Medical Specialties Commons^™

Medicaid Expansion And Breast Cancer Care And Outcomes-What Lies Ahead?, Meghan H. Maceyko, Oluwadamilola M. Fayanju

Department of Surgery Faculty Papers

No abstract provided.

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

Clinical Test Cases For Commissioning, Qa, And Benchmarking Of Model-Based Dose Calculation Algorithms In 1⁹2ir Hdr Gynecologic Tandem And Ring Brachytherapy, Vasiliki Peppa, Maude Robitaille, Fatemeh Akbari, Shirin Enger, Rowan Thomson, Firas Mourtada, Gabriel Fonseca

Department of Radiation Oncology Faculty Papers

PURPOSE: To develop clinically relevant test cases for commissioning Model-Based Dose Calculation Algorithms (MBDCAs) for ¹⁹²Ir High Dose Rate (HDR) gynecologic brachytherapy following the workflow proposed by the TG-186 report and the WGDCAB report 372.

ACQUISITION AND VALIDATION METHODS: Two cervical cancer intracavitary HDR brachytherapy models were developed based on a real patient, using either uniformly structured regions or realistic segmentation. The patient's computed tomography (CT) images were processed, converted to a series of digital imaging and communications in medicine (DICOM) CT images, and imported into two treatment planning systems (TPSs), the Oncentra Brachy and BrachyVision. The original segmentation …

Large Language Models Improve Readability Of Patient Education Materials On Vascular Conditions, Melissa Chen Xu, Nicola Habash, Justin Do, Jiaying Bi, Dawn Salvatore, Paul J Dimuzio, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

Objective: Patient education materials frequently exceed the recommended sixth-grade reading level. Although large language models (LLMs) have shown inconsistent accuracy in medical query responses, they have demonstrated promise in simplifying complex text. This capability has not yet been studied in vascular patient education materials. This study evaluates whether ChatGPT-4o and Gemini 1.5 Pro can improve the readability of Society for Vascular Surgery (SVS) patient education flyers. Methods: SVS health flyers were selected based on five common vascular conditions: abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, peripheral artery disease, and varicose veins. Each flyer was submitted to ChatGPT-4o and …

The Prevalence Of Diabetic Retinopathy In American Indians Or Alaska Natives And Non-Indigenous Americans: A Systematic Review And Meta-Analysis., Caberry W. Yu, Keean Nanji, Anubhav Garg, Michele Zaman, Jane Jomy, Abdullah El-Sayes, Catherine Sun, Shreyas Bhat, Mark Phillips, Dena Zeraatkar, Jinhui Ma, Enrico Borrelli, Sunir J Garg, David H. Steel, Tien Yin Wong, Sobha Sivaprasad, Charles C. Wykoff, Varun Chaudhary

Wills Eye Hospital Papers

TOPIC: To estimate the prevalence of diabetic retinopathy (DR) in adult American Indian or Alaska Native (AIAN) and non-AIAN patients with diabetes.

CLINICAL RELEVANCE: Although diabetes mellitus is more prevalent among AIAN patients compared with non-AIAN patients, the evidence is inconsistent regarding whether AIAN patients have a higher prevalence or severity of DR.

METHODS: We searched Ovid MEDLINE, EMBASE, and Web of Science databases from inception through February 23, 2025. We included primary studies evaluating the prevalence of DR in Americans with diabetes. The prevalence of (1) DR, (2) diabetic macular edema (DME), (3) proliferative diabetic retinopathy (PDR), (4) vision-threatening …

Conventional Versus Advanced Imaging Selection For Endovascular Treatment Of Basilar Artery Occlusion Strokes., Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Sami Al Kasab, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M. Starke, Marios-Nikos Psychogios, Edgar A. Samaniego, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Jonathan A. Grossberg, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G. Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Charles Matouk, Min S. Park, Michael R. Levitt, Waleed Brinjikji, Mark Moss, Travis Dumont, Ergun Daglioglu, Richard Williamson, Pedro Navia, Reade De Leacy, Shakeel Chowdhry, David J. Altschul, Alejandro M. Spiotta, Peter Kan

Department of Medicine Faculty Papers

INTRODUCTION: Endovascular thrombectomy (EVT) is an effective treatment for basilar artery occlusion (BAO) stroke in select patients. While there is a growing body of literature suggesting that advanced imaging modalities such as computed tomography perfusion (CTP) and magnetic resonance (MR) may not be necessary for selecting anterior circulation large vessel occlusion stroke patients for EVT, whether advanced imaging may be superior to conventional imaging (non-contrast CT and CT angiography) in identifying good treatment candidates among BAO patients is less clear.

PATIENTS AND METHODS: This was a multicenter retrospective cohort study of BAO EVT patients treated from 2013 to 2022 in …

New Therapies, New Challenges: Cystic Lung Disease After Cancer Immunotherapy, Ananya Venkatesh, David Camacho, Ross Summer, Michael Dong

Division of Internal Medicine Faculty Papers & Presentations

Immunotherapies have reduced reliance on cytotoxic strategies with their associated high toxicity levels, revolutionizing cancer care. However, these targeted therapies have also increased prevalence of previously rare sequelae, impacting patients experiencing longer survival. We describe a case of endometrial adenocarcinoma with lung metastases, in which tumor resolution following immunotherapy created cystic airspaces, leading to a pneumothorax complication. A 49-year-old female with advanced stage endometrial adenocarcinoma and lung metastasis developed cystic lung lesions in areas of previous metastatic lesions after treatment with Pembrolizumab and Bevacizumab. She developed a pneumothorax secondary to the rupture of one of the large lung cysts, leading …

Cervical Laminectomy For Degenerative Cervical Myelopathy: Is There A Role In The Modern Day? A Systematic Review And Meta-Analysis, Christopher S. Lozano, Armaan K. Malhotra, Husain Shakil, Vishwathsen Karthikeyan, Neevya Balasubramaniam, Uzondu Agochukwu, Ankit I. Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Aminul I. Ahmed, Ricardo Rodrigues-Pinto, Michael Fehlings, James S. Harrop, Shekar N. Kurpad, Jefferson R. Wilson

Department of Neurosurgery Faculty Papers

Study DesignSystematic Review and Meta-Analysis.ObjectivesTo compare clinical outcomes in degenerative cervical myelopathy (DCM) patients treated with laminectomy alone (LA) vs laminectomy with fusion (LF) and determine post-laminectomy kyphosis incidence.MethodsWe searched PubMed, Scopus, Embase, Web of Science, and MEDLINE from inception-September 2024 for studies comparing LA and LF for DCM. Outcomes assessed included post-laminectomy kyphosis, neurological recovery outcomes, patient-reported outcomes (PROs), and complication rates. Meta-analyses were performed using random-effects models.ResultsTwenty-seven studies including 3286 patients (2272 LA and 1014 LF), met the inclusion criteria. The pooled incidence of post-laminectomy kyphosis in the LA patients was 2.02 events per 100 person-years (95% CI: …

Associations Between Contralesional Neuroplasticity And Motor Impairment Through Deep Learning-Derived Mri Regional Brain Age In Chronic Stroke (Enigma): A Multicohort, Retrospective, Observational Study, Gilsoon Park, Mahir Khan, Justin Andrushko, Nerisa Banaj, Michael Borich, Lara Boyd, Amy Brodtmann, Truman Brown, Cathrin Buetefisch, Adriana Conforto, Steven Cramer, Michael Dimyan, Martin Domin, Miranda Donnelly, Natalia Egorova-Brumley, Elsa Ermer, Wuwei Feng, Fatemeh Geranmayeh, Colleen Hanlon, Brenton Hordacre, Neda Jahanshad, Steven Kautz, Mohamed Salah Khlif, Jingchun Liu, Martin Lotze, Bradley Macintosh, Feroze Mohamed, Jan Nordvik, Fabrizio Piras, Kate Revill, Andrew Robertson, Christian Schranz, Nicolas Schweighofer, Na Jin Seo, Surjo Soekadar, Shraddha Srivastava, Bethany Tavenner, Gregory Thielman, Sophia Thomopoulos, Daniela Vecchio, Emilio Werden, Lars Westlye, Carolee Winstein, George Wittenberg, Jennifer Ferris, Chunshui Yu, Paul Thompson, Sook-Lei Liew, Hosung Kim

Department of Radiology Faculty Papers

BACKGROUND: Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.

METHODS: …

Histopathological Effects Of The Intrathecal Chondroitinase Abc Administration In Spinal Cord Injured Rats: A Systematic Review, Mohammad Amin Habibi, Ali Anjomshoa, Mohsen Sadeghi-Naini, Zahra Ghodsi, Samuel Berchi Kankam, Erfan Razavi, Armin Aryannejad, Seyed Mohammad Piri, Akam Ramezani, Rasha Atlasi, Kawthar Mohamed, Sina Shoo, Meysam Kaveh, Akbar Fotouhi, Arman Zeinaddini, James S. Harrop, Alex R. Vaccaro, Michael G. Fehlings, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Introduction: Chondroitinase ABC (ChABC) has been considered a potential treatment for spinal cord injury (SCI). We aim to identify and evaluate the histopathological effects of intrathecal ChABC administration in SCI rat models.

Methods: We searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library for studies published from the inception of each database until November 22, 2022.

Results: Of 3857 screened citations, 17 studies met eligibility criteria and were entered into the qualitative analysis. Sixteen studies were of high quality, and one study was of medium quality. The four main rat strains used in studies were Sprague-Dawley, Wistar, Lister hooded, …

The Two-Step Allogeneic Stem Cell Transplant Is Associated With Excellent Engraftment, Improved Survival And Low Nonrelapse Mortality In Patients With Myelofibrosis, Xia Bi, Shaik Rashid, Joanne Filicko-O'Hara, Joseph Van Galen, William O'Hara, John L. Wagner, Dolores Grosso, Neal Flomenberg, Usama Gergis

Department of Medical Oncology Faculty Papers

Myelofibrosis is a chronic myeloproliferative disorder primarily affecting older adults, and allogeneic hematopoietic stem cell transplantation (HSCT) remains the only curative treatment option. However, HSCT for myelofibrosis presents significant challenges, including high nonrelapse mortality (NRM) and an increased risk of graft failure. In this 20-year retrospective study, we evaluated outcomes for 32 myelofibrosis patients who underwent HSCT at our institution, with particular focus on a two-step transplant approach designed to optimize T-cell dosing by separating the lymphoid and myeloid graft components, with cyclophosphamide administered after the lymphoid infusion and before infusion of CD34-selected stem cells. Eighteen patients underwent transplantation using …

Simulation Training In Radiation Oncology, Michael C. Schell, Andrew W. Beavis, Derek W. Brown, Michael Milano, Michael O'Neill, Yan Yu, Daniel C. Pavord, Peter Dunscombe

Department of Radiation Oncology Faculty Papers

Simulation training can be used in the design of new processes or, more commonly, to train and re-train healthcare personnel in standard processes. Simulation training is one avenue to making radiation oncology a high reliability health care intervention. In this paper, we explore the relevance of simulation training to the provision of high-quality and safe radiation oncology practice against the background of simulation training conducted in high reliability industries. The use of simulation training in healthcare, as well as specific examples in radiation oncology, is reviewed. An outline of the steps for developing a simulation training program is provided. Simulation …

Variation In Lung Cancer Risk Distribution By Race Across Modified Plcom2012 Risk Models Among Lung Cancer Screening Participants, Haley M. Evans, Rebecca Landy, Christine S. Shusted, Brooke Ruane, Eboni Anderson, Teresa Giamboy, Mary Mcmullen, Gregory C. Kane, Hee-Soon Juon, Julie Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Oxytocin Dosing During Trial Of Labor After Cesarean To Minimize The Risk Of Uterine Rupture: A Systematic Review And Meta-Analysis, Pierpaolo Nicolì, Moti Gulersen, Jordan Beacham, Hila Hochler, Alessandra Familiari, Anna Locatelli, Cynthia Abraham, Ettore Cicinelli, Amerigo Vitagliano, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Oxytocin remains the mainstay for induction and for the management of labor arrest during trial of labor after cesarean (TOLAC). Therefore, the clinical question should be not whether to use oxytocin, but how to optimize its administration. This meta-analysis aimed to assess which oxytocin protocol, in terms of initial dose, amount of increase, timing to next increase, and maximum dose, may minimize the risk of uterine rupture (UR) during TOLAC.

DATA SOURCES: PubMed, Embase and Clinicaltrials.gov were searched up to September 21, 2024.

STUDY ELIGIBILITY CRITERIA: Randomized and nonrandomized studies evaluating the association between induction and/or augmentation with oxytocin …

Impact Of Prophylactic Oral Azithromycin During Labor On Azithromycin Resistance (Amr) In Nasal Staphylococcus Aureus And Streptococcus Pneumoniae In Women And Infants In The Multi-Country Azithromycin Prevention In Labor Use Study (A-Plus)., Patricia L. Hibberd, Jean H. Kim, Marissa Trotta, Sixto M. Leal, Anna Aceituno, Doyle V. Ward, Archana Patel, Akila Subramaniam, Waldemar A. Carlo, Imran Ahmed, Sarah Saleem, Sk Masum Billah, Rashidun Haque, Manolo Mazariegos, Fabian Esamai, Manjunath S. Somannavar, Shivaprasad S. Goudar, Elwyn Chomba, Muska Mwenchanya, Adrien Lokangaka, Antoinette Tshefu, Robert L. Goldenberg, Melissa Bauserman, Nancy F. Krebs, Sherri Bucher, Richard J. Derman, William A. Petri, Marion Koso-Thomas, Denise C. Babineau, Elizabeth M. Mcclure, Alan T. N. Tita

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Prophylactic oral azithromycin vs. placebo reduced maternal, but not neonatal, mortality/sepsis in the A-PLUS Randomized Trial. While prophylactic intrapartum azithromycin reduces maternal mortality/sepsis, it may promote antimicrobial resistance (AMR) in commensal bacteria,.

METHODS: Randomly selected women and their infants participating in A-PLUS were enrolled in a longitudinal cross-sectional sub-study to assess the presence of azithromycin resistance in selected bacteria in nasal cultures. Staphylococcus aureus and Streptococcus pneumoniae were cultured on selective agar, then azithromycin-containing agar to select for azithromycin resistant bacteria, identified biochemically. Azithromycin susceptibility was assessed by E-test. Nasal cultures were collected from women and infants between August …

Outcomes And Implications Of Patients Included Vs. Excluded For Extracorporeal Cardiopulmonary Resuscitation After Initial Activation, Kevin George, Joshua B. Wiener, Michael Zacharias, Frank Forde, Yasir Abu-Omar, Colin Mccloskey

Division of Cardiology Faculty Papers

BACKGROUND: The aim of this study is to describe the implementation of a new Extracorporeal Cardiopulmonary Resuscitation (ECPR) program in Cleveland, Ohio, USA. We also provide a novel comparison of outcomes between patients cannulated vs excluded from cannulation for ECPR after initial field activation.

METHODS: A prospective observational study of ECPR activations between September 2021 and February 2025. Patients meeting initial eligibility criteria for out-of-hospital cardiac arrest (OHCA)-namely based on age, bystander-CPR, and initial shockable rhythm-were transported to the emergency department where the ECPR team completed cannulation based on further biochemical criteria. Medical records were used to collect data after …

External Multicenter Validation Of The Esah Score For Predicting Outcomes After Subarachnoid Hemorrhage, Natália Vasconcellos De Oliveira Souza, Rohan Sharma, Otavio Frederico De Toledo, Ingrid Pereira Marques, Salvador F. Gutierrez-Aguirre, Lara-Velazquez Montserrat, Eric Sauvageau, Naval Neeraj, Amin Aghaebrahim, Feres Chaddad Neto, Ricardo A. Hanel, Gisele Sampaio Silva, William David Freeman

Jefferson Hospital Staff Papers and Presentations

Reliable assessment of prognosis after aneurysmal subarachnoid hemorrhage (SAH) is essential to inform clinical decision-making and prevent premature assumptions of poor outcome. The enhanced SAH (eSAH) score combines three routinely available variables-age, Glasgow Coma Scale (GCS), and subarachnoid hemorrhage blood volume (SAHV)-to provide an objective framework for early outcome stratification. SAHV is estimated using the ABC/2-derived ellipsoid method applied across five major cisternal compartments on non-contrast CT. While the eSAH score has shown promise in initial derivation studies, its external performance and calibration have not yet been validated across diverse healthcare settings. We conducted a retrospective cohort study using consecutive …

Cytomegalovirus As A Potential Trigger For Acute Coronary Syndrome: A Case Of Nstemi In A Previously Healthy Patient, Hussam Al Hennawi, Muhammad Sabri, David Teng, Maxwell Berman, Botros Shenoda

Abington Jefferson Health Papers

Cytomegalovirus (CMV) infection has been implicated in endothelial dysfunction and atherogenesis, yet its role as a potential trigger for acute coronary syndrome (ACS) remains underrecognized. We present a case of a 32-year-old male with no prior medical history who developed non-ST elevation myocardial infarction (NSTEMI) and was subsequently found to have active CMV infection. The patient had no known history cardiovascular disease, though subsequent testing did reveal additional underlying risk factors. This case highlights the need to consider infectious etiologies, including CMV, as contributors to ACS in young, otherwise apparently healthy individuals. Understanding the interplay between viral infections and atherosclerotic …

Treatment Patterns For Genitourinary Syndrome Of Menopause: A Trinetx Analysis, Anushka Ghosh, Maria D'Amico, Yash B. Shah, Whitney R. Smith, Mihir S. Shah, Costas D. Lallas, Alana M. Murphy

Department of Urology Faculty Papers

BACKGROUND: Genitourinary syndrome of menopause (GSM) is a highly prevalent, underdiagnosed condition that can significantly impair quality of life (QoL). This study evaluates real-world treatment trends for GSM to better understand current management practices and highlight ongoing gaps in care. The background is in a different font than the rest of the abstract.

METHODS: We queried the TriNetX database for patients with a diagnosis of postmenopausal atrophic vaginitis (ICD N95.2) and treatment information from 2004-2024. A combination of RxNorm and International Classification of Diseases-10 (ICD) codes was used to classify disease and treatment type, including topical estrogen (RxNorm 4083, 4099), …

Low Utilization Of Intracavernosal Injection And Penile Doppler Ultrasound In The Evaluation Of Erectile Dysfunction And Peyronie's Disease, Joon Yau Leong, Tyler Gaines, Zachary J. Prebay, David Ebbott, Paul H. Chung

Department of Urology Faculty Papers

INTRODUCTION: Despite the diagnostic value of intracavernosal injections (ICI) and penile Doppler ultrasound (PDUS), there remain barriers to widespread clinical adaptation of these methods. The study aimed to evaluate the practice patterns of utilization of ICI and PDUS in the assessment of erectile dysfunction (ED) and Peyronie's disease (PD).

METHODS: Using the TriNetX database (Cambridge, MA, USA), adult (≥18 years) male patients with a diagnosis of ED on oral phosphodiesterase-5 (PDE5) inhibitors were identified. Current Procedural Terminology codes were utilized to identify patients who underwent further evaluation with ICI or PDUS, as well as penile prosthesis placement after PDUS. A …

Subgroup Analyses Of The Phase 3 Focus Study Of Melphalan/Hepatic Delivery System In Patients With Unresectable Metastatic Uveal Melanoma, Jonathan S. Zager, Marlana Orloff, Pier Francesco Ferrucci, Junsung Choi, David J. Eschelman, Evan S. Glazer, Aslam Ejaz, Erika Richtig, Sebastian Ochsenreither, Sunil A. Reddy, Michael C. Lowe, Georgia M. Beasley, Anja Gesierich, Martin Gschnell, Reinhard Dummer, Ana Arance, Stephen William Fenwick, Joseph J. Sacco, Johnny John, Matthew Wheater, Christian H. Ottensmeier

Department of Medical Oncology Faculty Papers

PURPOSE: To assess efficacy and safety in subgroups of patients treated with Melphalan/Hepatic Delivery System (melphalan/HDS), a drug/device combination for liver-directed treatment of metastatic UM (mUM) patients. Previously reported FOCUS study results indicated melphalan/HDS treatment provides a clinically meaningful response rate and favorable benefit-risk ratio in patients with unresectable mUM.

METHODS: Patients with mUM received treatment with melphalan (3.0 mg/kg ideal body weight) every 6-8 weeks for up to 6 cycles. Post hoc analyses of efficacy and safety were conducted for patient subgroups based on demographic and baseline disease characteristics.

RESULTS: 102 patients with mUM were enrolled; treatment was attempted …

Concentric Macular Rings And Oct Corrugations In Foveal Hypoplasia: Proof Of Concept For An Optical Interference Mechanism, Ari August, Ralph Eagle, Tatyana Milman, Rebecca Procopio, Bruce Schnall, Jose Pulido

Wills Eye Hospital Papers

BACKGROUND: Concentric macular rings (CMR) and Henle fiber layer (HFL) corrugations, potential clinical biomarkers of foveal hypoplasia, have been observed in laser fundus photographs and optical coherence tomography (OCT) images, respectively. Some believe these findings represent true anatomical structural changes while others hypothesize that they are artifacts of interference; however, to our knowledge, no previous study has provided evidence to support either theory.

METHODS: This retrospective case series analyzed CMR and OCT corrugations in 3 patients (6 eyes) with foveal hypoplasia. Dark fringe diameters of CMR at different wavelengths (λ: red = 635, green = 532, blue = 488 nm) …

Perspectives On Implementing Environmentally Sustainable Practices In Cataract Surgeries: Interviews Of Administrative And Frontline Healthcare Workers, Daniel Parra, Brooke Sherry, Emma Pak, Lauren Taylor, Erin S. Rogers, Sarah E. Hochman, Maria De Los Angeles Ramos Cadena, Joel S. Schuman, Christina R. Prescott, Cassandra L. Thiel

Wills Eye Hospital Papers

BACKGROUND: Healthcare is responsible for 8.5% of greenhouse gas emission in the United States. Physicians are becoming increasingly concerned about the climate crisis, particularly in the field of ophthalmology where there is a growing body of literature related to sustainability. Although emissions of cataracts surgery, one of the most performed surgical procedures in the world, have been quantified, modifications to practice have yet to be made. This study aims to uplift the perspectives of a diverse set of healthcare workers on implementing environmentally sustainable practices in the cataract surgery setting.

METHODS: 16 semi-structured interviews were conducted with professionals working in …

Metabolic Syndrome As A Risk Factor For Postoperative Complication In Patients Undergoing Spine Surgery: A Systematic Review And Meta-Analysis Of More Than 3 Million Cases, Amir-Mohammad Asgari, Farhad Shaker, Mohammad Taha Pahlevan Fallahy, Sourena Sharifkashani, Alireza Soltani Khaboushan, Dorsa Salabat, César Carballo Cuello, James Harrop, Puya Alikhani

Department of Neurosurgery Faculty Papers

OBJECTIVE: Including conditions like obesity, diabetes, hypertension, and dyslipidemia, metabolic syndrome disrupts metabolic homeostasis and impairs recovery, increasing the risk of surgical complications. This study evaluates the impact of metabolic syndrome on spine surgery outcomes, addressing inconsistencies in the existing literature.

METHODS: Four databases were searched until December 2024 for studies comparing the postoperative complication rates of spine surgeries between patients with and without metabolic syndrome. Following deduplication, 2 authors independently reviewed the studies. For each included study, demographics and incidence rates of postoperative complications were extracted separately by 2 authors. Data analysis was performed using R.

RESULTS: After deduplication, …

Synergizing Digital And Print: Leveraging Spine Surgeons' Social Media To Transform Publishing And Society Interaction, Benedikt W. Burkhardt, Kai-Uwe Lewandrowski, Choll W. Kim, Morgan P Lorio, Oscar L. Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Social media has fundamentally altered how information is created, disseminated, and consumed, with growing impact on spine surgeons and professional societies. Traditional academic publishing remains the standard for research validation, but digital platforms now shape much of the real-time dialogue in spine care.

OBJECTIVE: To explore strategies for integrating spine surgeons' social media presence with traditional publishing channels to enhance knowledge dissemination, support clinical innovation, and improve member engagement within spine societies.

METHODS: This perspective reviews current patterns of social media use among spine surgeons, focusing on platforms such as X (formerly Twitter), Instagram, and LinkedIn. It analyzes benefits …

Regenerative And Wellness Medicine: A Boon Or Barrier To Surgical Innovation In Degenerative Spine Care?, Álvaro Dowling, Kai-Uwe Lewandrowski, Morgan P. Lorio, Óscar L. Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A. Yuan, Alexander R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Regenerative and wellness medicine is rapidly reshaping health care, particularly in the management of degenerative spine conditions. Noninvasive or minimally invasive options such as stem cell therapy, platelet-rich plasma (PRP) injections, and holistic wellness programs are increasingly selected by patients who wish to avoid the risks, costs, and prolonged recovery associated with elective spine surgery.

PURPOSE: This perspective article examines whether regenerative and wellness approaches function primarily as a boon or a barrier to innovation in spine surgery and explores their impact on traditional, insurance-based surgical care models.

METHODS: Using a narrative, opinion-based framework, this article synthesizes current trends …

Collagen Type Ii-Targeting Lentiviral Gene Therapy For Mucopolysaccharidosis Iva, Betul Celik, Sampurna Saikia, Shaukat Khan, Krishna Sai Musini, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis (MPS IVA) is caused by pathogenic variations in the GALNS gene, leading to the accumulation of glycosaminoglycans in tissues and causing progressive skeletal lesions. While conventional lentiviral vectors (LVs) provide long-term stable expression, they do not deliver therapeutic levels to bone and cartilage. We hypothesized that engineering the LV envelope with a collagen type II-targeting peptide (WYRGRL) increases the binding affinity of the LVs for bone and cartilage. These modified vectors carrying the CBh and COL2A1 promoters delivered the GALNS gene to MPS IVA newborn mice via intravenous (IV) or intraarticular (IA) administration. The peptide-modified LVs exhibited markedly increased …

Tumor Biology And Access To Care And Metastatic Breast Cancer Outcomes, Matthew R. Dunn, Sarah C. Van Alsten, Marc A. Emerson, Katherine Reeder-Hayes, Terry Hyslop, Melissa A. Troester

Kimmel Cancer Center Faculty Papers

PURPOSE: To understand how access to care influences metastatic breast cancer burden (MBC) while accounting for molecular tumor characteristics, and identify interventions to reduce metastatic disease burden.

METHODS: The Carolina Breast Cancer Study is a population-based cohort with invasive breast cancer (diagnosed 2008-2013). Both de novo metastasis (stage IV at diagnosis) and distant recurrence were evaluated (12 years of follow-up. Tumor data were from medical records, pathology reports, and RNA expression data. Social variables and access to care were from participant surveys. Generalized linear models were used to estimate associations of biological and access characteristics with MBC; Cox models were …

Managing The Uncertainty Of "Precision" While Navigating Goals Of Care: A Framework For Collaborative Interpretation Of Complex Genomic Testing Results In Critically-Ill Neonates, Donnamaria E. Cortezzo, Katharine Press Callahan, Bimal P. Chaudhari, Elliott M. Weiss, Monica Hsiung Wojcik, Krishna Acharya, Amy B. Schlegel, Kevin M. Sullivan, Jessica T. Fry

Department of Pediatrics Faculty Papers

Each year, many neonates are born with genetic diagnoses that carry a range of prognoses. As the types and availability of genetic testing have expanded, neonatal intensive care units (NICUs) have served as "launching points" for their clinical application. Broad genetic testing has both improved diagnostic precision and expanded uncertainty. Genetic information may be explicitly uncertain, as in the case of a variant of unknown significance (VUS). But it is also frequently uncertain whether/how the information relates to a patient's phenotype or what it may mean for a child's future. Even without ambiguity in the diagnosis or prognosis, the significance …

Sex Differences In The Association Of Vascular Risk And Apoe Genotype With Cognitive Decline And Dementia: Evidence From A U.S. Longitudinal Study, Longjian Liu, Jintong Hou, Saishi Cui, Xiaopeng Zhao, Zuolu Liu, J. Craig Longenecker, Nathalie S May, Jin Jun Luo, Rose Ann Dimaria-Ghalili, Howard J. Eisen

Division of Cardiology Faculty Papers

BACKGROUND: Sex differences in the association between vascular factors and cognitive outcomes remain unclear. We aimed to investigate the associations of blood pressure metrics (hypertension, systolic blood pressure [SBP), pulse pressure, ankle and brachial pressures, and ankle to brachial pressure index [ABI]) with the risk of cognitive decline and dementia.

METHODS: We conducted a population-based longitudinal analysis using data from the Atherosclerosis Risk in Communities (ARIC) study (begun in 1987-1989) in the United States. We analyzed a total of 12,268 participants aged 45-64 years who had validated exposure measurements, cognitive function tests (first administrated 1990-1992), and followed up for incidence …