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  1. Article ; Online: A Ten-Year Analysis of Recent National Institutes of Health Funding for Anesthesiology Research in United States Medical Schools.

    Pagel, Paul S

    Journal of cardiothoracic and vascular anesthesia

    2022  Volume 36, Issue 7, Page(s) 1844–1855

    Abstract: ... of funding, and amount of grants, and the terminal degree(s), faculty rank, gender, board certification ... series), mentored career development awards (K series), and other grants (U and P series) using NIH ... Research Portfolio Online Reporting Tools. The terminal degree(s), faculty rank, gender, and type ...

    Abstract Objectives: The characteristics of recent National Institutes of Health (NIH) grant funding to anesthesiology researchers in United States (US) medical schools have not been systematically quantified. NIH funding to cardiac anesthesiologists has also not been estimated. The author conducted an internet-based analysis of NIH awards to anesthesiology researchers from 2011-2020 to identify the types, duration of funding, and amount of grants, and the terminal degree(s), faculty rank, gender, board certification status, and type of appointment of the grant recipients including those with an interest in cardiac anesthesiology.
    Design: Observational study.
    Setting: Internet analysis.
    Participants: NIH grants recipients.
    Interventions: None.
    Measurements and main results: NIH grant recipients affiliated with anesthesiology departments were identified from the Blue Ridge Institute for Medical Research website. The number of grants, years of support, and total amount of funding were quantified for research project grants (R series), mentored career development awards (K series), and other grants (U and P series) using NIH Research Portfolio Online Reporting Tools. The terminal degree(s), faculty rank, gender, and type of appointment of grant recipients were identified using department web pages. American Board of Anesthesiology (ABA) certification, National Board of Echocardiography Advanced Perioperative Transesophageal Echocardiography (TEE) certification, and previous or current Foundation for Anesthesia Education and Research (FAER) awards to NIH grant recipients were obtained from each organization's website. A total of 532 researchers received 1250 grants with 3844 cumulative years of funding amounting to $1,676,482,440. R series grants accounted for three-quarters of all funding. PhDs were awarded more than one-half of NIH grants. MDs had lower median numbers of projects, R01 grants, and total R series grants than their colleagues with PhD or MD PhD degrees, but MDs received more K awards. One hundred ninety-eight MD and MD PhD NIH grant recipients were ABA diplomates. These physician-scientists received 26.0% and 53.1% of R and K series grants, respectively. Thirty physician-scientists also held TEE certification; these individuals with an interest in cardiac anesthesiology were awarded 4.8% of all NIH grants. Full Professors were awarded more than three-quarters of R grants and amassed more than $1.3 billion in funding, whereas assistant and associate professors received the majority of K series grants. Male investigators received greater median R grants but fewer median K awards than female researchers. One hundred-fifteen previous or current holders of FAER grants were identified; these individuals earned a total of 240 NIH awards totaling $357.7 million.
    Conclusion: PhDs, Professors, and male researchers receive the majority of R01 and other R series grants to anesthesiology departments at US medical schools. Physician-scientists, including those interested in cardiac anesthesiology, are awarded a minority of R series grants. FAER continues to provide an important stimulus for subsequent NIH funding of physician-scientists in anesthesiology.
    MeSH term(s) Anesthesiology ; Biomedical Research ; Female ; Humans ; Male ; National Institutes of Health (U.S.) ; Research Personnel ; Schools, Medical ; United States
    Language English
    Publishing date 2022-02-11
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.02.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Conference proceedings: Immune modulation by the endothelial protein C receptor (EPCR) in cancer progression

    Pott, J / Pagel, S / Wilgenbus, P / Ruf, W / Graf, C

    Hämostaseologie

    2023  Volume 43, Issue S 01

    Event/congress GTH Congress 2023 - 67th Annual Meeting of the Society of Thrombosis and Haemostasis Research - The patient as a benchmark, Frankfurt, Germany, 2023-02-21
    Language English
    Publishing date 2023-02-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 801512-0
    ISSN 2567-5761 ; 0720-9355
    ISSN (online) 2567-5761
    ISSN 0720-9355
    DOI 10.1055/s-0042-1760605
    Database Thieme publisher's database

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  3. Article ; Online: Large Mass in the Left Atrium: The Usual Myxoma or Another Common Etiology?

    Hang, Dustin / Subramani, Matthew / Gozdecki, Leo / Lozano, Pedro / Pagel, Paul S

    Journal of cardiothoracic and vascular anesthesia

    2022  Volume 36, Issue 12, Page(s) 4541–4545

    MeSH term(s) Humans ; Myxoma/complications ; Myxoma/diagnostic imaging ; Myxoma/surgery ; Heart Atria/diagnostic imaging ; Heart Neoplasms/complications ; Heart Neoplasms/diagnostic imaging ; Heart Neoplasms/surgery ; Atrial Fibrillation
    Language English
    Publishing date 2022-08-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.08.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Skinly: A novel handheld IoT device for validating biophysical skin characteristics.

    Tobar, Maria Del Pilar Bonilla / Clemann, Sven / Hagens, Ralf / Pagel-Wolff, Sonja / Hoppe, Stefan / Behm, Peter / Engelhard, Felicia / Langhals, Maria / Gallinat, Stefan / Zhavoronkov, Alex / Georgievskaya, Anastasia / Kiselev, Konstantin / Tlyachev, Timur / Jaspers, Sören

    Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)

    2024  Volume 30, Issue 3, Page(s) e13613

    Abstract: Background: Recent advancements in artificial intelligence have revolutionized dermatological diagnostics. These technologies, particularly machine learning (ML), including deep learning (DL), have shown accuracy equivalent or even superior to human ... ...

    Abstract Background: Recent advancements in artificial intelligence have revolutionized dermatological diagnostics. These technologies, particularly machine learning (ML), including deep learning (DL), have shown accuracy equivalent or even superior to human experts in diagnosing skin conditions like melanoma. With the integration of ML, including DL, the development of at home skin analysis devices has become feasible. To this end, we introduced the Skinly system, a handheld device capable of evaluating various personal skin characteristics noninvasively.
    Materials and methods: Equipped with a moisture sensor and a multi-light-source camera, Skinly can assess age-related skin parameters and specific skin properties. Utilizing state-of-the-art DL, Skinly processed vast amounts of images efficiently. The Skinly system's efficacy was validated both in the lab and at home, comparing its results to established "gold standard" methods.
    Results: Our findings revealed that the Skinly device can accurately measure age-associated parameters, that is, facial age, skin evenness, and wrinkles. Furthermore, Skinly produced data consistent with established devices for parameters like glossiness, skin tone, redness, and porphyrin levels. A separate study was conducted to evaluate the effects of two moisturizing formulations on skin hydration in laboratory studies with standard instrumentation and at home with Skinly.
    Conclusion: Thanks to its capability for multi-parameter measurements, the Skinly device, combined with its smartphone application, holds the potential to replace more expensive, time-consuming diagnostic tools. Collectively, the Skinly device opens new avenues in dermatological research, offering a reliable, versatile tool for comprehensive skin analysis.
    MeSH term(s) Humans ; Artificial Intelligence ; Skin/diagnostic imaging ; Mobile Applications ; Melanoma ; Skin Neoplasms/diagnosis
    Language English
    Publishing date 2024-02-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 1229160-2
    ISSN 1600-0846 ; 0909-752X ; 1397-1344
    ISSN (online) 1600-0846
    ISSN 0909-752X ; 1397-1344
    DOI 10.1111/srt.13613
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Recombinant activated factor VII for hemostasis in patients undergoing complex ascending aortic surgery: A single-center, single-surgeon retrospective analysis.

    Hang, Dustin / Koss, Kevin / Rokkas, Chris K / Pagel, Paul S

    Journal of cardiac surgery

    2021  Volume 36, Issue 12, Page(s) 4558–4563

    Abstract: ... ascending aorta, and aortic arch surgery (80.0% vs. 64.1%, p = .52). Patients receiving rFVIIa had longer ... mean cross clamp times (212 vs. 173 min, p = .03) and received a greater median number ... of intraoperative blood products (18.5 vs. 12.0, p < .001). The number of patients who needed postoperative products ...

    Abstract Background: Use of recombinant activated factor VII (rFVIIa) to achieve hemostasis during cardiac surgery continues to be debated, as support for its efficacy and safety has not been consistent. We examined our experience with rFVIIa for achieving hemostasis in high-risk patients undergoing complex ascending aortic surgery.
    Methods: We reviewed patients who underwent complex ascending aortic surgery performed by a single surgeon (C. K. R.) from August 2014 to February 2019. Outcomes of patients who received rFVIIa were compared with those who did not.
    Results: Of 59 consecutive patients, 20 patients (33.9%) received rFVIIa, whereas 39 (66.1%) did not. Median dose was 45.4 mcg/kg. rFVIIa was administered intraoperatively to 95% of patients who received it. Most patients underwent combined aortic valve, ascending aorta, and aortic arch surgery (80.0% vs. 64.1%, p = .52). Patients receiving rFVIIa had longer mean cross clamp times (212 vs. 173 min, p = .03) and received a greater median number of intraoperative blood products (18.5 vs. 12.0, p < .001). The number of patients who needed postoperative products (75.0% vs. 60.5%, p = .39), the median number of blood products transfused postoperatively (2 vs. 2, p = .40), and chest tube output (1138 vs. 805 ml, p = .17) were similar between groups. In-hospital mortality was similar between groups (10.0% vs. 10.3%, p = 1.00). Incidences of postoperative stroke (10.0% vs. 13.5%, p = 1.00) and thromboembolic events (10.0% vs. 13.5%, p = 1.00) were similar.
    Conclusions: Administration of rFVIIa intraoperatively for refractory bleeding during complex ascending aortic surgery provided hemostasis without greater in-hospital mortality or a higher risk of stroke and thromboembolic events.
    MeSH term(s) Factor VIIa ; Hemostasis ; Humans ; Postoperative Hemorrhage/epidemiology ; Recombinant Proteins ; Retrospective Studies ; Surgeons
    Chemical Substances Recombinant Proteins ; recombinant FVIIa (AC71R787OV) ; Factor VIIa (EC 3.4.21.21)
    Language English
    Publishing date 2021-10-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639059-6
    ISSN 1540-8191 ; 0886-0440
    ISSN (online) 1540-8191
    ISSN 0886-0440
    DOI 10.1111/jocs.16048
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Differences in bone turnover markers and injury risks between local and international horses: A Victorian Spring Racing Carnival study.

    Ayodele, Babatunde A / Pagel, Charles N / Mackie, Eleanor J / Armour, Fiona / Yamada, Sean / Zahra, Paul / Courtman, Natalie / Whitton, R Chris / Hitchens, Peta L

    Equine veterinary journal

    2024  

    Abstract: ... horses (main effect, Coef. 0.39; 95% CI 0.24, 0.54; p < 0.001) but they decreased and were not different ... to those of local horses at the second timepoint (interaction effect, Coef. -0.27; 95% CI -0.46, -0.07; p = 0.007 ... 0.16; 95% CI -0.31, -0.01; p = 0.043). The prevalence of MSI was higher in the international (26 ...

    Abstract Background: Musculoskeletal injuries (MSI) are common in racehorses and have been of increasing concern in horses travelling internationally to compete. Understanding the differences in bone turnover between local horses and international horses following long-distance air transportation may inform MSI prevention strategies.
    Objectives: To understand the differences in bone turnover markers and risk of MSI between local horses and international horses following long-distance air transportation.
    Study design: Prospective cohort.
    Methods: The concentrations of bone turnover markers (OCN and CTXI), markers of stress (cortisol), inflammation (serum amyloid A) and circadian rhythm (melatonin), and bisphosphonates were determined in blood samples collected twice (14-17 days apart), from horses following international travel (n = 69), and from local horses (n = 79). The associations between markers, long-distance travel and MSI were determined using multivariable generalised linear regression models.
    Results: Within 3-5 days post-transport, concentrations of cortisol in international horses were higher than those of local horses (main effect, Coef. 0.39; 95% CI 0.24, 0.54; p < 0.001) but they decreased and were not different to those of local horses at the second timepoint (interaction effect, Coef. -0.27; 95% CI -0.46, -0.07; p = 0.007). After adjusting for age and sex, OCN and CTXI were not significantly different between international and local horses; however, OCN was lower in international horses at timepoint 2 (interaction effect, Coef. -0.16; 95% CI -0.31, -0.01; p = 0.043). The prevalence of MSI was higher in the international (26%; 95% CI 16, 38%) compared with local horses (8%; 95% CI 3, 16%; p < 0.001), with all severe MSI sustained by the international horses. At the second timepoint compared with the first timepoint post-transport, cortisol remained high or increased (interaction effect, Coef. 0.43; 95% CI 0.24, 0.61; p < 0.001) and OCN increased (interaction effect, Coef. 0.26; 95% CI 0.08, 0.44; p = 0.006) in the horses that sustained severe MSI.
    Main limitations: Horse population and racing career parameters differed between groups. Bone turnover markers have low sensitivity to detect local bone changes.
    Conclusions: Most horses showed minimal effects of long-distance air transport within 2 weeks relative to local horses as assessed by stress and bone turnover markers. Screening for persistent high cortisol and evidence of net bone formation after long-distance air transportation may help to identify racehorses at high risk of catastrophic MSI.
    Language English
    Publishing date 2024-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 41606-x
    ISSN 2042-3306 ; 0425-1644
    ISSN (online) 2042-3306
    ISSN 0425-1644
    DOI 10.1111/evj.14098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Gradually Progressive Dyspnea and Exercise Intolerance in an Otherwise Active Middle-Aged Woman: Why Was the Presentation of Congenital Heart Disease Delayed?

    Kothari, Perin / Nguyen, Quoc-Sy / Pagel, Paul S / Choi, Christine

    Journal of cardiothoracic and vascular anesthesia

    2020  Volume 35, Issue 4, Page(s) 1225–1230

    Abstract: Patients with congenital heart disease (CHD) increasingly are surviving into adulthood. In the United States alone, there are more than one million adult patients living with CHD with the number increasing about 5% each year. With more than 85% of ... ...

    Abstract Patients with congenital heart disease (CHD) increasingly are surviving into adulthood. In the United States alone, there are more than one million adult patients living with CHD with the number increasing about 5% each year. With more than 85% of infants with CHD surviving into adulthood with their disease, encounters with these patients in the operating room for cardiac and noncardiac operative procedures is becoming more commonplace. Most of these patients receive corrective surgery early in life, although some may live with uncorrected CHD with no-to-relatively mild symptoms and present at a later time in life with symptoms of heart failure or pulmonary hypertension. The authors present an adult patient with uncorrected CHD presenting with late onset of heart failure symptoms. The authors also review the patient's complex congenital heart lesion, transesophageal echocardiography findings, and intraoperative management.
    MeSH term(s) Adult ; Dyspnea/diagnosis ; Dyspnea/etiology ; Echocardiography, Transesophageal ; Female ; Heart Defects, Congenital/complications ; Heart Defects, Congenital/diagnostic imaging ; Heart Failure ; Humans ; Hypertension, Pulmonary/diagnostic imaging ; Hypertension, Pulmonary/etiology ; Infant ; Middle Aged
    Language English
    Publishing date 2020-12-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2020.11.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The effect of care provided by paediatric critical care transport teams on mortality of children transported to paediatric intensive care units in England and Wales: a retrospective cohort study.

    Seaton, Sarah E / Draper, Elizabeth S / Pagel, Christina / Rajah, Fatemah / Wray, Jo / Ramnarayan, Padmanabhan

    BMC pediatrics

    2021  Volume 21, Issue 1, Page(s) 217

    Abstract: Background: Centralisation of paediatric intensive care units (PICUs) has the increased the need for specialist paediatric critical care transport teams (PCCT) to transport critically ill children to PICU. We investigated the impact of care provided by ... ...

    Abstract Background: Centralisation of paediatric intensive care units (PICUs) has the increased the need for specialist paediatric critical care transport teams (PCCT) to transport critically ill children to PICU. We investigated the impact of care provided by PCCTs for children on mortality and other clinically important outcomes.
    Methods: We analysed linked national data from the Paediatric Intensive Care Audit Network (PICANet) from children admitted to PICUs in England and Wales (2014-2016) to assess the impact of who led the child's transport, whether prolonged stabilisation by the PCCT was detrimental and the impact of critical incidents during transport on patient outcome. We used logistic regression models to estimate the adjusted odds and probability of mortality within 30 days of admission to PICU (primary outcome) and negative binomial models to investigate length of stay (LOS) and length of invasive ventilation (LOV).
    Results: The study included 9112 children transported to PICU. The most common diagnosis was respiratory problems; junior doctors led the PCCT in just over half of all transports; and the 30-day mortality was 7.1%. Transports led by Advanced Nurse Practitioners and Junior Doctors had similar outcomes (adjusted mortality ANP: 0.035 versus Junior Doctor: 0.038). Prolonged stabilisation by the PCCT was possibly associated with increased mortality (0.059, 95% CI: 0.040 to 0.079 versus short stabilisation 0.044, 95% CI: 0.039 to 0.048). Critical incidents involving the child increased the adjusted odds of mortality within 30 days (odds ratio: 3.07).
    Conclusions: Variations in team composition between PCCTs appear to have little effect on patient outcomes. We believe differences in stabilisation approaches are due to residual confounding. Our finding that critical incidents were associated with worse outcomes indicates that safety during critical care transport is an important area for future quality improvement work.
    MeSH term(s) Child ; Critical Care ; Critical Illness ; England/epidemiology ; Humans ; Infant ; Intensive Care Units, Pediatric ; Retrospective Studies ; Wales/epidemiology
    Language English
    Publishing date 2021-05-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-021-02689-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Clinical Features of COVID-19 Infection in Patients Treated at a Large Veterans Affairs Medical Center.

    Ebert, Thomas J / Dugan, Shannon / Barta, Lauren / Gordon, Brian / Nguyen-Ho, Calvin / Pagel, Paul S

    WMJ : official publication of the State Medical Society of Wisconsin

    2021  Volume 119, Issue 4, Page(s) 248–252

    Abstract: ... and 45.2%, respectively; P < 0.05 for each).: Conclusion: COVID-19-positive veterans are ...

    Abstract Introduction: During recent months, reports describing the characteristics of COVID-19 patients in China, Italy, and the United States have been published. Military veterans represent another unique population affected by COVID-19. This report summarizes the demographics and baseline clinical comorbidities in veterans testing positive for COVID-19 in Milwaukee, Wisconsin.
    Methods: Patient evaluations were conducted at the Zablocki VA Medical Center, Milwaukee, Wisconsin between March 11, 2020 and June 1, 2020. Patient demographics, baseline comorbidities, home medications, presenting symptoms, and outcomes were obtained via electronic medical record.
    Results: Ninety-five patients (88 men, 7 women) tested positive for COVID-19 and were evaluated. Fourteen required mechanical ventilation; 50 and 31 patients were treated in the hospital without ventilation or were discharged to home isolation, respectively. Discharged patients were younger than patients hospitalized. Most patients with COVID-19 were African American (63.2%). Patients whose disease progressed to mechanical ventilation had, on admission, more dyspnea, higher heart and respiratory rates, and lower oxygen saturation than other patients. COVID-19 patients who required mechanical ventilation had a longer length of stay and higher mortality than other groups and were more likely to have a history of hypertension and hyperlipidemia than patients who were discharged to home quarantine (85.7% and 78.6% vs 48.4% and 45.2%, respectively; P < 0.05 for each).
    Conclusion: COVID-19-positive veterans are predominantly African American men with hypertension and hyperlipidemia receiving beta blockers or ACEi/ARB. COVID-19-positive veterans who presented with dyspnea, tachypnea, tachycardia, and hypoxemia were more likely to require endotracheal intubation and mechanical ventilation, had longer hospital length-of-stay, and experienced greater mortality than comparison groups.
    MeSH term(s) Adult ; Aged ; COVID-19/epidemiology ; COVID-19/therapy ; Comorbidity ; Female ; Hospitals, Veterans ; Humans ; Male ; Middle Aged ; Pandemics ; United States/epidemiology ; Veterans ; Wisconsin/epidemiology
    Language English
    Publishing date 2021-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 441051-8
    ISSN 2379-3961 ; 0043-6542 ; 1098-1861
    ISSN (online) 2379-3961
    ISSN 0043-6542 ; 1098-1861
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Impact on 30-day survival of time taken by a critical care transport team to reach the bedside of critically ill children.

    Seaton, Sarah E / Ramnarayan, Padmanabhan / Pagel, Christina / Davies, Patrick / Draper, Elizabeth S

    Intensive care medicine

    2020  Volume 46, Issue 10, Page(s) 1953–1955

    MeSH term(s) Child ; Critical Care ; Critical Illness ; Humans ; Intensive Care Units, Pediatric
    Language English
    Publishing date 2020-06-22
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-020-06149-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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