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Article ; Online: Percutaneous Left Atrial Appendage Occlusion in Comparison to Non-Vitamin K Antagonist Oral Anticoagulant Among Patients With Atrial Fibrillation.

Noseworthy, Peter A / Van Houten, Holly K / Krumholz, Harlan M / Kent, David M / Abraham, Neena S / Graff-Radford, Jonathan / Alkhouli, Mohamad / Henk, Henry J / Shah, Nilay D / Gersh, Bernard J / Friedman, Paul A / Holmes, David R / Yao, Xiaoxi

Journal of the American Heart Association

2022 Volume 11, Issue 19, Page(s) e027001

Abstract: ... vitamin K antagonist oral anticoagulants among patients with atrial fibrillation. Methods and Results ... among whom 8397 were treated with LAAO and 554 453 were treated with non-vitamin K antagonist oral anticoagulants ...

Abstract	Background This study aimed to compare percutaneous left atrial appendage occlusion (LAAO) with non-vitamin K antagonist oral anticoagulants among patients with atrial fibrillation. Methods and Results Using a US administrative database, 562 850 patients with atrial fibrillation were identified, among whom 8397 were treated with LAAO and 554 453 were treated with non-vitamin K antagonist oral anticoagulants between March 13, 2015 and December 31, 2018. Propensity score overlap weighting was used to balance baseline characteristics. The primary outcome was a composite end point of ischemic stroke or systemic embolism, major bleeding, and all-cause mortality. The mean age was 76.4±7.6 years; 280 097 (49.8%) were female. Mean follow-up was 1.5±1.0 years. LAAO was associated with no significant difference in the risk of the primary composite end point (hazard ratio [HR], 0.93 [0.84-1.03]), or the secondary outcomes including ischemic stroke/systemic embolism (HR, 1.07 [0.81-1.41]), and intracranial bleeding (HR, 1.08 [0.72-1.61]). LAAO was associated with a higher risk of major bleeding (HR, 1.22 [1.05-1.42],
MeSH term(s)	Aged ; Aged, 80 and over ; Anticoagulants/adverse effects ; Atrial Appendage/surgery ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Embolism/complications ; Female ; Fibrinolytic Agents ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Humans ; Intracranial Hemorrhages ; Ischemic Stroke ; Male ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Treatment Outcome
Chemical Substances	Anticoagulants ; Fibrinolytic Agents
Language	English
Publishing date	2022-09-29
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.121.027001
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Article: Artificial Intelligence-Based Student Activity Monitoring for Suicide Risk: Considerations for K-12 Schools, Caregivers, Government, and Technology Developers.

Ayer, Lynsay / Boudreaux, Benjamin / Paige, Jessica Welburn / Holmes, Pierrce / Blagg, Tara Laila / Mendon-Plasek, Sapna J

Rand health quarterly

2024 Volume 11, Issue 2, Page(s) 2

Abstract: In response to the widespread youth mental health crisis, some kindergarten-through-12th-grade (K ... monitoring programs are implemented in K-12 schools, how stakeholders perceive the effects that the programs ...

Abstract	In response to the widespread youth mental health crisis, some kindergarten-through-12th-grade (K-12) schools have begun employing artificial intelligence (AI)-based tools to help identify students at risk for suicide and self-harm. The adoption of AI and other types of educational technology to partially address student mental health needs has been a natural forward step for many schools during the transition to remote education. However, there is limited understanding about how such programs work, how they are implemented by schools, and how they may benefit or harm students and their families. To assist policymakers, school districts, school leaders, and others in making decisions regarding the use of these tools, the authors address these knowledge gaps by providing a preliminary examination of how AI-based suicide risk monitoring programs are implemented in K-12 schools, how stakeholders perceive the effects that the programs are having on students, and the potential benefits and risks of such tools. Using this analysis, the authors also offer recommendations for school and district leaders; state, federal, and local policymakers; and technology developers to consider as they move forward in maximizing the intended benefits and mitigating the possible risks of AI-based suicide risk monitoring programs.
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article
ISSN	2162-8254
ISSN	2162-8254
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Article ; Online: Association of Recent Use of Non-Vitamin K Antagonist Oral Anticoagulants With Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Treated With Alteplase.

Kam, Wayneho / Holmes, DaJuanicia N / Hernandez, Adrian F / Saver, Jeffrey L / Fonarow, Gregg C / Smith, Eric E / Bhatt, Deepak L / Schwamm, Lee H / Reeves, Mathew J / Matsouaka, Roland A / Khan, Yosef M / Unverdorben, Martin / Birmingham, Mary C / Lyden, Patrick D / Asimos, Andrew W / Altschul, Dorothea / Schoonover, Timothy L / Jumaa, Mouhammad A / Nomura, Jason T /

Suri, Muhammad Fareed K / Moore, S Arthur / Lafranchise, Eugene F / Olson, DaiWai / Peterson, Eric D / Xian, Ying

JAMA

2022 Volume 327, Issue 8, Page(s) 760–771

Abstract: ... with acute ischemic stroke who are taking non-vitamin K antagonist oral anticoagulants (NOACs).: Objective ...

Abstract	Importance: Current guidelines recommend against use of intravenous alteplase in patients with acute ischemic stroke who are taking non-vitamin K antagonist oral anticoagulants (NOACs). Objective: To evaluate the safety and functional outcomes of intravenous alteplase among patients who were taking NOACs prior to stroke and compare outcomes with patients who were not taking long-term anticoagulants. Design, setting, and participants: A retrospective cohort study of 163 038 patients with acute ischemic stroke either taking NOACs or not taking anticoagulants prior to stroke and treated with intravenous alteplase within 4.5 hours of symptom onset at 1752 US hospitals participating in the Get With The Guidelines-Stroke program between April 2015 and March 2020, with complementary data from the Addressing Real-world Anticoagulant Management Issues in Stroke registry. Exposures: Prestroke treatment with NOACs within 7 days prior to alteplase treatment. Main outcomes and measures: The primary outcome was symptomatic intracranial hemorrhage occurring within 36 hours after intravenous alteplase administration. There were 4 secondary safety outcomes, including inpatient mortality, and 7 secondary functional outcomes assessed at hospital discharge, including the proportion of patients discharged home. Results: Of 163 038 patients treated with intravenous alteplase (median age, 70 [IQR, 59 to 81] years; 49.1% women), 2207 (1.4%) were taking NOACs and 160 831 (98.6%) were not taking anticoagulants prior to their stroke. Patients taking NOACs were older (median age, 75 [IQR, 64 to 82] years vs 70 [IQR, 58 to 81] years for those not taking anticoagulants), had a higher prevalence of cardiovascular comorbidities, and experienced more severe strokes (median National Institutes of Health Stroke Scale score, 10 [IQR, 5 to 17] vs 7 [IQR, 4 to 14]) (all standardized differences >10). The unadjusted rate of symptomatic intracranial hemorrhage was 3.7% (95% CI, 2.9% to 4.5%) for patients taking NOACs vs 3.2% (95% CI, 3.1% to 3.3%) for patients not taking anticoagulants. After adjusting for baseline clinical factors, the risk of symptomatic intracranial hemorrhage was not significantly different between groups (adjusted odds ratio [OR], 0.88 [95% CI, 0.70 to 1.10]; adjusted risk difference [RD], -0.51% [95% CI, -1.36% to 0.34%]). There were no significant differences in the secondary safety outcomes, including inpatient mortality (6.3% for patients taking NOACs vs 4.9% for patients not taking anticoagulants; adjusted OR, 0.84 [95% CI, 0.69 to 1.01]; adjusted RD, -1.20% [95% CI, -2.39% to -0%]). Of the secondary functional outcomes, 4 of 7 showed significant differences in favor of the NOAC group after adjustment, including the proportion of patients discharged home (45.9% vs 53.6% for patients not taking anticoagulants; adjusted OR, 1.17 [95% CI, 1.06 to 1.29]; adjusted RD, 3.84% [95% CI, 1.46% to 6.22%]). Conclusions and relevance: Among patients with acute ischemic stroke treated with intravenous alteplase, use of NOACs within the preceding 7 days, compared with no use of anticoagulants, was not associated with a significantly increased risk of intracranial hemorrhage.
MeSH term(s)	Administration, Intravenous ; Administration, Oral ; Aged ; Aged, 80 and over ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Female ; Fibrinolytic Agents/therapeutic use ; Humans ; Intracranial Hemorrhages/etiology ; Ischemic Stroke/complications ; Ischemic Stroke/drug therapy ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Tissue Plasminogen Activator/therapeutic use
Chemical Substances	Anticoagulants ; Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
Language	English
Publishing date	2022-02-10
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.0948
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Article ; Online: Implementation of a pooled surveillance testing program for asymptomatic SARS-CoV-2 infections in K-12 schools and universities.

Mendoza, Rachelle P / Bi, Chongfeng / Cheng, Hui-Ting / Gabutan, Elmer / Pagaspas, Guillerre Jan / Khan, Nadia / Hoxie, Helen / Hanna, Stephen / Holmes, Kelly / Gao, Nicholas / Lewis, Raychel / Wang, Huaien / Neumann, Daniel / Chan, Angela / Takizawa, Meril / Lowe, James / Chen, Xiao / Kelly, Brianna / Asif, Aneeza /

EClinicalMedicine

2021 Volume 38, Page(s) 101028

Abstract: ... that included students, faculty and staff from K-12 schools (student age range 5-18 years) and universities ... from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were ...

Abstract	Background: The negative impact of continued school closures during the height of the COVID-19 pandemic warrants the establishment of cost-effective strategies for surveillance and screening to safely reopen and monitor for potential in-school transmission. Here, we present a novel approach to increase the availability of repetitive and routine COVID-19 testing that may ultimately reduce the overall viral burden in the community. Methods: We implemented a testing program using the SalivaClear࣪ pooled surveillance method that included students, faculty and staff from K-12 schools (student age range 5-18 years) and universities (student age range >18 years) across the country (Mirimus Clinical Labs, Brooklyn, NY). The data analysis was performed using descriptive statistics, kappa agreement, and outlier detection analysis. Findings: From August 27, 2020 until January 13, 2021, 253,406 saliva specimens were self-collected from students, faculty and staff from 93 K-12 schools and 18 universities. Pool sizes of up to 24 samples were tested over a 20-week period. Pooled testing did not significantly alter the sensitivity of the molecular assay in terms of both qualitative (100% detection rate on both pooled and individual samples) and quantitative (comparable cycle threshold (Ct) values between pooled and individual samples) measures. The detection of SARS-CoV-2 in saliva was comparable to the nasopharyngeal swab. Pooling samples substantially reduced the costs associated with PCR testing and allowed schools to rapidly assess transmission and adjust prevention protocols as necessary. In one instance, in-school transmission of the virus was determined within the main office and led to review and revision of heating, ventilating and air-conditioning systems. Interpretation: By establishing low-cost, weekly testing of students and faculty, pooled saliva analysis for the presence of SARS-CoV-2 enabled schools to determine whether transmission had occurred, make data-driven decisions, and adjust safety protocols. We provide strong evidence that pooled testing may be a fundamental component to the reopening of schools by minimizing the risk of in-school transmission among students and faculty. Funding: Skoll Foundation generously provided funding to Mobilizing Foundation and Mirimus for these studies.
Language	English
Publishing date	2021-07-17
Publishing country	England
Document type	Journal Article
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2021.101028
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Article ; Online: Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke.

Mac Grory, Brian / Holmes, DaJuanicia N / Matsouaka, Roland A / Shah, Shreyansh / Chang, Cherylee W J / Rison, Richard / Jindal, Jenelle / Holmstedt, Christine / Logan, William R / Corral, Candy / Mackey, Jason S / Gee, Joey R / Bonovich, David / Walker, James / Gropen, Toby / Benesch, Curtis / Dissin, Jonathan / Pandey, Hemant / Wang, David /

Unverdorben, Martin / Hernandez, Adrian F / Reeves, Mathew / Smith, Eric E / Schwamm, Lee H / Bhatt, Deepak L / Saver, Jeffrey L / Fonarow, Gregg C / Peterson, Eric D / Xian, Ying

JAMA

2023 Volume 329, Issue 23, Page(s) 2038–2049

Abstract: Importance: Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular ...

Abstract	Importance: Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion at increased risk of complications. Objective: To determine the association between recent use of a VKA and outcomes among patients selected to undergo EVT in clinical practice. Design, setting, and participants: Retrospective, observational cohort study based on the American Heart Association's Get With the Guidelines-Stroke Program between October 2015 and March 2020. From 594 participating hospitals in the US, 32 715 patients with acute ischemic stroke selected to undergo EVT within 6 hours of time last known to be well were included. Exposure: VKA use within the 7 days prior to hospital arrival. Main outcome and measures: The primary end point was symptomatic intracranial hemorrhage (sICH). Secondary end points included life-threatening systemic hemorrhage, another serious complication, any complications of reperfusion therapy, in-hospital mortality, and in-hospital mortality or discharge to hospice. Results: Of 32 715 patients (median age, 72 years; 50.7% female), 3087 (9.4%) had used a VKA (median international normalized ratio [INR], 1.5 [IQR, 1.2-1.9]) and 29 628 had not used a VKA prior to hospital presentation. Overall, prior VKA use was not significantly associated with an increased risk of sICH (211/3087 patients [6.8%] taking a VKA compared with 1904/29 628 patients [6.4%] not taking a VKA; adjusted odds ratio [OR], 1.12 [95% CI, 0.94-1.35]; adjusted risk difference, 0.69% [95% CI, -0.39% to 1.77%]). Among 830 patients taking a VKA with an INR greater than 1.7, sICH risk was significantly higher than in those not taking a VKA (8.3% vs 6.4%; adjusted OR, 1.88 [95% CI, 1.33-2.65]; adjusted risk difference, 4.03% [95% CI, 1.53%-6.53%]), while those with an INR of 1.7 or lower (n = 1585) had no significant difference in the risk of sICH (6.7% vs 6.4%; adjusted OR, 1.24 [95% CI, 0.87-1.76]; adjusted risk difference, 1.13% [95% CI, -0.79% to 3.04%]). Of 5 prespecified secondary end points, none showed a significant difference across VKA-exposed vs VKA-unexposed groups. Conclusions and relevance: Among patients with acute ischemic stroke selected to receive EVT, VKA use within the preceding 7 days was not associated with a significantly increased risk of sICH overall. However, recent VKA use with a presenting INR greater than 1.7 was associated with a significantly increased risk of sICH compared with no use of anticoagulants.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Anticoagulants/administration & dosage ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Brain Ischemia/drug therapy ; Brain Ischemia/mortality ; Brain Ischemia/surgery ; Endovascular Procedures/adverse effects ; Endovascular Procedures/methods ; Endovascular Procedures/mortality ; Fibrinolytic Agents/administration & dosage ; Fibrinolytic Agents/adverse effects ; Fibrinolytic Agents/therapeutic use ; Hemorrhage/chemically induced ; Intracranial Hemorrhages/chemically induced ; Intracranial Hemorrhages/etiology ; Ischemic Stroke/drug therapy ; Ischemic Stroke/mortality ; Ischemic Stroke/surgery ; Retrospective Studies ; Thrombectomy/adverse effects ; Thrombectomy/methods ; Thrombectomy/mortality ; Treatment Outcome ; Vitamin K/antagonists & inhibitors ; Administration, Oral ; Hospital Mortality ; International Normalized Ratio
Chemical Substances	Anticoagulants ; Fibrinolytic Agents ; Vitamin K (12001-79-5)
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2023.8073
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Article ; Online: Development and scale-up of gluten-free sorghum-based bakery goods for K-state Dining Services

Aidan Cairns / Sophia Brazington / Emmalee Gragg / Amanda Holmes / Christy Vavra / Kelly Whitehair / Kelly Getty

Journal of Agriculture and Food Research, Vol 14, Iss , Pp 100840- (2023)

2023

Abstract: To create new product opportunities for sorghum in the state of Kansas, the FARMUs project had three primary pillars: Innovate, Scale, and Connect. The project aims to close the gap between industry and consumers by peaking interest in sorghum, its ... ...

Abstract	To create new product opportunities for sorghum in the state of Kansas, the FARMUs project had three primary pillars: Innovate, Scale, and Connect. The project aims to close the gap between industry and consumers by peaking interest in sorghum, its nutritional and sustainable benefits, and consumption of sorghum-based products. The primary focus of this study was to develop and scale-up three gluten-free sorghum-based products for Kansas State Dining Services. The secondary objective was to evaluate the sensory and physical properties of these products to provide developmental and research experience for students. Preliminary testing involved identifying optimum ratios of sorghum flour, xanthan gum, starch, and eggs for proper binding. Whipped egg whites were tested at different levels for product volume and texture. Repetition and reformulation of the products provided various renditions of each product. Quantity equipment needs, staffing feasibility, ingredient availability, and cost were determined. Dining staff evaluated each product and once recipes were finalized, parameters (color, specific gravity, internal temperature, moisture loss, height/width, water activity) were evaluated. Dining center customers provided acceptability feedback for the three gluten-free products using the 9-point Hedonic scale. The first product, a savory waffle, can be stacked with turkey sausage and cheddar cheese for a breakfast sandwich. It utilizes sorghum flour, egg whites, xanthan gum, starch, and flaxseed for structure. This product received a range of 7.03–7.63 (n = 43) for all sensory attributes (acceptability, flavor, mouthfeel, texture, and aftertaste). The lemon blueberry muffin contains sorghum flour, eggs, buttermilk, xanthan gum, potato starch, and egg whites. Sensory data (n = 49) measured at acceptability (7.4), flavor (7.6), mouthfeel (6.4), texture (6.6), and aftertaste (7.6). The third product, a sweet potato muffin top, contains sorghum flour, xanthan gum, eggs, egg whites, and sweet potatoes. All three ...
Keywords	Sorghum ; Sustainability ; Bakery goods ; Gluten-free ; Whole-grain ; Agriculture (General) ; S1-972 ; Nutrition. Foods and food supply ; TX341-641
Subject code	660
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Preparing Teachers to Teach in K-12 Blended Environments: A Systematic Mapping Review of Research Trends, Impact, and Themes.

Short, Cecil R / Graham, Charles R / Holmes, Theresa / Oviatt, Laura / Bateman, Hannah

TechTrends : for leaders in education & training

2021 Volume 65, Issue 6, Page(s) 993–1009

Abstract: Despite evidence concerning the widespread growth of K-12 blended teaching and the impact ... that emergency remote teaching during the COVID-19 pandemic has had on the spread of K-12 online and blended ... teaching, we could find no systematic reviews focused on preparing K-12 teachers for blended teaching ...

Abstract	Despite evidence concerning the widespread growth of K-12 blended teaching and the impact that emergency remote teaching during the COVID-19 pandemic has had on the spread of K-12 online and blended teaching, we could find no systematic reviews focused on preparing K-12 teachers for blended teaching. Previous literature reviews, such as those from Halverson et al. (2012) and Drysdale et al. (2013), have noted the lack of research focused on K-12 blended teaching contexts. This systematic mapping review (Grant & Booth, 2009) of 88 K-12 blended teacher preparation articles focused on identifying trends in author impact according to citation count and number of publications, journal impact according to number of publications, prevalence of research methods, and prevalence of research themes according to research questions and findings. The analysis provides a valuable snapshot of current literature, sets a foundation for a deeper thematic analysis of K-12 blended teacher preparation literature, and identifies some potential areas for future K-12 blended teaching research.
Language	English
Publishing date	2021-07-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2144706-8
ISSN	1559-7075 ; 8756-3894
ISSN (online)	1559-7075
ISSN	8756-3894
DOI	10.1007/s11528-021-00626-4
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Article ; Online: Variability in Nonvitamin K Oral Anticoagulant Dose Eligibility and Adjustment According to Renal Formulae and Clinical Outcomes in Patients With Atrial Fibrillation With and Without Chronic Kidney Disease: Insights From ORBIT-AF II.

Yao, Ren Jie Robert / Holmes, DaJuanicia N / Andrade, Jason G / Levin, Adeera / Piccini, Jonathan P / Fordyce, Christopher B

Journal of the American Heart Association

2023 Volume 12, Issue 6, Page(s) e026605

Abstract: Background Nonvitamin K oral anticoagulants require dose adjustment based on kidney function ... nonvitamin K oral anticoagulants dosing ( ...

Abstract	Background Nonvitamin K oral anticoagulants require dose adjustment based on kidney function.The most common estimate of kidney function employed in clinical practice is estimated glomerular filtration rate (eGFR); however, product monographs recommend the use of the Cockcroft-Gault estimated creatinine clearance (eCrCl) for dose adjustment. Methods and Results The authors included patients enrolled in the ORBIT-AF II (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation AF II) trial. Dosing was considered inappropriate when use of eGFR resulted in a lower (undertreatment) or higher (overtreatment) dose than that recommended by the eCrCl. The primary outcome of major adverse cardiovascular and neurological events was a composite of cardiovascular death, stroke or systemic embolism, new-onset heart failure, and myocardial infarction. Among 8727 in the overall cohort, agreement between eCrCl and eGFR was observed in 93.5% to 93.8% of patients. Among 2184 patients with chronic kidney disease (CKD), the agreement between eCrCl and eGFR was 79.9% to 80.7%. Dosing misclassification was more frequent in the CKD population (41.9% of rivaroxaban users, 5.7% of dabigatran users, and 4.6% apixaban users). At 1 year, undertreated patients in the CKD group had significantly greater major adverse cardiovascular and neurological events (adjusted hazard ratio, 2.93 [95% CI, 1.08-7.92]) compared with the group with appropriate nonvitamin K oral anticoagulants dosing (
MeSH term(s)	Humans ; Administration, Oral ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Dabigatran ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Rivaroxaban ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology
Chemical Substances	Anticoagulants ; Dabigatran (I0VM4M70GC) ; Rivaroxaban (9NDF7JZ4M3)
Language	English
Publishing date	2023-03-09
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.026605
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Article: Disentangling the neurological basis of chronic ocular pain using clinical, self-report, and brain imaging data: use of K-means clustering to explore patient phenotypes.

Holmes, Scott / Reyes, Nicholas / Huang, Jaxon J / Galor, Anat / Pattany, Pradip M / Felix, Elizabeth R / Moulton, Eric A

Frontiers in neurology

2023 Volume 14, Page(s) 1265082

Abstract: Introduction: The factors that mediate the expression of ocular pain and the mechanisms that promote chronic ocular pain symptoms are poorly understood. Central nervous system involvement has been postulated based on observations of pain out of ... ...

Abstract	Introduction: The factors that mediate the expression of ocular pain and the mechanisms that promote chronic ocular pain symptoms are poorly understood. Central nervous system involvement has been postulated based on observations of pain out of proportion to nociceptive stimuli in some individuals. This investigation focused on understanding functional connectivity between brain regions implicated in chronic pain in persons reporting ocular pain symptoms. Methods: We recruited a total of 53 persons divided into two cohorts: persons who reported no ocular pain, and persons who reported chronic ocular pain, irrespective of ocular surface findings. We performed a resting state fMRI investigation that was focused on subcortical brain structures including the trigeminal nucleus and performed a brief battery of ophthalmological examinations. Results: Persons in the pain cohort reported higher levels of pain symptoms relating to neuropathic pain and ocular surface disease, as well as more abnormal tear metrics (stability and tear production). Functional connectivity analysis between groups evinced multiple connections exemplifying both increases and decreases in connectivity including regions such as the trigeminal nucleus, amygdala, and sub-regions of the thalamus. Exploratory analysis of the pain cohort integrating clinical and brain function metrics highlighted subpopulations that showed unique phenotypes providing insight into pain mechanisms. Discussion: Study findings support centralized involvement in those reporting ocular-based pain and allude to mechanisms through which pain treatment services may be directed in future research.
Language	English
Publishing date	2023-11-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1265082
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Article ; Online: Comparison of k-wire insertion using oscillatory and unidirectional drilling modes under constant thrust force.

Chen, Lei / Li, Annie D R / Symonds, Christopher / Holmes, James R / Weick, Jack W

Journal of orthopaedic research : official publication of the Orthopaedic Research Society

2021 Volume 40, Issue 6, Page(s) 1301–1311

Abstract: Heat generation during the Kirschner wire (K-wire) insertion process, under either unidirectional ... outcomes. Controlled machine-based constant thrust force K-wire insertion experiments were conducted ... For oscillatory mode, a small thrust force to keep the K-wire engaged with the bone is optimal. ...

Abstract	Heat generation during the Kirschner wire (K-wire) insertion process, under either unidirectional or oscillatory drilling mode, places bone at risk of thermal osteonecrosis which can lead to infection. There is a lack of quantitative understanding of the heat generation difference between the two drilling modes and knowledge of optimal thrust force level under each mode is missing. The goal of this study is to investigate the effects of drilling modes and thrust force levels on the bone drilling outcomes. Controlled machine-based constant thrust force K-wire insertion experiments were conducted with key process parameters monitored and compared quantitatively. Statistical analysis showed that the oscillatory mode consumed 2.6 times more electricity than the unidirectional mode but generated 53% less thermal energy and 23% lower peak temperature. However, the oscillation also led to 18% higher peak torque in the transient drilling stage and 23% shallower drilling depth. The optimal choice of the drilling mode depends on specific surgical needs to minimize bone damage (control of peak temperature vs. exposure time and torque control). Heat generation was dominated by the torque and corresponding rotational power under both modes. To minimize the bone temperature while keeping high drilling speed efficiency, a moderate thrust force is preferred under the unidirectional mode to balance between feed force and compressed debris resistance. For oscillatory mode, a small thrust force to keep the K-wire engaged with the bone is optimal.
MeSH term(s)	Bone Wires ; Hot Temperature ; Orthopedic Procedures ; Temperature ; Torque
Language	English
Publishing date	2021-08-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605542-4
ISSN	1554-527X ; 0736-0266
ISSN (online)	1554-527X
ISSN	0736-0266
DOI	10.1002/jor.25163
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Zs.A 1879: Show issues

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