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Article ; Online: Recent advances in understanding and treating scabies.

Welch, Emily / Romani, Lucia / Whitfeld, Margot J

Faculty reviews

2021 Volume 10, Page(s) 28

Abstract: Scabies is an infestation of the skin caused by the ... ...

Abstract	Scabies is an infestation of the skin caused by the mite
Language	English
Publishing date	2021-03-11
Publishing country	England
Document type	Journal Article ; Review
ISSN	2732-432X
ISSN (online)	2732-432X
DOI	10.12703/r/10-28
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Article ; Online: Acute intermittent hypercapnic-hypoxia elicits central neural respiratory motor plasticity in humans.

Welch, Joseph F / Nair, Jayakrishnan / Argento, Patrick J / Mitchell, Gordon S / Fox, Emily J

The Journal of physiology

2022 Volume 600, Issue 10, Page(s) 2515–2533

Abstract: Acute intermittent hypoxia (AIH) elicits long-term facilitation (LTF) of respiration. Although LTF is observed when ... ...

Abstract	Acute intermittent hypoxia (AIH) elicits long-term facilitation (LTF) of respiration. Although LTF is observed when CO
MeSH term(s)	Adult ; Animals ; Carbon Dioxide ; Diaphragm/physiology ; Humans ; Hypercapnia ; Hypoxia ; Neuronal Plasticity ; Phrenic Nerve/physiology ; Rats ; Rats, Sprague-Dawley
Chemical Substances	Carbon Dioxide (142M471B3J)
Language	English
Publishing date	2022-04-28
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	3115-x
ISSN	1469-7793 ; 0022-3751
ISSN (online)	1469-7793
ISSN	0022-3751
DOI	10.1113/JP282822
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Article: APOE4, Age & Sex Regulate Respiratory Plasticity Elicited By Acute Intermittent Hypercapnic-Hypoxia.

Nair, Jayakrishnan / Welch, Joseph F / Marciante, Alexandria B / Hou, Tingting / Lu, Qing / Fox, Emily J / Mitchell, Gordon S

bioRxiv : the preprint server for biology

2023

Abstract: Rationale: Acute intermittent hypoxia (AIH) is a promising strategy to induce functional motor recovery following chronic spinal cord injuries and neurodegenerative diseases. Although significant results are obtained, human AIH trials report ... ...

Abstract	Rationale: Acute intermittent hypoxia (AIH) is a promising strategy to induce functional motor recovery following chronic spinal cord injuries and neurodegenerative diseases. Although significant results are obtained, human AIH trials report considerable inter-individual response variability. Objectives: Identify individual factors ( Methods: Associations of individual factors with the magnitude of AIHH (15, 1-min O Results: AIHH-induced changes in diaphragm MEP amplitudes were lower in individuals heterozygous for Conclusions: APOE Addition to knowledge base: Acute intermittent hypoxia (AIH) is a novel rehabilitation strategy to induce functional recovery of respiratory and non-respiratory motor systems in people with chronic spinal cord injury and/or neurodegenerative diseases. Since most AIH trials report considerable inter-individual variability in AIH outcomes, we investigated factors that potentially undermine the response to an optimized AIH protocol, acute intermittent hypercapnic-hypoxia (AIHH), in healthy humans. We demonstrate that genetics (particularly the lipid transporter,
Language	English
Publishing date	2023-01-07
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.01.06.522840
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Article ; Online: Cardiorespiratory Responses to Acute Intermittent Hypoxia in Humans With Chronic Spinal Cord Injury.

Welch, Joseph F / Vose, Alicia K / Cavka, Kate / Brunetti, Gina / DeMark, Louis A / Snyder, Hannah / Wauneka, Clayton N / Tonuzi, Geneva / Nair, Jayakrishnan / Mitchell, Gordon S / Fox, Emily J

Journal of neurotrauma

2024

Abstract: Brief exposure to repeated episodes of low inspired oxygen, or acute intermittent hypoxia (AIH), is a promising therapeutic modality to improve motor function after chronic, incomplete spinal cord injury (SCI). Although therapeutic AIH is under extensive ...

Abstract	Brief exposure to repeated episodes of low inspired oxygen, or acute intermittent hypoxia (AIH), is a promising therapeutic modality to improve motor function after chronic, incomplete spinal cord injury (SCI). Although therapeutic AIH is under extensive investigation in persons with SCI, limited data are available concerning cardiorespiratory responses during and after AIH exposure despite implications for AIH safety and tolerability. Thus, we recorded immediate (during treatment) and enduring (up to 30 min post-treatment) cardiorespiratory responses to AIH in 19 participants with chronic SCI (>1 year post-injury; injury levels C1 to T6; American Spinal Injury Association Impairment Scale A to D; mean age = 33.8 ± 14.1 years; 18 males). Participants completed a single AIH (15, 60-sec episodes, inspired O
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	645092-1
ISSN	1557-9042 ; 0897-7151
ISSN (online)	1557-9042
ISSN	0897-7151
DOI	10.1089/neu.2023.0353
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Article ; Online: APOE4, Age, and Sex Regulate Respiratory Plasticity Elicited by Acute Intermittent Hypercapnic-Hypoxia.

Nair, Jayakrishnan / Welch, Joseph F / Marciante, Alexandria B / Hou, Tingting / Lu, Qing / Fox, Emily J / Mitchell, Gordon S

Function (Oxford, England)

2023 Volume 4, Issue 5, Page(s) zqad026

Abstract: Rationale: Acute intermittent hypoxia (AIH) shows promise for enhancing motor recovery in chronic spinal cord injuries and neurodegenerative diseases. However, human trials of AIH have reported significant variability in individual responses.: ... ...

Abstract	Rationale: Acute intermittent hypoxia (AIH) shows promise for enhancing motor recovery in chronic spinal cord injuries and neurodegenerative diseases. However, human trials of AIH have reported significant variability in individual responses. Objectives: Identify individual factors (eg, genetics, age, and sex) that determine response magnitude of healthy adults to an optimized AIH protocol, acute intermittent hypercapnic-hypoxia (AIHH). Methods: In 17 healthy individuals (age = 27 ± 5 yr), associations between individual factors and changes in the magnitude of AIHH (15, 1-min O2 = 9.5%, CO2 = 5% episodes) induced changes in diaphragm motor-evoked potential (MEP) amplitude and inspiratory mouth occlusion pressures (P0.1) were evaluated. Single nucleotide polymorphisms (SNPs) in genes linked with mechanisms of AIH induced phrenic motor plasticity ( Results: AIHH-induced changes in diaphragm MEP amplitudes were lower in individuals heterozygous for Conclusions: APOE4 Addition to knowledge base: AIH is a novel rehabilitation strategy to induce functional recovery of respiratory and non-respiratory motor systems in people with chronic spinal cord injury and/or neurodegenerative disease. Figure 5 Since most AIH trials report considerable inter-individual variability in AIH outcomes, we investigated factors that potentially undermine the response to an optimized AIH protocol, AIHH, in healthy humans. We demonstrate that genetics (particularly the lipid transporter,
MeSH term(s)	Adult ; Animals ; Female ; Humans ; Male ; Rats ; Young Adult ; Apolipoprotein E4/genetics ; Hypercapnia/genetics ; Hypoxia/genetics ; Neurodegenerative Diseases ; Neuronal Plasticity/genetics ; Rats, Sprague-Dawley ; Spinal Cord Injuries
Chemical Substances	Apolipoprotein E4 ; ApoE protein, human
Language	English
Publishing date	2023-06-13
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	2633-8823
ISSN (online)	2633-8823
DOI	10.1093/function/zqad026
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Article ; Online: Evaluation of Post-thrombolytic Events to Determine Appropriate ICU Monitoring Duration for Patients with Ischemic Stroke.

Reimer, James / Wang, Fajun / Ramiro, Joanna / Welch, Emily / Christopher, Kara M / Braun, James

Neurocritical care

2024

Abstract: Background: Standard treatment for eligible patients presenting with acute ischemic stroke (AIS) is thrombolysis with tissue plasminogen activators alteplase or tenecteplase. Current guidelines recommend monitoring patients in an intensive care unit ( ... ...

Abstract	Background: Standard treatment for eligible patients presenting with acute ischemic stroke (AIS) is thrombolysis with tissue plasminogen activators alteplase or tenecteplase. Current guidelines recommend monitoring patients in an intensive care unit (ICU) for 24 h after thrombolytic therapy. However, recent studies have questioned the need for prolonged ICU monitoring. This retrospective cohort study aims to identify potential candidates for early transition to a lower level of care by assessing risk factors for neurological deterioration, symptomatic intracranial hemorrhage (sICH), or need for ICU intervention within 24 h post-thrombolysis. Methods: This retrospective cohort study included adult patients 18 years and older with AIS who received thrombolysis. Patients were excluded if they were transferred to another facility, if they were transitioned to comfort care or hospice care within 24 h, or if they lacked imaging and National Institutes of Health Stroke Scale (NIHSS) score data. The primary end point was incidence of sICH between 0-12 and 12-24 h. Secondary end points included the need for ICU intervention and rates of neurological deterioration. Results: The analysis included 204 patients who received the full dose of alteplase. Among them, ten patients (4.9%) developed sICH, with the majority (n = 7) occurring within 12 h post-thrombolysis. Sixty-two patients required ICU interventions within 12 h compared with four patients after 12 h. Twenty-four patients had neurological deterioration within 12 h, and seven patients had neurological deterioration after 12 h. Multivariable analysis identified mechanical thrombectomy and increased blood pressure at presentation as predictors of ICU need beyond 12 h post-thrombolysis. Conclusions: Our study demonstrates that sICH, neurological deterioration, and need for ICU intervention rarely occur beyond 12 h after thrombolytic administration. Patients presenting with blood pressures < 140/90 mm Hg, NIHSS scores < 10, and not undergoing mechanical thrombectomy may be best candidates for early de-escalation. Larger prospective studies are needed to more fully evaluate the safety, feasibility, and financial impact of early transition out of the ICU.
Language	English
Publishing date	2024-04-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2381896-7
ISSN	1556-0961 ; 1541-6933
ISSN (online)	1556-0961
ISSN	1541-6933
DOI	10.1007/s12028-024-01979-3
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Article ; Online: Responsive neurostimulation for pediatric patients with drug-resistant epilepsy: a case series and review of the literature.

Curtis, Kendall / Hect, Jasmine L / Harford, Emily / Welch, William P / Abel, Taylor J

Neurosurgical focus

2022 Volume 53, Issue 4, Page(s) E10

Abstract: Objective: Responsive neurostimulation (RNS) is a promising treatment for pediatric patients with drug-resistant epilepsy for whom resective surgery is not an option. The relative indications and risk for pediatric patients undergoing RNS therapy ... ...

Abstract	Objective: Responsive neurostimulation (RNS) is a promising treatment for pediatric patients with drug-resistant epilepsy for whom resective surgery is not an option. The relative indications and risk for pediatric patients undergoing RNS therapy require further investigation. Here, the authors report their experience with RNS implantation and therapy in pediatric patients. Methods: The authors performed a retrospective chart review to identify patients implanted with RNS depth or strip electrodes for the treatment of drug-resistant epilepsy at their institution between 2020 and 2022. Patient demographics, surgical variables, and patient seizure outcomes (Engel class and International League Against Epilepsy [ILAE] reporting) were evaluated. Results: The authors identified 20 pediatric patients ranging in age from 8 to 21 years (mean 15 [SD 4] years), who underwent RNS implantation, including depth electrodes (n = 15), strip electrodes (n = 2), or both (n = 3). Patient seizure semiology, onset, and implantation strategy were heterogeneous, including bilateral centromedian nucleus (n = 5), mesial temporal lobe (n = 4), motor cortex or supplementary motor area (n = 7), or within an extratemporal epileptogenic zone (n = 4). There were no acute complications of RNS implantation (hemorrhage or stroke) or device malfunctions. One patient required rehospitalization for postoperative infection. At the longest follow-up (mean 10 [SD 7] months), 13% patients had Engel class IIB, 38% had Engel class IIIA, 6% had Engel class IIIB, 19% had Engel class IVA, 19% had Engel class IVB, and 6% had Engel class IVC outcomes. Using ILAE metrics, 6% were ILAE class 3, 25% were ILAE class 4, and 69% were ILAE class 5. Conclusions: This case series supports current literature suggesting that RNS is a safe and potentially effective surgical intervention for pediatric patients with drug-resistant epilepsy. The authors report comparable rates of serious adverse events to current RNS literature in pediatric and adult populations. Seizure outcomes may continue to improve with follow-up as stimulation strategy is refined and the chronic neuromodulatory effect evolves, as previously described in patients with RNS. Further large-scale, multicenter case series of RNS in pediatric patients with drug-resistant epilepsy are required to determine long-term pediatric safety and effectiveness.
MeSH term(s)	Adolescent ; Adult ; Child ; Drug Resistant Epilepsy/etiology ; Drug Resistant Epilepsy/surgery ; Electrodes, Implanted/adverse effects ; Epilepsy/therapy ; Humans ; Multicenter Studies as Topic ; Retrospective Studies ; Seizures/etiology ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2022-10-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2022.7.FOCUS22331
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Article ; Online: Improved Strategies for Teaching Surgical Skills in the Obstetrics-Gynecology Clerkship: Simulation and Beyond.

Welch, Eva K / Jordan, Sali M / Marko, Emily / Sheridan, Michael J / McLeod, Francine

Surgical innovation

2020 Volume 28, Issue 3, Page(s) 388–389

MeSH term(s)	Computer Simulation ; Gynecology/education ; Humans ; Obstetrics/education ; Students, Medical
Language	English
Publishing date	2020-08-21
Publishing country	United States
Document type	Letter
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350620952248
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Article ; Online: Reliability of diaphragmatic motor-evoked potentials induced by transcranial magnetic stimulation.

Welch, Joseph F / Argento, Patrick J / Mitchell, Gordon S / Fox, Emily J

Journal of applied physiology (Bethesda, Md. : 1985)

2020 Volume 129, Issue 6, Page(s) 1393–1404

Abstract: The diaphragmatic motor-evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) permits electrophysiological assessment of the cortico-diaphragmatic pathway. Despite the value of TMS for investigating diaphragm motor integrity in health ...

Abstract	The diaphragmatic motor-evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) permits electrophysiological assessment of the cortico-diaphragmatic pathway. Despite the value of TMS for investigating diaphragm motor integrity in health and disease, reliability of the technique has not been established. The study aim was to determine within- and between-session reproducibility of surface electromyogram recordings of TMS-evoked diaphragm potentials. Fifteen healthy young adults participated (6 females, age = 29 ± 7 yr). Diaphragm activation was determined by gradually increasing the stimulus intensity from 60 to 100% of maximal stimulator output (MSO). A minimum of seven stimulations were performed at each intensity. A second block of stimuli was delivered 30 min later for within-day comparisons, and a third block was performed on a separate day for between-day comparisons. Reliability of diaphragm MEPs was assessed at 100% MSO using intraclass correlation coefficients (ICC) and 95% limits of agreement (LOA). MEP latency (ICC = 0.984,
MeSH term(s)	Adult ; Diaphragm ; Electromyography ; Evoked Potentials, Motor ; Female ; Humans ; Male ; Reproducibility of Results ; Transcranial Magnetic Stimulation ; Young Adult
Language	English
Publishing date	2020-10-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00486.2020
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Article ; Online: Utilization of Sacubitril/Valsartan in Real-World Settings.

Eworuke, Efe / Menzin, Talia J / Welch, Emily C / Kolonoski, Joy / Huang, Ting-Ying

American journal of cardiovascular drugs : drugs, devices, and other interventions

2020 Volume 20, Issue 6, Page(s) 619–623

MeSH term(s)	Adolescent ; Adult ; Aged ; Aminobutyrates/therapeutic use ; Angiotensin Receptor Antagonists/therapeutic use ; Biphenyl Compounds/therapeutic use ; Drug Combinations ; Female ; Heart Failure/drug therapy ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Socioeconomic Factors ; Valsartan/therapeutic use ; Young Adult
Chemical Substances	Aminobutyrates ; Angiotensin Receptor Antagonists ; Biphenyl Compounds ; Drug Combinations ; Valsartan (80M03YXJ7I) ; sacubitril and valsartan sodium hydrate drug combination (WB8FT61183)
Language	English
Publishing date	2020-08-10
Publishing country	New Zealand
Document type	Letter
ZDB-ID	2052547-3
ISSN	1179-187X ; 1175-3277
ISSN (online)	1179-187X
ISSN	1175-3277
DOI	10.1007/s40256-020-00433-x
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