Medical Specialties Commons^™

Quantifying Sleep Wake Rhythms In The Hospital Environment With Digital Technologies, Carsten Skarke, Nadim El Jamal, Michael V. Genuardi, Thomas G. Brooks, Antonijo Mrčela, Nicholas F. Lahens, Makayla Cordoza, Sean Sarles, Amarachi Mbadugha, Dineth R. Karunamuni, Shikhar Gupta, Charles J. Bae, Amita Sehgal, Thomas P. Cappola, Jacob T. Gutsche, Pavan Atluri, Nimesh D. Desai, Michael A. Acker, Gregory R. Grant, Richard J. Schwab, Ilene M. Rosen, Garret A. Fitzgerald

Division of Cardiology Faculty Papers

Postoperative clinical care is prone to circadian desynchronization that may influence health outcomes. In an exploratory, feasibility-oriented and signal-exploration effort, we collected 1.8 million data points using 11 remote sensors during preoperative, in-hospital and post-discharge settings in 13 elective cardiac surgery patients (5.2% enrolled from 252 screened). We found that room traffic continued during nighttime with ≥1 visit/h. Sound levels exceeded the recommended 45 dBA threshold (51.9 ± 3.3 vs. 48.3 ± 4.2 dBA during nighttime). Brightness dropped at night (89.9 ± 87.7 to 3.7 ± 9.8 lux), but bright light exposures occurred. Ambient room temperature lacked sleep-inducing diurnal variability. …

Hydatid Cyst In The Right Ventricle Leading To Tricuspid Stenosis And Heart Failure: A Case Report, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Shafaq Saleem, Muhammad Ahsan, Sarah Rahman, Azeen Razzaq, Ali Iqbal, Muhammad Sohaib Alvi, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Cystic hydatid infection is a parasitic disease caused by the larval stages of Echinococcus granulosus, most commonly involving the liver and lungs. Cardiac involvement is rare, accounting for less than 2% of cases, with the left ventricle being the most commonly affected site. Involvement of the right ventricle is extremely uncommon and may lead to life-threatening complications such as tricuspid valve obstruction and hemodynamic compromise.

CASE PRESENTATION: We report a rare case of a 42-year-old patient who presented to the emergency department with exertional dyspnea, hemoptysis, chest pain, syncope, peripheral edema, and signs of right-sided heart failure. The patient …

Health Professional Education Associations: What Other Professions Teach Us About Building Resources, Community, And Advocacy For Midwifery Educators, Kim Q. Dau, Ms, Cnm

Doctor of Midwifery Advances in Midwifery Projects

In response to a looming health care workforce deficit, several health professions have experienced recent rapid workforce growth. These professions are supported by specialized health professional associations designed to promote educational excellence in the face of rapid growth. In contrast, the midwifery profession does not have dedicated professional organizations to support education programs. The purpose of this study is to better understand the various strategies used by selected health professional education associations and their value to the profession. This can be adapted to promote the growth and excellence of midwifery education in the United States, responding to the need for …

Ms-Gator: Multi-Scale Graph Attention With Topological Reasoning For Segmentation And Classification Of Prostate Cancer Based On Gleason Scores Using Histopathology Images, Sujata Patil, Mahadeva Swamy, Kavitha Sooda, Rajanikanth Vadigepalli, Khalid Nazim Abdul Sattar, Md Rafeeq

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prostate cancer is one of the prevalent and potentially fatal malignancies, affecting men globally. Accurate segmentation and classification of prostate cancer in histopathology images remain challenging due to complex tissue architecture, staining variability, and high inter-observer differences in manual diagnosis. To address these challenges, this research proposes a Multi-Scale Graph Attention with Topological Reasoning (MS-GATOR) for segmentation and classification of prostate cancer based on Gleason Scores (GS). The MS-GATOR incorporates topological reasoning with hierarchical biological structures by constructing a graph-based representation among three spatial scales such as nuclei, glands, and tissues using Delaunay triangulation to capture both geometric and photometric …

Patient's Age Impact On Stroke Risk And Intracranial Aneurysm Occlusion: Scent Flow Diverter Study-A Nonrandomized Clinical Trial On Large And Giant Aneurysms, Ajay K. Wakhloo, Paul Jenkins, Philip M. Meyers, Alexander L. Coon, Peter T. Kan, Ajit S. Puri, Joost De Vries, Giuseppe Lanzino, Mark D. Bain, Koji C. Ebersole, Babu G. Welch, Aclan Dogan, Pascal Jabbour, J. Mocco, Adnan H. Siddiqui, Aquilla S. Turk, Philipp Taussky, Ricardo A. Hanel

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: The prospective single-arm nonrandomized SCENT (Surpass Intracranial Aneurysm Embolization System Pivotal) trial on flow diverter treatment of large and giant intracranial aneurysms (IA) was analyzed for patients' age and IA characteristics affecting stroke and occlusion rates over 5 years (Trial registration NCT01716117).

METHODS: Impact on major ipsilateral stroke and IA occlusion was studied by stratifying age as 65 years and younger vs older than 65. Kaplan-Meier estimates of time to both endpoints, stratified by age, were created. Univariate predictors of time-to-stroke were analyzed using univariable proportional hazards regression models. Limited bivariable modeling was also attempted.

RESULTS: Of …

Lateral Minimally Invasive Si Joint Fusion Following Adult Spinal Deformity: A Case-Report And Literature Review, Basel Musmar, Hassan Saad, Joshua Pelta-Heller

Department of Neurosurgery Faculty Papers

This case report describes lateral minimally invasive sacroiliac (SI) joint fusion for SI joint–mediated pain in a patient with a history of adult spinal deformity surgery. A 48-year-old woman with multiple medical comorbidities previously underwent long thoracolumbar fusion. She subsequently had L4-S1 anterior lumbar interbody fusion and posterior L4-pelvis instrumentation in 2010. Following a ground-level fall in 05/2021, she developed new left-sided hip and sacroiliac pain with intermittent left lower-extremity numbness. Radiographs demonstrated mild hip osteoarthritis and sacroiliac joint sclerosis; spine imaging revealed discontinuity of the right iliac fixation rod without acute fracture. MRI of the hip showed bilateral sacroiliitis …

Anesthetic Management In Patients With Impella Devices: A Retrospective Review And Clinical Guide, Harrison Yang, Divakara Gouda, Kent B. Berg, Katherine Green, Suvan Sundaresh, Basavana Goudra

Department of Anesthesiology Faculty Papers

Background: The Impella family of percutaneous a left ventricular assist devices are increasingly used for hemodynamic support in patients with cardiogenic shock or advanced heart failure. However, guidance on anesthetic management for patients with Impella support undergoing noncardiac procedures remains sparse. This study reviews perioperative practices and outcomes to inform clinical management.

Methods: Following institutional review board approval, a retrospective analysis was performed of adult patients receiving an Impella device (2.5, CP, 5.0, or 5.5) at Thomas Jefferson University Hospital, Philadelphia, USA, between December 2017 and October 2024. Patients, who subsequently underwent procedures involving anesthesia care were included. Demographics, procedure …

Dasatinib And Quercetin Senolytic Treatment Delays Early Onset Intervertebral Disc Degeneration In Sm/J Mice, Emanuel J. Novais, Olivia K. Ottone, Sanjana Jagannath, Esther Jesutofunmi Akande, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Genetic background is a major determinant of disc degeneration, a leading cause of chronic back pain and disability. Herein, we demonstrate that premature disc cell senescence contributes to early-onset degeneration in SM/J mice and test two systemic senotherapeutic strategies to mitigate it: Navitoclax (Nav.) and a cocktail of Dasatinib and Quercetin (DQ). While Nav. treatment did not improve severe degeneration in SM/J mice or senescence status, DQ-treated mice showed lower grades of degeneration and a decreased abundance of senescence markers, including p19ARF, p21, and the senescence-associated secretory phenotype (SASP). DQ improved disc cell viability and phenotype retention and retarded fibrosis …

Reirradiation Treatment Effects In The Clinic (Retec) Proposal - Proof Of Concept Based On Spinal Cord Dose Tolerance For Reirradiation With Stereotactic Body Radiotherapy, Jimm Grimm, Anand Mahadevan, Olusola Obayomi-Davies, Scott G. Soltys, Arjun Sahgal, Kristin J. Redmond, Michael T. Milano, Wolfgang A. Tomé, Kenneth Brooks, Scott Dodd, John Austin Vargo, Gopal Subedi, Jinyu Xue, Bisher Ebid, Felix Ehret, Byung-Han Andrew Rhieu, Christoph Fürweger, Rachel Grimm, Alexander Muacevic, Vitali Moiseenko, Shalom Kalnicki, Mark Mclaughlin, Lawrence R. Kleinberg, John R. Adler, Iris C. Gibbs

College of Health Professions Faculty Papers

BACKGROUND: Since the inception of spinal radiosurgery decades ago, the factors influencing spinal cord recovery have remained unclear. Elucidating these factors would aid in reirradiation planning and delivery. We describe modeling reirradiation normal tissue complication probabilities (NTCP) from compiled published data, akin to the collaborative Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) and High Dose per Fraction, Hypofractionated Treatment Effects in the Clinic (HyTEC) projects.

PURPOSE: Simple dose-time recovery factors for the spinal cord serve as a basis to propose the Reirradiation Treatment Effects in the Clinic (ReTEC) project. ReTEC aims to define human organ recovery factors …

Utility Of Right Ventricular Mass Ratios In Recipients With Pulmonary Hypertension: A United Network For Organ-Sharing Database Analysis, Matthew P. Weber, Danial Ahmad, Howard J. Eisen, Eugene Storozynsky, René J. Alvarez, J. Eduardo Rame, Keshava Rajagopal, John W. Entwistle, Charles Hoopes, Vakhtang Tchantchaleishvili

Division of Cardiology Faculty Papers

PURPOSE: There is a lack of data reviewing the role of predicted cardiac mass ratio (PCMR) in transplant recipients with pulmonary hypertension (PH). In particular, the right ventricular (RV) mass ratio (RVMR) is a component of PCMR not yet studied separately for this purpose. We aimed to review the relationship of PCMR and RVMR with PH in terms of post-transplant overall survival.

METHODS: The United Network for Organ-Sharing (UNOS) database was queried for primary heart transplant (HTx) patients from 2004 to 2023. Predicted RVMR was calculated for donors and recipients. A parsimonious multivariable model Cox model was formed for risk …

Cerebellar Oligodendrocytic Α-Synuclein Pathology And Dentate Nucleus Neuronal Hypertrophy In Parkinson’S Disease, Diego Iacono, Hui Peng, John Paul Bouffard, Roger Kurlan

Department of Neurology Faculty Papers

Idiopathic Parkinson's disease (iPD) research has historically prioritized basal ganglia dysfunction and neuronal Lewy body pathology, often overlooking cerebellar and non-neuronal cells contributions. This study investigates cerebellar neuropathology in iPD, specifically focusing on neuronal and non-neuronal cells of the dentate nucleus (DN) and its adjacent white matter (DN-WM). We systematically assessed autopsy-confirmed iPD brains vs. age-matched controls using immunohistochemistry and stereology-based morphometry methods. The study evaluated α-synuclein pathology, other common age-related co-occurring pathologies (β-amyloid, Tau, neuroinflammation), myelin integrity (Luxol-Fast-Blue), and neuronal volumetric changes in the DN of the cerebellum. In iPD brains, we identified intracytoplasmic α-synuclein inclusions within oligodendrocytes across …

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

Contraception In The Ed: Understanding Education And Opportunities For Clinicians To Advise Patients, Hannah B. Lewis, Teagan R. Mccarthy, Dara Kass, Jennifer L. Kahoud

Department of Emergency Medicine Faculty Papers

Introduction: The United States faces a high rate of unwanted pregnancies. Despite this, many people continue to face barriers to accessing contraception. The emergency department (ED) can help bridge these gaps, but emergency clinicians must first feel comfortable offering contraceptive services. In this study, we sought to determine emergency clinician comfort in prescribing contraceptives and educating patients on their use. We also gauged clinician interest in receiving education specifically geared toward contraceptive care.

Methods: We conducted an online survey of ED residents, attendings, and advanced practice clinicians at Thomas Jefferson Univerity Hospital and affiliates in both the urban and suburban …

Progesterone Receptors Drive Advanced Breast Cancer Phenotypes Including Circulating Tumor- And Stem-Like Cell Expansion In The Context Of Esr1 Mutation, Thu H. Truong, Noelle E. Gillis, Amy R. Dwyer, Rosemary J. Huggins, Kyla M. Hagen, Sai Harshita Posani, Nuri A. Temiz, Carlos Perez Kerkvliet, Ellie M. Piepgras, Julie H. Ostrander, Geoffrey L. Greene, Carol A. Lange

Department of Urology Faculty Papers

Endocrine therapy resistance remains a major challenge in the treatment of advanced estrogen receptor positive (ER+) breast cancer. This can be driven by acquired mutations in the estrogen receptor gene (ESR1), such as Y537S or D538G, that results in constitutive estrogen-independent ER activity. Progesterone receptors (PR) are important modifiers of ER activity, in part via direct binding. We previously showed that PR mediates expansion of cancer stem-like cell (CSC) populations. In this study, we sought to define whether PR function changes in the context of ESR1 mutations. PR readily interacted with wild type (WT), but not Y537S or D538G ERs. …

A Prolonged Nightly Fasting Plus Telehealth Coaching Intervention (Pnf+) For Men On Androgen Deprivation Therapy For Pca: A Pilot Feasibility Randomized Controlled Trial, Kuang-Yi Wen, Julianne Freedman, Kevin K. Zarrabi, Rachel Slamon, Rita Smith, Jessica Liang, Patrick Mille, William J. Tester, William Kevin Kelly

Department of Medical Oncology Faculty Papers

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa.

Methods: The study was carried out via a two-armed randomized controlled trial including 40 patients with PCa at a medical center in Philadelphia. During the 3-month period, the intervention group (PNF+) received health coaching utilizing an interactive text message system, and the control group received healthy eating text messages for the same duration. The outcome variables were feasibility and acceptability.

Results: The PNF+ group (n = 27) had high …

Emergency Care Outside Of The Four Walls Of The Emergency Department, Judd E. Hollander

Department of Emergency Medicine Faculty Papers

No abstract available

Retracted: Idea Density And Grammatical Complexity As Neurocognitive Markers, Diego Iacono, Gloria C. Feltis

Department of Neurology Faculty Papers

The journal retracts the article titled “Idea Density and Grammatical Complexity as Neurocognitive Markers” [1], cited above. Following publication, concerns were brought to the attention of the Editorial Office regarding the presence of misnamed phrases and the accuracy of several references cited in this paper [1]. In accordance with the journal’s standard procedures, the Editorial Office and Editorial Board conducted an investigation that confirmed the presence of a misnamed phrase for ROSE model and significant number of non-existent references, which were determined to undermine the overall reliability of this study. In addition, the investigation identified indications of generative AI use …

Organ Procurement Organization Utilization Of Portable Hypothermic Oxygenated Machine Perfusion In Liver Transplantation: The First Us Experience, Christine E. Haugen, Muhammad Bilal Moeen-Ud-Din, Abdalla M. Hadhoud, Achintya Kaw, James R. Butler, James V. Guarrera, Sherry Quire, Ralph C. Quillin

Department of Surgery Faculty Papers

BACKGROUND: Advanced machine perfusion techniques have increased the use of hard-to-place organs, effectively changing the liver transplantation landscape. Liver transplantation machine perfusion has been driven largely by industry or individual transplant centers. We describe the implementation of a portable, organ procurement organization-initiated hypothermic oxygenated machine perfusion strategy for liver transplantation as a proof of concept.

METHODS: Surgeons and staff at a regional organ procurement organization (Indiana Donor Network) were trained to use and cannulate liver allografts using a portable hypothermic oxygenated machine perfusion platform. We evaluated all liver transplantations recovered and placed on hypothermic oxygenated machine perfusion (N = 18) …

Icdpicr2 Calculates Abbreviated Injury Scale Scores From Diagnostic Codes: Limitations For Traumatic Brain Injury Epidemiology, Joseph Piatt

Department of Pediatrics Faculty Papers

BACKGROUND: Many large data sets are limited in their usefulness for trauma epidemiology by a paucity of clinical data reflecting injury severity. Software packages have been developed for extrapolation of diagnostic codes to Injury Severity Scores commonly used in trauma research. The aim of this project was to evaluate one recently upgraded package, ICDPICR2.

METHODS: Data were taken from the Trauma Quality Improvement Program (TQIP) for 2022. The inclusion criterion was an Abbreviated Injury Scale (AIS) head score of 1 or greater. The ICDPICR2 package in R was used to calculate AIS body region scores and Injury Severity Scores (ISS) …

The History Of Women In Neuroradiology In North America From 1990 To The Present, Vijay M. Rao

Department of Radiology Faculty Papers

From 1990 to 2024, women neuroradiologists in North America have made tremendous progress in the areas of leadership, clinical innovation, research, education, diversity, equity and inclusion, and global outreach. This chapter begins with summaries of their key accomplishments in four broad domains, followed by short biographical sketches of numerous luminaries organized by leadership roles and areas of expertise, and ending with conclusions and future directions.

Transcultural Headache Medicine: A Framework For Integrating Cultural Contexts Into Headache Science And Care - A Call To Action From The International Headache Society., Mario F. P. Peres, Giancarlo Lucchetti, Homero Vallada, Ivy L. Riso, Georgia K. Westenhofen, Marcelo Moraes Valença, Juliana Ramos De Andrade, K. C. Brennan, Morris Levin, Tsubasa Takizawa, Zhao Dong, Yonggang Wang, Wanakorn Rattanawong, Henry Riyanto Sofyan, Massimo Leone, Freda Dodd-Glover, Hsiangkuo Yuan, Abdulrazaq Albilali, Taoufik Alsaadi, Leonardo Caixeta, Anna P. Andreou, Peter J. Goadsby, Antoinette Maassenvandenbrink, Sait Ashina, Rami Burstein, Patricia Pozo-Rosich, Fayyaz Ahmed, Shuu-Jiun Wang

Department of Jefferson Headache Center Papers and Presentations

Headache disorders are among the most disabling neurological conditions, affecting over 1.5 billion people globally. Despite advances in pharmacological therapies, major inequities persist due to underdiagnosis, undertreatment and limited access to effective care, particularly in low- and middle-income countries. Social determinants of health, including cultural meanings, language and health beliefs, are increasingly recognized as key drivers of disparities in burden, diagnosis and treatment outcomes. Traditional medicine, used by more than 80% of the global population, remains first-line care in many regions and continues to influence therapeutic choices in high-income settings. Major systems such as Ayurveda, Traditional Chinese Medicine, Unani and …

Hemodialysis Access-Related High-Output Heart Failure: From Mechanisms To Multidisciplinary Management, Chukwuemezie Mamanu, Estefania Oliveros, Yevgeniy Brailovsky

Department of Medicine Faculty Papers

No abstract provided.

Postmarketing Safety Of Bimekizumab For Hidradenitis Suppurativa: An Early Pharmacovigilance Analysis Using The United States Food And Drug Administration Adverse Event Reporting System, Simona A. Alomary, Nicole J. Baker, Temitayo Ogunleye, Susan C. Taylor

Student Papers, Posters & Projects

No abstract provided.

Occupational Epidemiology Of Acral Lentiginous Melanoma, Lily Guo, Robin Kikuchi, April W. Armstrong, Suephy C. Chen

Department of Dermatology and Cutaneous Biology Faculty Papers

Acral lentiginous melanoma (ALM) classically presents in glabrous skin. Some studies suggest an association between mechanical stress and ALM development. People working jobs with long periods of standing/walking may be exposed to near-daily mechanical stress. To investigate the relationship between occupation type and ALM development, we performed a retrospective cohort study using Optum’s Clinformatics Database (2007—2023). We compared the risk of ALM in adults with occupational data (n = 9,270,935). Retired patients had the highest prevalence (0.081) and incidence per 1,000,000 person-years (0.514, 95% confidence interval = 0.487—0.542) of ALM. We performed multivariate logistic regression, adjusted for demographics and insurance, …

Predicting Ventilation From Single Breathing Phase Non-Contrast Ct Using Swin Transformers, Yi-Kuan Liu, Hsu-Ting Kuo, Alaa Melek, Richard Castillo, Yevgeniy Vinogradskiy, Lili Zhao, Girish Nair, Edward Castillo

Department of Radiation Oncology Faculty Papers

BACKGROUND: Pulmonary ventilation imaging enables functional avoidance radiotherapy treatment plans by quantifying regional lung function. However, current clinical standards, such as 99𝑚Tc-based single-photon emission computed tomography (SPECT), rely on radioactive tracers, which can introduce imaging deposition artifacts. CT ventilation imaging (CTVI) methods based on both physical models and deep learning approaches currently require multiple CT images as input, such as the inhale/exhale phases of a 4DCT. While the theoretical foundation of physics-based CTVI is built on multi-phase information, the feasibility of single-phase deep learning CTV models has not been determined.

PURPOSE: While deep learning methods have predicted SPECT ventilation from …

Computed Tomography For Four-Dimensional Dose Calculation: Effect Of Detector Array Length, Inhwan Yeo, Qianyi Xu

Department of Radiation Oncology Faculty Papers

PURPOSE: Four-dimensional computed tomography (4DCT) is susceptible to a geometrical error when respiration changes upon patient shift. 4DCT using 16-cm detector arrays, not needing the shift, has been shown to improve geometrical accuracy, compared with a conventional 4DCT (4-cm array), albeit with some Hounsfield unit discrepancies. The 4DCTs were validated for 4D planning.

MATERIALS AND METHODS: A lung-mimicking phantom containing a spherical target with ten respiratory traces and three tumor-shaped targets with their traces was respectively imaged when, to each of the ten-positions/phases, the lung was moved (1) step-wisely by helical scan at each movement (ground truth; 4DCT_GT), …

Single-Center Experience Using Endologix Anatomically Fixated Endograft Device For Treatment Of Aortoiliac Occlusive Disease, Isabella Muti, Gaurang Joshi, Dawn M. Salvatore, Michael J. Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

OBJECTIVE: The covered endovascular reconstruction of the aortic bifurcation (CERAB) technique was developed in recent years as a novel surgical intervention for aortoiliac occlusive disease (AIOD). One tool frequently used in such procedures is the anatomically fixated endograft (AFX), manufactured by Endologix. The present study aimed to review the outcomes of patients with AIOD after CERAB procedure using the Endologix AFX device.

METHODS: This is an institutional review board-approved retrospective study investigating the experience of a single center in using Endologix's AFX device as CERAB for AIOD from September 2018 to June 2024. Data were obtained from the medical records …

Initial Site Of Metastasis Influences Prognosis In Pancreatic Ductal Adenocarcinoma, Eleanor Mancheski, David Baek, Wilbur Bowne, Harish Lavu, Charles Yeo, Avinoam Nevler

Department of Surgery Faculty Papers

INTRODUCTION: Metastatic pancreatic ductal adenocarcinoma (mPDAC) is a highly aggressive malignancy. Prior studies suggest that the initial site of metastasis may impact prognosis. This study investigates whether overall survival in mPDAC patients differs between patients first presenting with lung metastases versus those presenting with liver metastases.

METHODS: This retrospective analysis utilized the multi-institutional TriNetX database, identifying patients with histologically diagnosed PDAC who initially presented with either liver or lung metastases. Demographic, histologic, and outcome data were collected and analyzed. Patients were matched 1:1 using a nearest neighbor propensity score (PS) algorithm, and Kaplan-Meier survival analyses were performed. Cox regression was …

Free Versus In Situ Right Internal Mammary Artery As A Conduit In Coronary Artery Bypass Surgery: A Meta-Analysis, Yuta Kikuchi, Tomoki Sakata, Tomonari Shimoda, Shinichi Fukuhara, Junichi Shimamura, Makoto Hibino, Tsuyoshi Kaneko, Hiroo Takayama, Hisato Takagi, Michel Pompeu Sa, Toshiki Kuno

Department of Medicine Faculty Papers

OBJECTIVES: There is debate regarding the optimal choice for a second conduit in coronary artery bypass grafting. The right internal mammary artery (RIMA) is commonly employed as a second conduit; however, it is unclear whether the free (fRIMA) or in situ (isRIMA) configuration yields superior outcomes. We performed a systematic review and meta-analysis to compare clinical outcomes between fRIMA and isRIMA as the second conduit.

METHODS: A comprehensive search of PubMed (MEDLINE), EMBASE, and CENTRAL was performed through May 2025 to identify studies comparing outcomes in patients undergoing coronary artery bypass grafting with either fRIMA or isRIMA as a second …

Incidence Of Carpal Tunnel Syndrome After The Diagnosis Of Ulnar Neuropathy, Harrison S. Fellheimer, Eric Didomenico, Mahaa Ayub, Magnolia Livingston, William L. Justice, Gabriel I. Onor, Eric Tecce, Pedro K. Beredjiklian

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: The purpose of this study is to determine whether patients diagnosed with ulnar nerve lesions (UNLs) have an increased risk of developing carpal tunnel syndrome (CTS).

METHODS: A retrospective cohort study was conducted using the TriNetX database, which contains data of >100 million patients. We identified 360,021 patients with UNLs and matched them 1:1 with controls. The incidence of CTS was assessed at 1, 2, 3, 4, and 5 years following the diagnosis of UNL. Statistical analyses were used to evaluate the development of CTS in the UNL cohort compared with controls.

RESULTS:  Patients with UNL demonstrated a significantly …