal alcohol syndrome (FAS). Since miR-9 targets several genes that regulate synaptic plasticity, EtOH-induced inhibition of miR-9 could potentially result in dysregulation of genes involved in synaptogenesis/plasticity.

Methods: Rats were fed a …

Semi-Automated Virtual Endoscopy Of The Frontal Recess, Ali Jafar, William Yao, Martin Citardi

Faculty, Staff and Student Publications

Introduction: Virtual endoscopy (VE) is the computer-based reprocessing of diagnostic imaging to simulate endoscopy of an anatomic region of interest. VE of the Frontal Sinus Outflow Tract (FSOT) may assist surgical planning and education.

Method: VE was performed on 16 normal sinus computed tomography (CT) scans for a total of 32 sides using the "path-to-target" tool on the TruDi surgical navigation system (ver. 2.3; Acclarent, Irving, CA, USA). To aid orientation during VE, planning points were placed on the middle turbinate, ethmoidal bulla, and skull base. The VE representation of anatomy and FSOT accuracy was manually confirmed by reviewing the …

Three-Year Outcomes After Temperature-Controlled Radiofrequency Treatment Of Nasal Airway Obstruction, William C Yao, Randall Ow, Michael J Sillers, Nathan E Nachlas, Curtis D Johnson, Dale Ehmer, Jordan Pritikin, Henry P Barham

Faculty, Staff and Student Publications

Objective: To evaluate the long-term safety and effectiveness of temperature-controlled radiofrequency (TCRF) treatment of nasal valve collapse (NVC) in patients with nasal airway obstruction (NAO).

Study design: This is an extended follow-up from a prospective, multicenter, single-arm study. The initial study included participants from 12 sites across the United States who were followed for 24 months and additionally agreed to participate in the extended 36-month follow-up.

Setting: Procedure was performed in-office with an in-person follow-up at 3 months and subsequent follow-up assessment remotely.

Methods: Participants received TCRF treatment of only the nasal valve and participated in the extended 36-month follow-up. …

Semi-Quantitative Assessment Of Surgical Navigation Accuracy During Endoscopic Sinus Surgery In A Real-World Environment, David Z Allen, Jason Talmadge, Martin J Citardi

Faculty, Staff and Student Publications

Introduction: Although surgical navigation is commonly used in rhinologic surgery, data on real world performance are sparse because of difficulties in collecting measurements for target registration error (TRE). Despite publications showing submillimeter TRE, surgeons do report TRE of >3 mm. We describe a novel method for assessing TRE during surgery and report findings with this technique.

Methods: The TruDi navigation system (Acclarent, Irving, CA) was registered using a contour-based protocol. The surgeon estimated target registration error (e-TRE) at up to 8 points (anatomic regions of interest [ROI]) during endoscopic sinus surgery (ESS). System logs were used to simulate the localization …

Synthetic Versus Biologic Mesh For Complex Open Ventral Hernia Repair: 3-Year Follow-Up Of A Pilot Randomized Controlled Trial, Naila H Dhanani, Nicole B Lyons, Kyung Hyun Lee, Oscar A Olavarria, Aris R Arakelians, Julie L Holihan, Lillian S Kao, Ali Siddiqui, Connor Hogan, Tunmi Anwoju, Zuhair Ali, Mike K Liang

Faculty, Staff and Student Publications

Background: Biologic mesh is often used in complex hernia repair, but there has been limited clinical evidence to date to support this practice. The aim of this study was to compare clinical and patient-reported outcomes of biologic versus synthetic mesh for complex open ventral hernia repair (OVHR) at 3 years.

Methods: Patients from a single center, randomized, controlled, pilot trial comparing biologic versus synthetic mesh in complex OVHR were followed for 3 years. The primary outcome focused on major complications, namely mesh infections, hernia recurrences, reoperations, and deaths. Secondary outcomes included surgical site infections, surgical site occurrences, and patient-reported outcomes. …

Poor Oral Health Is Associated With Social Vulnerability In Critically Ill Trauma Patients, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Chelsea J Guy-Frank, Gabrielle E Hatton, Kayli A Quinton, Sophia Syed, Erin E Fox, Charles E Wade, Kimberly A Mankiewicz, Lillian S Kao

Faculty, Staff and Student Publications

Background: Social factors affect oral health status, and poor oral health has been associated with worse health outcomes. Using the Oral Health Risk Assessment Value Index (OHRAVI), a bedside tool for non-dentists to assess oral health, we investigated the interplay of oral health with social drivers of health and social vulnerability, as measured by the Social Vulnerability Index (SVI), in severely injured patients.

Methods: Our retrospective study included dentulous critically ill trauma patients who were previously assigned an OHRAVI score (range 0-3; unhealthy score >1). Patient demographics, comorbidities, and self-reported social drivers were obtained from health records. SVI was calculated …

The Interplay Between Pulse Width And Activation Depth In Tens: A Computational Study, Alexander Guillen, Dennis Q Truong, Yusuf O Cakmak, Sheng Li, Abhishek Datta

Faculty, Staff and Student Publications

Background: Transcutaneous electrical nerve stimulation (TENS) has been a commonly used modality to relieve aches and pain for over 40 years. Commercially available devices provide multiple therapy modes involving a different combination of frequency and pulse width with intensity. While frequency sets sensation, intensity helps determine tolerability, longer pulse width is reported to induce a feeling of deeper stimulation. In fact, longer pulse width has been empirically shown to deliver current into deeper tissues, but in context of other electrical stimulation modalities. The goal of this study was to unpack the relationship between pulse width and activation depth in TENS. …

Suicide Phenotyping From Clinical Notes In Safety-Net Psychiatric Hospital Using Multi-Label Classification With Pre-Trained Language Models, Zehan Li, Yan Hu, Scott Lane, Salih Selek, Lokesh Shahani, Rodrigo Machado-Vieira, Jair Soares, Hua Xu, Hongfang Liu, Ming Huang

Faculty, Staff and Student Publications

Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using binary relevance (acc=0.86, F1=0.78). MentalBERT (F1=0.74) also exceeded BioClinicalBERT (F1=0.72). RoBERTa fine-tuned with …