Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Real-World Impact Of Acupuncture On Analgesics And Healthcare Resource Utilization In Breast Cancer Survivors With Pain, Dina Quan Ng, Sanghoon Lee, Richard T. Lee, Yun Wang, Alexandre Chan

Pharmacy Faculty Articles and Research

Background

This study evaluated the real-world impact of acupuncture on analgesics and healthcare resource utilization among breast cancer survivors.

Methods

From a United States (US) commercial claims database (25% random sample of IQVIA PharMetrics® Plus for Academics), we selected 18–63 years old malignant breast cancer survivors experiencing pain and ≥ 1 year removed from cancer diagnosis. Using the difference-in-difference technique, annualized changes in analgesics [prevalence, rates of short-term (< 30-day supply) and long-term (≥ 30-day supply) prescription fills] and healthcare resource utilization (healthcare costs, hospitalizations, and emergency department visits) were compared between acupuncture-treated and non-treated patients.

Results

Among 495 (3%) acupuncture-treated patients (median age: 55 years, stage 4: 12%, average 2.5 years post cancer diagnosis), most had commercial health insurance (92%) and experiencing musculoskeletal pain (98%). Twenty-seven …

Safety And Efficacy Of Minimally Invasive Posterior Cervical Fusion: A Single Center, Single Surgeon Retrospective Review, George A. Crabill, Kaleb Derouen, Kierany B. Shelvin, John M. Wilson, Gabriel C. Tender

School of Medicine Faculty Publications

Standard posterior cervical fusion is a common surgical technique that utilizes lateral mass screws and rods for fixation. A relatively new, minimally invasive technique involving interfacet decortication and placement of spacers has shown promise in terms of outcomes. We sought to determine fusion rates and complications of this new technique at our institution to bolster current literature. We retrospectively reviewed all patients that underwent a 3-level or less minimally invasive posterior cervical fusions by a single surgeon. Patients were evaluated to determine fusion rates and postoperative complications. Twenty-eight patients underwent minimally invasive posterior cervical fusion. Twenty-seven demonstrated fusion (96%). One …

Acne And The Cutaneous Microbiome: A Systematic Review Of Mechanisms And Implications For Treatments, Alicia Podwojniak, Isabella J Tan, John Sauer, Zachary Neubauer, Hanna Rothenberg, Hira Ghani, Aarushi K Parikh, Bernard Cohen

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Acne vulgaris is a pervasive skin disease characterized by inflammation of sebaceous units surrounding hair follicles. It results from the complex interplay between skin physiology and the intricate cutaneous microbiome. Current acne treatments, while effective, have major limitations, prompting a shift towards microbiome-based therapeutic approaches. This study aims to determine the relationship between acne and the cutaneous microbiome, assess the effects of current treatments on the cutaneous microbiome and explore the implications for developing new therapies. A systematic review was performed using PubMed and SCOPUS databases within the last 10 years. Methodological quality was assessed independently by two authors. The …

Effect Of Cemented Vs Uncemented On Outcomes For Hemiarthroplasty In The Elderly: A Meta-Analysis Of Randomized Clinical Trials, Yuning Feng, Jun Wan, Haidong Deng, Lvlin Chen, Yangchun Xiao, Tiangui Li, Jialing He, Peng Wang, Weelic Chong, Yang Hai, Lu Jia, Yu Zhang

Department of Medical Oncology Faculty Papers

PURPOSE: In patients undergoing hemiarthroplasty in the elderly, the choice of the cemented method remains controversial. This meta-analysis was undertaken to compare the impact of cemented vs uncemented on outcomes for hemiarthroplasty in the elderly.

METHODS: This study included randomized controlled trials comparing the postoperative effects of cemented vs uncemented in patients with hemiarthroplasty. With no language restrictions, we searched Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Cochrane Collaboration), Clinical Trials.gov, the ISRCTN registry, as well as gray literature with no language restrictions from January 1966 to April 2023. Data were quantitatively summarized using a random-effects model. …

Transcatheter Aortic Valve Replacement Is Ready For Most Low-Risk Patients: A Systematic Review Of The Literature, Ahmad Jabri, Anas Alameh, Gennaro Giustino, Pedro Engel Gonzalez, Brian O'Neill, Rodrigo Bagur, Pedro Cox, Tiberio Frisoli, James Lee, Dee Dee Wang, William W. O'Neill, Pedro Villablanca

School of Medicine Faculty Publications

Transcatheter aortic valve replacement (TAVR) has undergone rapid expansion, emerging as a viable therapeutic option for low-risk patients in lieu of surgical aortic valve replacement. This paper aims to provide a review of the scientific evidence concerning TAVR in low-risk patients, encompassing both observational and clinical trial data. Furthermore, a substantial proportion of low-risk patients possesses a bicuspid aortic valve, necessitating careful examination of the pertinent anatomic and clinical considerations to TAVR that is highlighted in this review. Additionally, the review expands upon some of the unique challenges associated with alternate access in low-risk patients evaluated for TAVR. Last, this …

Shining Light On The Invisible: Fluorescent Detection Of Reactive Oxygen Species, Alex Zuo

Research Colloquium

Background

Reactive oxygen species (ROS) play an important role in cell signaling and homeostasis. However, overproduction of ROS leads to oxidative stress, as well as other related diseases, including cancer, neurodegenerative diseases, and cardiovascular disorders. Conventional ROS detection methods are limited by their low sensitivity and low specificity in real-time measurements. Fluorescent probes can offer valuable tools to detect ROS in biological systems. This study is focused on the detection of ROS formation during hypoxia and reoxygenation.

Methods

We used fluorescence detection techniques to study ROS in isolated rodent skeletal muscle models, which were exposed to alternating hyperoxia and hypoxia. …

Unmasking Atrial Flutter In An Elderly Patient With Complex Cardiac History: A Case Report On Diagnostic Challenges And Effective Management, Cesar F. Ortega, Roy Kondapavuluru, Nida Asif, Johanne Chaglasian, Fatimah Bello

Research Colloquium

Introduction: About 200,000 new patients each year are affected by atrial flutter. It is an abnormal cardiac rhythm characterized by rapid regular atrial depolarizations at a rate of approximately 300 beats/minute and a regular ventricle rate of about 150 beats/minute. It can go undiagnosed because it is often asymptomatic and usually diagnosed when patients are being evaluated for other health issues. This case report emphasizes the importance of thorough evaluation of symptoms suggestive of arrhythmia even if they occur intermittently.

Case Presentation: An 81-year-old lady with history of coronary artery disease, status post coronary artery bypass graft, valvular heart disease …

Comprehensive Diagnosis And Management Of Renal Tubular Acidosis Type 1: A Case Report, Cesar F. Ortega, Roy Kondapavuluru, Johanne Chaglasian, Nida Asif, Fatimah Bello

Research Colloquium

Introduction: Renal tubular acidosis type 1 (RTA type 1), also known as distal renal tubular acidosis, is a disorder characterized by the inability of the distal nephron to secrete hydrogen ions and reabsorb bicarbonate (HCO3-) in the presence of metabolic acidosis, leading to a chronic state of metabolic acidosis with a normal anion gap. This disorder has an estimated prevalence of 0.46- 1.60 per 10,000 people. RTA type 1 can often go undiagnosed in hospital settings due to its nonspecific presentation, such as weakness, fatigue or cramps, causing physicians to focus on empirically correcting low electrolyte levels rather than investigating …

Autonomic Nervous System And Viscera-Related Responses To Manual Therapy: A Narrative Overview, Murdi Alanazi, Brian Degenhardt Do, Gwyn Kelley-Franklin, Eric Jacobson, Sandy Fritz, Norman Kettner, Vaclav Kremen, Laura Lipke, William Reed

Library Scholarship

Background: Manual therapy (MT) has long-held that it physiologically impacts autonomic nervous system (ANS)and viscera-related function. This narrative review is intended to serve as a consolidated interdisciplinary resource of original studies related to physiological effects of MT as it relates to the ANS for MT clinicians and researchers new to this MT-related topic.

Objective: This review seeks to identify ANS and viscera-related physiological responses to MT interventions using search terms commonly used by chiropractic, massage, osteopathic, physical therapy, and structural integration clinicians and to provide a quick reference resource of original MT-related studies investigating ANS effects.

Methods: For this interdisciplinary …

Efficacy Of Thoracic Endovascular Aortic Repair Versus Medical Therapy For Treatment Of Type B Aortic Dissection, Karam Motawea, Samah Rouzan, Rowan Elhalag, Abdelrhaman Abdelwahab, Hussam Al Hennawi, Salem Elshenawy, Mai Saad Mohamed, Pensée Chébl, Mohamed Salem Madian, Mostafa Elsayed Elsayed Hewalla, Sarya Swed, Wael Hafez, Bisher Sawaf, Samer Kaspo, Naim Battikh, Mohammed Najdat Seijari, Amr Farwati, Amine Rakab

Abington Jefferson Health Papers

BACKGROUND: Techniques in endovascular therapy have evolved to offer a promising alternative to medical therapy alone for Type B aortic dissections (TBADs).

AIM: The aim of this meta-analysis was to compare mortality and overall complications between thoracic endovascular aortic repair (TEVAR) and best medical therapy (BMT) in patients with TBADs.

METHODS: We included randomized control trials and prospective or retrospective cohort studies that compared TEVAR and BMT for the treatment of type B aortic dissection. Multiple electronic databases were searched.

RESULTS: Thirty-two cohort studies including 150,836 patients were included. TEVAR was associated with a significantly lower 30-day mortality rate than …

Immunoactive Signatures Of Circulating Trna- And Rrna-Derived Rnas In Chronic Obstructive Pulmonary Disease, Megumi Shigematsu, Takuya Kawamura, Deepak Deshpande, Yohei Kirino

Computational Medicine Center Faculty Papers

Chronic obstructive pulmonary disease (COPD) is the most prevalent lung disease, and macrophages play a central role in the inflammatory response in COPD. We here report a comprehensive characterization of circulating short non-coding RNAs (sncRNAs) in plasma from patients with COPD. While circulating sncRNAs are increasingly recognized for their regulatory roles and biomarker potential in various diseases, the conventional RNA sequencing (RNA-seq) method cannot fully capture these circulating sncRNAs due to their heterogeneous terminal structures. By pre-treating the plasma RNAs with T4 polynucleotide kinase, which converts all RNAs to those with RNA-seq susceptible ends (5′-phosphate and 3′-hydroxyl), we comprehensively sequenced …

Preferences For Attributes Of Oral Antipsychotic Treatments: Results From A Discrete-Choice Experiment In Respondents With Schizophrenia Or Bipolar I Disorder, Martha Sajatovic

Faculty Scholarship

Background: Antipsychotic medications are effective treatments for schizophrenia (SZ) and bipolar I disorder (BD-I), but when presented with different treatment options, there are tradeoffs that individuals make between clinical improvement and adverse effects. As new options become available, understanding the attributes of antipsychotic medications that are valued and the tradeoffs that individuals consider when choosing among them is important. Methods: A discrete-choice experiment (DCE) was administered online to elicit preferences across 5 attributes of oral antipsychotics: treatment efficacy (i.e., improvement in symptom severity), weight gain over 6 months, sexual dysfunction, sedation, and akathisia. Eligible respondents were aged 18–64 years with …

The Effectiveness Of The Gnana Laryngeal Mask Airway Ii (Gla-Ii) With Novel Suction Tubing In Gastrointestinal (Gi) Cases, Shahab Ahmadzadeh, Landyn D. Johnson, William T. Barham, James Ilochi, Matthew Fredericks, Giustino Varrassi, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

INTRODUCTION: The Gnana laryngeal mask airway II (GLA-II) is a supraglottic airway device similar to the classic laryngeal mask airway, except it has an additional suction port. This suction port allows for the removal of secretions and saliva. A previous version of the Gnana laryngeal airway 4 was made of silicone, while this newer version is made of polyvinyl chloride (PVC), which is more affordable. This study aimed to demonstrate the effectiveness and tolerability of this PVC-designed GLA-II and evaluate its ability to suction secretions. METHODS: The prospective cohort study included 100 gastrointestinal (GI) cases to determine the effectiveness and …

A Presentation Of Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (Mogad) As Optic Neuritis, Kirhyn A. Stein, Laura Garcia, Sobia Memon, Hernan Guanajuato, Johanna Mora

Research Colloquium

Background: Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (MOGAD) is a relatively new and rare autoimmune disease that causes demyelination of the central nervous system. The pathogenicity of this disease is characterized by an immune reaction against myelin oligodendrocyte glycoprotein: a component of the myelin sheath that is also expressed on the surface of oligodendrocytes. The purpose of this glycoprotein is thought to be for construction and maintenance of myelin and cell to cell communication. The destruction of oligodendrocytes and myelin in the central nervous system affects the brain, spinal cord, and optic nerves, and can cause symptoms such as acute …

A Case Of Rheumatoid Arthritis On Newly Initiated Tnf- Inhibitor Developing Gpa Vasculitis- Conundrum About An Overlap Or Drug-Induced Vasculitis, Jessica Marcela Daza, Joud Enabi, Cristine Arcilla, Myint Thway, Gurjit Kaeley

Research Colloquium

Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitides subset of ANCA-associated vasculitis (AAVs) that involves small-sized arteries affecting multisystemic organs. Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammatory polyarthritis involving the small joints. GPA and RA can have overlapping clinical presentations, including vasculitis, ocular inflammation, interstitial lung disease, and arthritis, but existing evidence indicates they are distinct conditions. Vasculitis-induced biologic TNF inhibitors have been reported (1-3), particularly cutaneous vasculitis and lupus-like syndromes. We retrospectively review a case of a patient with rheumatoid arthritis with a newly diagnosed GPA with RA on anti-TNF therapy. The coexistence of RA …

Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Reductions in opioid prescribing by health care providers can lead to a decreased risk of opioid dependence in patients. Peer comparison has been demonstrated to impact providers' prescribing habits, though its effect on opioid prescribing has predominantly been studied in the emergency department setting.

OBJECTIVE: The purpose of this study is to describe the development of an enterprise-wide opioid scorecard, the architecture of its implementation, and plans for future research on its effects.

METHODS: Using data generated by the author's enterprise vendor-based electronic health record, the enterprise analytics software, and expertise from a dedicated group of informaticists, physicians, and …

Novel Computed Tomography Angiography Parameter Is Associated With Low Cardiac Index In Patients With Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Analysis, Estefania Oliveros, Michel Ibrahim, Carlos Manuel Romero, Paul Navo, Patricia Otero Valdes, Yevgeniy Brailovsky, Amir Darki, Riyaz Bashir, Anjali Vaidya, Paul Forfia, Chandra Dass

Division of Cardiology Faculty Papers

UNLABELLED: Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of incomplete resolution of acute pulmonary embolism. We hypothesize changes in CT Hounsfield Unit gradient (HU-Δ) created by the dispersion of IV contrast through the downstream blood pool correlate with cardiac index (CI). We sought to compare HU-Δ with invasively obtained CI.

METHODS: We completed a retrospective analysis of CTEPH patients in which individuals with low CI (<2.2-L/min/m²) were identified. Both absolute and fractional HU-Δ were derived from pulmonary CTA by subtracting the HU value of the left atrium (LA) and left ventricle (LV) from the main pulmonary artery …

Barriers To Health Care Among Adults With Disabilities In Connecticut, Mary Beth Bruder Phd, Tara M. Lutz Phd, Kelly E. Ferreira Phd

Developmental Disabilities Network Journal

It is estimated that 25% of adults in the US are living with one or more disabilities. Persons with disabilities (PWD) have unmet health care needs, experience health disparities compared to those without disabilities. Barriers to quality health care include structural barriers such as access to transportation, physical access to facilities, and lack of accessible medical equipment. Other barriers include the knowledge, skills, beliefs, and attitudes of health care providers to meet the needs of PWD. To examine the barriers to health care experienced by adults with disabilities in Connecticut, the University of Connecticut Center for Excellence in Developmental Disabilities …

Building And Sustaining Flu Vaccine Acceptance And Trust In The Black Community Through Partnerships With Churches, Salons, And Barbershops, Henry Nuss, Lois Privor-Dumm, Chinonso Ukachukwu, Laura Lee Hall

School of Public Health Faculty Publications

Despite the benefits of flu vaccines, Black adults continue to experience lower vaccination rates in the United States. Contributing factors include lack of access to health care and trusted information about vaccines. The National Minority Quality Forum's Center for Sustainable Health Care Quality and Equity collaborated with church pastors, barbers, and hair stylists to disseminate a survey to their communities to assess barriers/facilitators to flu vaccine uptake. The population (n = 262) was mostly Black (93%), female (77%), between the age of 50-64 (39%) and vaccinated (73%). The most common reasons cited by respondents for being vaccinated were personal health, …

Multimodal Mixing Convolutional Neural Network And Transformer For Alzheimer’S Disease Recognition, Junde Chen, Yun Wang, Adnan Zeb, M. D. Suzauddola, Yuxin Wen

Engineering Faculty Articles and Research

Early recognition of Alzheimer’s disease (AD) and its precursor state, mild cognitive impairment (MCI), is pivotal in interrupting the progression of the disease and providing suitable treatment. Recent development in deep learning techniques has drawn great research attention for improving the efficacy of AD recognition. However, numerous current methods solely utilize data from a single auxiliary domain, limiting their ability to harness valuable intrinsic insights from multiple domains. To cope with the challenge, this paper is devoted to establishing an innovative multimodal medical data fusion model, termed as MMDF, to perform Alzheimer’s disease recognition. Multimodal data including clinical records and …

An International Consensus Panel On The Potential Value Of Digital Surgery, Jamie Erskine, Payam Abrishami, Jean Christophe Bernhard, Richard Charter, Richard Culbertson, Jo Carol Hiatt, Ataru Igarashi, Gretchen Purcell Jackson, Matthew Lien, Guy Maddern, Joseph Soon Yau Ng, Anita Patel, Koon Ho Rha, Prasanna Sooriakumaran, Scott Tackett, Giuseppe Turchetti, Anastasia Chalkidou

School of Public Health Faculty Publications

OBJECTIVES: The use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purchasing decisions. We explore the potential value of digital technologies in surgery and produce expert consensus on how to assess this value. DESIGN: A modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion. SETTING AND PARTICIPANTS: An international panel of 14 experts was assembled, representing relevant …

Transcatheter Closure Of Complex Multifenestrated Atrial Septal Defect Using Three Septal Occluders: Is Three Too Many?, Hussam Al Hennawi, Appa Bandi, Ahmad Abulshamat, Shaurya Srivastava, Mohammed Qintar

Abington Jefferson Health Papers

Atrial septal defects (ASDs) are a common form of adult congenital heart disease, with surgical or transcatheter closure being the mainstay of treatment in patients with hemodynamic or clinical complications. Transcatheter repair of secundum ASD is safe and effective. Complex secundum ASDs with multifenestrated defects pose a unique challenge to transcatheter repair. We report a successful but complex transcatheter closure of an ASD using three overlapping Amplazter devices.

Chylopericardium And Superior Vena Cava Syndrome Caused By Central Venous Occlusion From Indwelling Hemodialysis Catheters, Daniel Underberg, Nicholas Demario, Sebastian Rodriguez, Khulkar Mirzozoda, Mark Decaro, Gregary Marhefka

Division of Cardiology Faculty Papers

Chylopericardium is a rare condition. Causes include superior vena cava syndrome resulting from indwelling catheters. We present a case of this condition in a 42-year-old man with end-stage renal disease treated with hemodialysis through a right subclavian vein catheter. He underwent successful endovascular stenting with resolution of his symptoms and chylopericardium.

Transorbital Alternating Current Stimulation In A Double-Masked Randomized Clinical Trial: Visual Functional Effect And Quality Of Life, Maria De Los Angeles Ramos Cadena, Ashley Sohn, Heather Livengood, Ting-Fang Lee, Batsheva Rubin, Jiyuan Hu, Bernhard A. Sabel, Rachel Matayev, Joseph Panarelli, Gadi Wollstein, Joel S. Schuman

Wills Eye Hospital Papers

PURPOSE: To determine the efficacy and safety of repetitive transorbital alternating current stimulation (rtACS) treatment by assessing vision-related quality of life and visual function outcome in subjects treated with rtACS versus sham-control.

STUDY DESIGN: Double masked, randomized, sham-controlled clinical trial (NCT03188042).

SUBJECTS: Sixteen subjects with moderate-to-advanced glaucoma (visual field [VF] mean deviation [MD] ≤-6.00 decibels) randomized into sham (9 subjects) or rtACS intervention (7 subjects) groups.

METHODS: Subjects underwent 10 rtACS sessions over 2 weeks. All subjects had comprehensive ocular examination at baseline, 1-week, and 4-weeks posttreatment.

MAIN OUTCOME MEASURES: Visual acuity (VA), contrast sensitivity (CS), VF MD, number of …

A Clinician’S Perspective On The New Organ Mesentery And Non-Vascular Mesenteropathies, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Mesentery was discovered as a new organ in 2017. It is a continuous membranous tissue from the duodenojejunal flexure to the anorectal junction. It has distinct anatomy, physiology, and disease states. Primary mesenteropathies include vascular and non-vascular diseases. Some of them are common, and some of them are rarely seen in clinical practice. Secondary mesenteropathies occur when infection or malignancy in another organ spreads to the mesentery. Each entity has specific diagnostic and treatment protocols. Increased awareness of different mesenteropathies and an understanding of their various presentations at different stages of life can help in early diagnosis and improved clinical …

Smart Toys For Sensing And Soothing Distress In Pediatric Patients, Jonathan Daniel Bonilla

Dartmouth College Master’s Theses

This thesis develops and evaluates child-centered technologies to support remote monitoring of pediatric patients, with an emphasis on childhood cancer and pediatric chronic pain. For these and many other health conditions, current therapies tend to focus on treating physical symptoms yet neglect the psycho-emotional aspects of managing the illness. However, such mental states play a major role in recovery. Research has shown that cancer patients with better mental health have better prognoses, higher possibilities of remission, and faster healing processes, while chronic pain patients with better mental health report lower levels of pain. To enable more personalized, continuous, and scalable …

Successful Treatment Of A Chronic Recurrent Expanding Hematoma Of The Thigh, Gianfranco Galantini, Bakhtawar Mushtaq, Jesse Ottaway, Charles Long

Abington Jefferson Health Papers

Chronic expanding hematoma (CEH) is a rare entity that poses diagnostic and therapeutic challenges due to persistent growth, risk of recurrence, and potential for blood loss anemia. The most common etiologies of CEH are trauma or surgery. It is thought to occur due to irritant effects of blood breakdown products, causing bleeding from capillaries in chronic granulation tissue. Although treatment of CEH is variable, complete surgical excision of the hematoma and its pseudocapsule is the gold standard. We present a case of a 15-year CEH that was initially treated with limited evacuation of the hematoma and cavity decortication, resulting in …

Assessing The Accuracy And Utility Of Chatgpt Responses To Patient Questions Regarding Posterior Lumbar Decompression, Alec Giakas, Rajkishen Narayanan, Teeto Ezeonu, Jonathan Dalton, Yunsoo Lee, Tyler Henry, John Mangan, Gregory Schroeder, Alex Vaccaro, Christopher Kepler

Department of Orthopaedic Surgery Faculty Papers

Aim: To examine the clinical accuracy and applicability of ChatGPT answers to commonly asked questions from patients considering posterior lumbar decompression (PLD). Methods: A literature review was conducted to identify 10 questions that encompass some of the most common questions and concerns patients may have regarding lumbar decompression surgery. The selected questions were then posed to ChatGPT. Initial responses were then recorded, and no follow-up or clarifying questions were permitted. Two attending fellowship-trained spine surgeons then graded each response from the chatbot using a modified Global Quality Scale to evaluate ChatGPT’s accuracy and utility. The surgeons then analyzed each question, …

Complications And Influential Perioperative Factors Associated With Spaceoar Hydrogel Placement, Kerith Wang, Rishabh Simhal, Cassra Clark, Mark Mann, James Mark, Costas Lallas, Robert Den, Edouard Trabulsi

Department of Urology Faculty Papers

OBJECTIVE: To examine one academic institution's experiences with SpaceOAR placement, its associated complications, and periprocedural characteristics that affect outcomes for the purpose of quality improvement.

MATERIALS AND METHODS: We conducted a retrospective review of 233 patients who received SpaceOAR from four surgeons and one radiation oncologist between 2018 and 2021. Variables such as demographics, oncologic parameters, radiation plan, and radiographic assessment of hydrogel placement were recorded. The Charlson Comorbidity Index (CCI) was used to assess comorbidity risk. Mann-Whitney and Fisher's exact tests were performed to compare patients with and without complications.

RESULTS: Of the 233 patients who received SpaceOAR, 24 …

Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From Combine Af, Linda Johnson, Alexander Benz, Ashkan Shoamanesh, John W Eikelboom, Michael Ezekowitz, Robert Giugliano, Lars Wallentin, Christian Ruff, Renato Lopes, Sanjit Jolly, Richard Whitlock, Christopher Granger, Stuart Connolly, Jeffrey Healey

Division of Cardiology Faculty Papers

Background: Despite oral anticoagulation, patients with atrial fibrillation (AF) remain at risk of ischemic stroke and systemic embolism (SE) events. For patients whose residual risk is sufficiently high, additional therapies might be useful to mitigate stroke risk.

Methods and results: Individual patient data from 5 landmark trials testing oral anticoagulation in AF were pooled in A Collaboration Between Multiple Institutions to Better Investigate Non-Vitamin K Antagonist Oral Anticoagulant Use in AF (COMBINE AF). We calculated the rate of ischemic stroke/SE among oral anticoagulation-treated patients with a CHA₂DS₂-VASc score≥2, across strata of CHA₂DS₂-VASc …