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Article ; Online: Pan-cortical electrophysiologic changes underlying attention.

Lesser, Ronald P / Webber, W R S / Miglioretti, Diana L

2024 Volume 14, Issue 1, Page(s) 2680

Abstract: We previously reported that pan-cortical effects occur when cognitive tasks end afterdischarges. For this report, we analyzed wavelet cross-coherence changes during cognitive tasks used to terminate afterdischarges studying multiple time segments and ... ...

Abstract	We previously reported that pan-cortical effects occur when cognitive tasks end afterdischarges. For this report, we analyzed wavelet cross-coherence changes during cognitive tasks used to terminate afterdischarges studying multiple time segments and multiple groups of inter-electrode-con distances. We studied 12 patients with intractable epilepsy, with 970 implanted electrode contacts, and 39,871 electrode contact combinations. When cognitive tasks ended afterdischarges, coherence varied similarly across the cortex throughout the tasks, but there were gradations with time, distance, and frequency: (1) They tended to progressively decrease relative to baseline with time and then to increase toward baseline when afterdischarges ended. (2) During most time segments, decreases from baseline were largest for the closest inter-contact distances, moderate for intermediate inter-contact distances, and smallest for the greatest inter-contact distances. With respect to our patients' intractable epilepsy, the changes found suggest that future therapies might treat regions beyond those closest to regions of seizure onset and treat later in a seizure's evolution. Similar considerations might apply to other disorders. Our findings also suggest that cognitive tasks can result in pan-cortical coherence changes that participate in underlying attention, perhaps complementing the better-known regional mechanisms.
MeSH term(s)	Humans ; Drug Resistant Epilepsy ; Electroencephalography/methods ; Electrodes, Implanted ; Attention ; Seizures
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52717-w
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Article ; Online: Timing of cognitive effects on afterdischarge termination.

Lesser, Ronald P / Webber, W R S / Miglioretti, Diana L

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2023 Volume 153, Page(s) 28–32

Abstract: Objective: We previously studied efficacy of cognitive tasks on afterdischarge termination in patients undergoing cortical stimulation and found that diffuse wavelet cross-coherence changes on electrocorticography were associated with termination ... ...

Abstract	Objective: We previously studied efficacy of cognitive tasks on afterdischarge termination in patients undergoing cortical stimulation and found that diffuse wavelet cross-coherence changes on electrocorticography were associated with termination efficacy. We now report wavelet cross-coherence findings during different time segments of trials during which afterdischarges ended. Methods: For 12 patients with implanted subdural electrodes, we compared wavelet cross-coherence findings among several 1-second portions of cognitive tasks, reflecting task presentation, patient replies, and afterdischarge termination. Results: Coherence decreased significantly and progressively over time for 16.89, 22.53, and 30.03 Hz frequency ranges, but increased with afterdischarge termination. Coherence first increased, and then decreased for the 7.13 Hz frequency range. Conclusions: The findings suggest that cumulative but non-specific factors, likely related primarily to attention, influence the coherence results throughout the task, with a separate effect due to resolution of the afterdischarges at the end. Significance: Task performance is well known to localize to specific brain regions and to be restricted in timing. In contrast, attention and overall mental activation might be due to emergent properties of brain as a whole and that are less circumscribed in space or time. Cognitive tasks might modify seizures and other neurological disorders.
MeSH term(s)	Humans ; Electroencephalography/methods ; Seizures ; Brain/physiology ; Attention ; Cognition ; Electric Stimulation/methods
Language	English
Publishing date	2023-06-28
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2023.06.005
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Article ; Online: Pan-cortical coordination underlying mental effort.

Lesser, Ronald P / Webber, W R S / Miglioretti, Diana L

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2022 Volume 136, Page(s) 130–137

Abstract: Objective: It is well known that activity in, or coordination among, brain regions, can underlie movement, sensation, language, and cognition but there are observations that tasks unrelated to specific brain regions can nonetheless alter activity in ... ...

Abstract	Objective: It is well known that activity in, or coordination among, brain regions, can underlie movement, sensation, language, and cognition but there are observations that tasks unrelated to specific brain regions can nonetheless alter activity in those regions. These tasks might invoke activity in multiregional networks, but it also is possible that they are associated with changes beyond these networks. We therefore evaluated the possibility that more widespread, or even whole-cortical, mechanisms might complement or alter focal or multifocal cortical activity. Methods: We assessed the extent of electroencephalographic changes occurring outside areas with epileptiform activity, but that were associated with termination of the epileptiform activity. To do this, we measured the distribution of wavelet cross-coherence changes based on electrocorticography from 15 patients who showed regional afterdischarges in response to electrical brain stimulation prior to epilepsy surgery and in whom cognitive tasks were used in attempts to end the afterdischarges. There were 1276 electrodes implanted in these patients, and we analyzed a total of 55,494 electrode combinations. We compared recordings when cognitive effort was versus when it was not successful in ending afterdischarges. Results: We found that when afterdischarges were suppressed there were changes in electrocorticographic coherence that were similar throughout cortex, regardless of the distance between sites. Conclusions: The similarity implies coordination of the changes, and the similarity regardless of distance or location implies a pan-cortical effect. Significance: Our results provide physical support for hypotheses that pan-cortical processes complement the well-known regional and multiregional networks. These processes may participate in, be recruited by, modify, or underlie the conative experiences of waking life.
MeSH term(s)	Brain/physiology ; Brain Mapping/methods ; Cerebral Cortex/physiology ; Electrocorticography/methods ; Electroencephalography/methods ; Epilepsy ; Humans
Language	English
Publishing date	2022-01-25
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2021.12.021
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Article ; Online: Corrigendum to "Cognitive effort decreases beta, alpha, and theta coherence and ends afterdischarges in human brain" [Clin. Neurophysiol. 130(11) (2019) 2169-2181].

Lesser, Ronald P / Webber, W R S / Miglioretti, Diana L / Pillai, Jay J / Agarwal, Shruti / Mori, Susumu / Morrison, Peter F / Castagnola, Stefano / Lawal, Adeshola / Lesser, Helen J

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

2022 Volume 135, Page(s) 188

Language	English
Publishing date	2022-01-07
Publishing country	Netherlands
Document type	Published Erratum
ZDB-ID	1463630-x
ISSN	1872-8952 ; 0921-884X ; 1388-2457
ISSN (online)	1872-8952
ISSN	0921-884X ; 1388-2457
DOI	10.1016/j.clinph.2021.12.009
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Article ; Online: Importance of imaging-acquisition protocol and post-processing analysis for extracellular volume fraction assessment by computed tomography.

Koike, Hideki / Cheng, Victor Y / Lesser, Andrew / Enriquez-Sarano, Maurice / Caye, David J / Aluru, John Sukumar / Stanberry, Larissa I / Schelbert, Erik B / Sato, Hirotomo / Fukui, Miho / Bapat, Vinayak N / Sorajja, Paul / Lesser, John R / Cavalcante, João L

Journal of cardiovascular computed tomography

2023 Volume 17, Issue 3, Page(s) 222–225

Abstract: ... was associated with high-pitch scan mode (odds ratio: OR = 2.26, p = 0.036), along ... with the presence of intracardiac leads (OR = 4.91, p = 0.002), and BMI≥35 kg/m: Conclusions: Myocardial CT ...

Abstract	Background: Computed tomography angiography (CTA) assessment of myocardial extracellular volume fraction (CT-ECV) is feasible, although the protocols for imaging acquisition and post-processing methodology have varied. We aimed to identify a pragmatic protocol for CT-ECV assessment encompassing both imaging acquisition and post-processing methodologies to facilitate its clinical implementation. Methods: We evaluated consecutive patients with severe aortic stenosis undergoing evaluation for transcatheter aortic valve replacement (TAVR). Pre-contrast and 3-min-delayed CTA were obtained in systole using either helical prospective-ECG-triggered (high-pitch) or axial sequential-ECG-gated acquisition, adding to standard TAVR CTA protocol. Using a dedicated software for co-registration of CTA datasets, three methodologies for ECV measurement were evaluated: (1) mid-septum region of interest (Septal ECV), (2) averaged-global ECV (Global ECV) encompassing 16-AHA segments, and (3) average of septal and lateral segments (Averaged ECVsep and Averaged ECVlat). Results: Among the 142 patients enrolled (median = 81 years, 44% females), 8 were excluded due to significant imaging artifacts precluding Global ECV assessment. High-pitch scan mode was performed in 68 patients (48%). Suboptimal image quality for Global ECV assessment was associated with high-pitch scan mode (odds ratio: OR = 2.26, p = 0.036), along with the presence of intracardiac leads (OR = 4.91, p = 0.002), and BMI≥35 kg/m Conclusions: Myocardial CT-ECV assessment is feasible using a systolic sequential acquisition pre-contrast, and similar additional 3-min delayed scan. Septal ECV measurement provides similar values to Global ECV and is equally reproducible.
MeSH term(s)	Female ; Humans ; Male ; Prospective Studies ; Predictive Value of Tests ; Tomography, X-Ray Computed ; Computed Tomography Angiography/methods ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery
Language	English
Publishing date	2023-03-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2394360-9
ISSN	1876-861X ; 1934-5925
ISSN (online)	1876-861X
ISSN	1934-5925
DOI	10.1016/j.jcct.2023.02.007
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Article ; Online: Preprocedural Computed Tomography Planning for Surgical Aortic Valve Replacement.

Okada, Atsushi / Beckmann, Erik / Rocher, Erick E / Fukui, Miho / Wang, Cheng / Phichaphop, Asa / Koike, Hideki / Thao, Kiahltone R / Willett, Andrew / Walser-Kuntz, Evan / Stanberry, Larissa I / Enriquez-Sarano, Maurice / Lesser, John R / Sun, Benjamin / Steffen, Robert J / Sorajja, Paul / Cavalcante, João L / Bapat, Vinayak N

The Annals of thoracic surgery

2024

Abstract: ... than by conventional sizing (12% vs 31% [P = .001] and 0% vs 6% [P = .039], respectively). Interoperator variability ...

Abstract	Background: Selection of transcatheter valve size using preprocedural computed tomography (CT) is standardized and well established. However, valve sizing for surgical aortic valve replacement (SAVR) is currently performed intraoperatively by using sizers, which may result in variation among operators and risk for prosthesis-patient mismatch. This study evaluated the usefulness of CT annulus measurement for SAVR valve sizing. Methods: This study included patients who underwent SAVR using Inspiris or Magna Ease and received preoperative electrocardiogram-gated CT imaging. Starting from June 2022, study investigators applied a CT sizing algorithm using CT-derived annulus size to guide minimum SAVR label size. The final decision of valve selection was left to the operating surgeon during SAVR. The study compared the appropriateness of valve selection (comparing implanted size with CT-predicted size) and prosthesis-patient mismatch rates without aortic root enlargement between 2 cohorts: 102 cases since June 2022 (CT sizing cohort) and 180 cases from 2020 to 2021 (conventional sizing cohort). Results: Implanted size smaller than CT predicted size and severe prosthesis-patient mismatch were significantly lower by CT sizing than by conventional sizing (12% vs 31% [P = .001] and 0% vs 6% [P = .039], respectively). Interoperator variability was a factor associated with implanted size smaller than CT predicted with conventional sizing, whereas it became nonsignificant with CT sizing. Conclusions: Applying CT sizing to SAVR led to improved valve size selection, less prosthesis-patient mismatch, and less interoperator variability. CT sizing for SAVR could also be used to predict prosthesis-patient mismatch before SAVR and identify patients who need aortic root enlargement.
Language	English
Publishing date	2024-02-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2024.02.017
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Article ; Online: Cardiac MRI Uncovers Pathophysiology of Low Cardiac Output Syndrome Post-Transcatheter Mitral Valve Replacement.

Fukui, Miho / Sorajja, Paul / Enriquez-Sarano, Maurice / Lesser, John R / Bapat, Vinayak N / Cavalcante, João L

JACC. Cardiovascular interventions

2023 Volume 16, Issue 23, Page(s) 2927–2930

MeSH term(s)	Humans ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Cardiac Output, Low/surgery ; Treatment Outcome ; Heart Valve Diseases/surgery ; Heart Valve Prosthesis Implantation/adverse effects ; Magnetic Resonance Imaging ; Cardiac Catheterization/adverse effects ; Ventricular Outflow Obstruction ; Heart Valve Prosthesis
Language	English
Publishing date	2023-11-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2023.10.018
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Article ; Online: Deformation of transcatheter heart valves with mitral valve-in-valve.

Fukui, Miho / Okada, Atsushi / Burns, Marcus R / Sato, Hirotomo / Thao, Kiahltone R / Wang, Cheng / Koike, Hideki / Hamid, Nadira / Enriquez-Sarano, Maurice / Lesser, John R / Cavalcante, Joao L / Sorajja, Paul / Bapat, Vinayak N

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology

2023 Volume 19, Issue 11, Page(s) e937–e947

Abstract: ... with greater underexpansion and a higher deformation index (β=-0.634; p<0.001; β=0.594; p<0.001, respectively ...

Abstract	Background: The use of oversizing in mitral valve-in-valve (MViV) procedures can lead to non-uniform expansion of transcatheter heart valves (THV). This may have implications for THV durability. Aims: The objective of this study was to assess the extent and predictors of THV deformation in MViV procedures. Methods: We examined 33 patients who underwent MViV with SAPIEN prostheses. The extent of THV deformation (deformation index, eccentricity, neosinus volume, asymmetric leaflet expansion and vertical deformation) and hypoattenuating leaflet thickening (HALT) were assessed using cardiac computed tomography (CT), performed prospectively at 30 days post-procedure. For descriptive purposes, the THV deformation index was calculated, with values >1.00 representing a more hourglass shape. Results: Non-uniform underexpansion of THV was common after MViV implantation, with a median expansion area of 74.0% (interquartile range 68.1-84.1) at the narrowest level and a THV deformation index of 1.21 (1.13-1.29), but circularity was maintained with eccentricity ranging from 0.24 to 0.28. The degree of oversizing was a key factor associated with greater underexpansion and a higher deformation index (β=-0.634; p<0.001; β=0.594; p<0.001, respectively). Overall, the incidence of HALT on the 30-day postprocedural CT was 27.3% (9 of 33). Most patients (32 of 33) were on anticoagulation therapy, but the prothrombin time and international normalised ratio (PT-INR) at the time of the CT scan was <2.5 in 23 of 32 patients. Among patients with a PT-INR of <2.5, HALT was predominantly observed with a high THV deformation index of ≥1.18. Conclusions: THV deformation, i.e., underexpansion and an hourglass shape, commonly occurs after MViV implantation and is negatively affected by excessive oversizing. Optimising THV expansion during MViV could potentially prevent HALT.
MeSH term(s)	Humans ; Aortic Valve Stenosis/surgery ; Mitral Valve/diagnostic imaging ; Mitral Valve/surgery ; Treatment Outcome ; Heart Valve Prosthesis ; Transcatheter Aortic Valve Replacement ; Prosthesis Design ; Aortic Valve/surgery
Language	English
Publishing date	2023-12-18
Publishing country	France
Document type	Journal Article
ZDB-ID	2457174-X
ISSN	1969-6213 ; 1774-024X
ISSN (online)	1969-6213
ISSN	1774-024X
DOI	10.4244/EIJ-D-23-00614
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Zs.A 6680: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Field evaluation of WALS truck-mounted A1 super duty mist sprayer® with VectoBac® WDG against Aedes aegypti (Diptera:Culicidae) populations in Manatee County, Florida

Katie Katie Williams / Samantha Ramirez / Christopher R. Lesser

SN Applied Sciences, Vol 4, Iss 2, Pp 1-

2022 Volume 15

Abstract: ... in female adults (P = 0.0002) and landing rate counts (P = 0.0058) as a result of treatment. Larval ...

Abstract	Abstract Aedes aegypti, the Dengue and Zika vector, is a domestic mosquito that is difficult to control. The challenge lies in the mosquito’s preference to lay its eggs in cryptic habitats such as fence post openings, buckets and bird baths, cups. Additionally, current methods of control are labor-intensive. We employed the WALS strategy to evaluate the operational efficacy of applying VectoBac WDG using a truck-mounted mister to control local populations of Ae. aegypti in urban settings with difficult-to-reach larval mosquito habitats. Our study was conducted in Cortez (Manatee County), Florida, USA (27° 27’ N, 82° 40’ W). We selected two study sites, one untreated control (21.9 ha) and one treatment site (23.1 ha) where historical data have shown high populations of Ae. aegypti based on weekly ovitrap surveillance. Weekly BGs and ovitraps (10–15 traps/site) were deployed to monitor adult population dynamics. A total of 50 bioassay jars were placed in the field each afternoon of the Bti application (8 application events) at fixed locations to collect droplets and gauge efficacy. We found significant reduction in female adults (P = 0.0002) and landing rate counts (P = 0.0058) as a result of treatment. Larval bioassays during the eight applications confirmed Bti deposit in a variety of coverage types regardless of placement in the yards. WALS applications with a truck-mounted mister can be effective at reducing disease carrying mosquito populations in residential areas and can be implemented in an integrated vector management program.
Keywords	Integrated vector management ; Ovitrap ; Egg surveillance ; Adult surveillance ; Insecticides ; Resistance ; Science ; Q ; Technology ; T
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Springer
Document type	Article ; Online
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Article: Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry.

McLean, Robert R / Sima, Adam P / Beaty, Silky / Low, Robert / Spitzer, Rebecca L / Stark, Jeffrey L / Lesser, Elizabeth / Lee, Edward / Armstrong, April

Dermatology and therapy

2023 Volume 13, Issue 11, Page(s) 2739–2751

Abstract: ... hazard ratio [HR] = 2.61; 95% confidence interval [CI] 1.35, 5.02; p = 0.004) and PASI75 < 90 (HR = 2.97 ... CI 1.58, 5.58; p = 0.001) groups compared to the PASI100 group. The risk of treatment failure was ... p < 0.001).: Conclusions: The results suggest that patients are more likely to remain ...

Abstract	Introduction: Complete and near-complete skin clearance have become achievable treatment goals for patients with psoriasis receiving systemic biologic therapies. However, there is limited real-world evidence regarding the impact of the degree of skin clearance on biologic treatment patterns among these patients. Methods: This longitudinal cohort study assessed the relationship between degree of skin clearance following initiation of a systemic biologic therapy and treatment failure among patients from the CorEvitas Psoriasis Registry (April 2015-August 2021). Patients had Psoriasis Area and Severity Index (PASI) score > 5 at systemic biologic therapy initiation and ≥ 1 follow-up visit(s) within 15 months of initiation. Treatment failure (discontinuation due to poor response/adverse event; addition of non-biologic therapy) and degree of skin clearance (measured by PASI) were assessed following biologic initiation. Proportional hazards regression was used to estimate the association between PASI response level and treatment failure over follow-up. Results: This study included 2701 patient initiations from 2516 unique patients with 3846 total visits over follow-up. Over half of the patient initiations (n = 1412; 52.3%) were among patients with PASI >10. Treatment failure occurred in 1.3% of visits at which PASI100 was achieved, while those achieving PASI90 - < 100 and PASI75 - < 90 had treatment failure rates of 3.4% and 3.5%, respectively. After adjustment for confounders, the risk of treatment failure was two to three times higher in the PASI90 - < 100 (hazard ratio [HR] = 2.61; 95% confidence interval [CI] 1.35, 5.02; p = 0.004) and PASI75 < 90 (HR = 2.97; CI 1.58, 5.58; p = 0.001) groups compared to the PASI100 group. The risk of treatment failure was more than 20 times higher in the < PASI75 group versus the PASI100 group (HR = 22.26; CI 13.32, 37.21; p < 0.001). Conclusions: The results suggest that patients are more likely to remain on a systemic biologic therapy if they achieve near-complete or complete skin clearance, supporting the continued need to target skin clearance as a treatment goal in psoriasis. Trial registration: ClinicalTrials.gov identifier, NCT02707341.
Language	English
Publishing date	2023-09-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2680284-3
ISSN	2190-9172 ; 2193-8210
ISSN (online)	2190-9172
ISSN	2193-8210
DOI	10.1007/s13555-023-01027-6
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