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Article ; Online: White Matter Organization and Cortical Thickness Differ Among Active Duty Service Members With Chronic Mild, Moderate, and Severe Traumatic Brain Injury.

Gimbel, Sarah I / Hungerford, Lars D / Twamley, Elizabeth W / Ettenhofer, Mark L

2023 Volume 41, Issue 7-8, Page(s) 818–835

Abstract: ... ...

Abstract	Abstract
MeSH term(s)	Humans ; White Matter/diagnostic imaging ; White Matter/pathology ; Diffusion Tensor Imaging ; Brain/pathology ; Brain Injuries/complications ; Brain Concussion/complications ; Brain Injury, Chronic/complications ; Brain Injuries, Traumatic/complications
Language	English
Publishing date	2023-11-15
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.2023.0336
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Article ; Online: Associations of mTBI and post-traumatic stress to amygdala structure and functional connectivity in military Service Members.

Gimbel, Sarah I / Wang, Cailynn C / Hungerford, Lars / Twamley, Elizabeth W / Ettenhofer, Mark L

Frontiers in neuroimaging

2023 Volume 2, Page(s) 1129446

Abstract: Introduction: Traumatic brain injury (TBI) is one of the highest public health priorities, especially among military personnel where comorbidity with post-traumatic stress symptoms and resulting consequences is high. Brain injury and post-traumatic ... ...

Abstract	Introduction: Traumatic brain injury (TBI) is one of the highest public health priorities, especially among military personnel where comorbidity with post-traumatic stress symptoms and resulting consequences is high. Brain injury and post-traumatic stress symptoms are both characterized by dysfunctional brain networks, with the amygdala specifically implicated as a region with both structural and functional abnormalities. Methods: This study examined the structural volumetrics and resting state functional connectivity of 68 Active Duty Service Members with or without chronic mild TBI (mTBI) and comorbid symptoms of Post-Traumatic Stress (PTS). Results and discussion: Structural analysis of the amygdala revealed no significant differences in volume between mTBI and healthy comparison participants with and without post-traumatic stress symptoms. Resting state functional connectivity with bilateral amygdala revealed decreased anterior network connectivity and increased posterior network connectivity in the mTBI group compared to the healthy comparison group. Within the mTBI group, there were significant regions of correlation with amygdala that were modulated by PTS severity, including networks implicated in emotional processing and executive functioning. An examination of a priori regions of amygdala connectivity in the default mode network, task positive network, and subcortical structures showed interacting influences of TBI and PTS, only between right amygdala and right putamen. These results suggest that mTBI and PTS are associated with hypo-frontal and hyper-posterior amygdala connectivity. Additionally, comorbidity of these conditions appears to compound these neural activity patterns. PTS in mTBI may change neural resource recruitment for information processing between the amygdala and other brain regions and networks, not only during emotional processing, but also at rest.
Language	English
Publishing date	2023-03-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	3123824-5
ISSN	2813-1193 ; 2813-1193
ISSN (online)	2813-1193
ISSN	2813-1193
DOI	10.3389/fnimg.2023.1129446
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Article ; Online: Clinical validation of an optimized multimodal neurocognitive assessment of chronic mild TBI.

Ettenhofer, Mark L / Gimbel, Sarah I / Cordero, Evelyn

Annals of clinical and translational neurology

2020 Volume 7, Issue 4, Page(s) 507–516

Abstract: Objective: Previous laboratory-based studies have shown that neurocognitive eye-tracking metrics are sensitive to chronic effects of mild traumatic brain injury (mTBI), even in individuals with normal performance on traditional neuropsychological ... ...

Abstract	Objective: Previous laboratory-based studies have shown that neurocognitive eye-tracking metrics are sensitive to chronic effects of mild traumatic brain injury (mTBI), even in individuals with normal performance on traditional neuropsychological measures. In this study, we sought to replicate and extend these findings in a military medical environment. We expected that metrics from the multimodal Fusion n-Back test would successfully distinguish chronic mTBI participants from controls, particularly eye movement metrics from the more cognitively challenging "1-Back" subtest. Methods: We compared performance of participants with chronic mTBI (n = 46) and controls (n = 33) on the Fusion n-Back test and a battery of conventional neuropsychological tests. Additionally, we examined test reliability and the impact of potential confounds to neurocognitive assessment. Results: Our results supported hypotheses; Fusion 1-Back metrics were successful in multimodal (saccadic and manual) classification of chronic mTBI versus control. In contrast, conventional neuropsychological measures could not distinguish these groups. Additional findings demonstrated the reliability of Fusion n-Back test metrics and provided evidence that saccadic metrics are resistant to confounding influences of age, intelligence, and psychiatric symptoms. Interpretation: The Fusion n-Back test could provide advantages in differential diagnosis for complex brain injury populations. Additionally, the rapid administration of this test could be valuable for screening patients in clinical settings where longer test batteries are not feasible.
MeSH term(s)	Adult ; Brain Concussion/diagnosis ; Brain Concussion/physiopathology ; Chronic Disease ; Eye Movement Measurements/standards ; Female ; Humans ; Male ; Military Personnel ; Neuropsychological Tests/standards ; Veterans ; Young Adult
Language	English
Publishing date	2020-03-23
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Validation Study
ZDB-ID	2740696-9
ISSN	2328-9503 ; 2328-9503
ISSN (online)	2328-9503
ISSN	2328-9503
DOI	10.1002/acn3.51020
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Article ; Online: Brain bases of recovery following cognitive rehabilitation for traumatic brain injury: a preliminary study.

Gimbel, Sarah I / Ettenhofer, Mark L / Cordero, Evelyn / Roy, Michael / Chan, Leighton

Brain imaging and behavior

2020 Volume 15, Issue 1, Page(s) 410–420

Abstract: Many patients with traumatic brain injury (TBI) have persistent cognitive deficits, including decreased attention and working memory. This preliminary study examined fMRI data from a clinical trial implementing a 4-week virtual reality driving ... ...

Abstract	Many patients with traumatic brain injury (TBI) have persistent cognitive deficits, including decreased attention and working memory. This preliminary study examined fMRI data from a clinical trial implementing a 4-week virtual reality driving intervention to assess how sustained training can improve deficits related to traumatic brain injury. Previously-reported behavioral findings showed improvements in working memory and processing speed in those who received the intervention; this report explores the brain bases of these effects by comparing neural activity related to working memory (n-back task) and resting state connectivity before and after the intervention. In the baseline visit (n = 24), working memory activity was prominent in bilateral DLPFC and prefrontal cortex, anterior insula, medial superior frontal gyrus, left thalamus, bilateral supramarginal / angular gyrus, precuneus, and left posterior middle temporal gyrus. Following intervention, participants showed less global activation on the n-back task, with regions of activity only in the bilateral middle frontal cortex, posterior middle frontal gyrus, and supramarginal gyrus. Activity related to working memory load was reduced for the group that went through the intervention (n = 7) compared to the waitlist control group (n = 4). These results suggest that successful cognitive rehabilitation of working memory in TBI may be associated with increased efficiency of brain networks, evidenced by reduced activation of brain activity during cognitive processing. These results highlight the importance of examining brain activity related to cognitive rehabilitation of attention and working memory after brain injury.
MeSH term(s)	Brain/diagnostic imaging ; Brain Injuries, Traumatic/diagnostic imaging ; Cognition ; Humans ; Magnetic Resonance Imaging ; Memory, Short-Term
Language	English
Publishing date	2020-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2377165-3
ISSN	1931-7565 ; 1931-7557
ISSN (online)	1931-7565
ISSN	1931-7557
DOI	10.1007/s11682-020-00269-8
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Article ; Online: A Shocking End to the Defibrillator as We Know It: Unmet Needs and the Case for a Stand-Alone Device that Uses Pacing Only to Treat the Risk of Life-Threatening Arrhythmias.

Gimbel, J Rod

Pacing and clinical electrophysiology : PACE

2015 Volume 38, Issue 6, Page(s) 655–658

Abstract: ... seen a marked de-emphasis on the perceived value, necessity and safety of shocks. As a consumer product ...

Abstract	The defining feature of an ICD is its capacity to deliver a shock. However, the past decade has seen a marked de-emphasis on the perceived value, necessity and safety of shocks. As a consumer product, it is time to reimagine the ICD, decoupling the shock feature from pacing and antitachycardia pacing.
MeSH term(s)	Arrhythmias, Cardiac/therapy ; Cardiac Pacing, Artificial ; Defibrillators, Implantable ; Electric Countershock/instrumentation ; Equipment Safety ; Humans ; Patient Safety ; Risk
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	424437-0
ISSN	1540-8159 ; 0147-8389
ISSN (online)	1540-8159
ISSN	0147-8389
DOI	10.1111/pace.12605
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Zs.A 1466: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 399: Show issues

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Article ; Online: Haptic tuck for reverse optic capture of a single-piece acrylic toric or other single-piece acrylic intraocular lenses.

Gimbel, Howard V / Marzouk, Hala A

Journal of cataract and refractive surgery

2018 Volume 45, Issue 2, Page(s) 125–129

Abstract: ... a toric IOL, with the toric marks on the optic aligned with the corneal marks. Then, each haptic is ...

Abstract	We describe a new technique for capsule fixation of 1-piece acrylic toric intraocular lens (IOL) or other 1-piece acrylic IOLs in the presence of a large posterior capsule tear resulting in an open capsule. To keep the thick haptics out of the sulcus, reverse optic capture is necessary, with the haptics below the capsule and the optic edges above the capsule. This is done by placing the IOL in the sulcus and if it is a toric IOL, with the toric marks on the optic aligned with the corneal marks. Then, each haptic is separately tucked through the anterior continuous curvilinear capsulorhexis (CCC) opening, leaving the optic edges above the capsule. This technique achieves reverse optic capsulorhexis capture without the challenge of injecting the IOL through the CCC with an open posterior capsule. We propose the term haptic tuck for reverse optic capture for this technique.
MeSH term(s)	Aged ; Capsulorhexis/methods ; Female ; Humans ; Lens Capsule, Crystalline/surgery ; Lens Implantation, Intraocular/methods ; Lenses, Intraocular ; Phacoemulsification/methods ; Polymethyl Methacrylate ; Prosthesis Design
Chemical Substances	Polymethyl Methacrylate (9011-14-7)
Language	English
Publishing date	2018-12-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1016/j.jcrs.2018.09.026
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Article: High GILT Expression Is Associated with Improved Survival in Metastatic Melanoma Patients Treated with Immune Checkpoint Inhibition.

Adams, Anngela C / Borden, Elizabeth S / Macy, Anne M / Thomson, Nick / Cui, Haiyan / Gimbel, Mark I / Wilson, Melissa A / Buetow, Kenneth H / Roe, Denise J / DiCaudo, David J / Homsi, Jade / Hastings, Karen Taraszka

Cancers

2022 Volume 14, Issue 9

Abstract: Gamma-interferon-inducible lysosomal thiol reductase (GILT) is critical for MHC class II restricted presentation of multiple melanoma antigens. There is variable GILT protein expression in malignant melanocytes in melanoma specimens. High GILT mRNA ... ...

Abstract	Gamma-interferon-inducible lysosomal thiol reductase (GILT) is critical for MHC class II restricted presentation of multiple melanoma antigens. There is variable GILT protein expression in malignant melanocytes in melanoma specimens. High GILT mRNA expression in melanoma specimens is associated with improved overall survival, before the advent of immune checkpoint inhibitors (ICI). However, the association of GILT in metastatic melanoma with survival in patients treated with ICI and the cell type expressing GILT associated with survival have not been determined. Using RNA sequencing datasets, high GILT mRNA expression in metastatic melanoma specimens was associated with improved progression-free and overall survival in patients treated with ICI. A clinical dataset of metastatic melanoma specimens was generated and annotated with clinical information. Positive GILT immunohistochemical staining in antigen presenting cells and melanoma cells was observed in 100% and 65% of metastatic melanoma specimens, respectively. In the subset of patients treated with ICI in the clinical dataset, high GILT protein expression within melanoma cells was associated with improved overall survival. The association of GILT mRNA and protein expression with survival was independent of cancer stage. These studies support that high GILT mRNA expression in bulk tumor samples and high GILT protein expression in melanoma cells is associated with improved survival in ICI-treated patients. These findings support further investigation of GILT as a biomarker to predict the response to ICI.
Language	English
Publishing date	2022-04-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14092200
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Article: Surgical Nipple Delay and its Expanded Indications for Nipple-sparing Mastectomy.

Lee, Phoebe L / Ma, Irene T / Schusterman, Mark Asher / Beiriger, Justin / Ahrendt, Gretchen / De La Cruz, Carolyn / Diego, Emilia J / Steiman, Jennifer G / McAuliffe, Priscilla F / Gimbel, Michael L

Plastic and reconstructive surgery. Global open

2023 Volume 11, Issue 1, Page(s) e4783

Abstract: Necrosis of the nipple-areolar complex (NAC) or surrounding skin has been reported in 6%-30% of nipple-sparing mastectomy (NSM) patients, with higher rates associated with larger breasts, previous breast surgery, previous radiation, and active smoking. ... ...

Abstract	Necrosis of the nipple-areolar complex (NAC) or surrounding skin has been reported in 6%-30% of nipple-sparing mastectomy (NSM) patients, with higher rates associated with larger breasts, previous breast surgery, previous radiation, and active smoking. The nipple delay (ND) procedure is known to improve viability of the NAC in NSM patients with high-risk factors. Methods: A single-institution retrospective review was done of patients who underwent ND and NSM or NSM alone from 2012 to 2022. Patient demographics, risk factors, and outcomes were compared. Results: Forty-two breasts received ND-NSM and 302 breasts received NSM alone. The ND-NSM group had significantly more high-risk factors, including elevated BMI (26.3 versus 22.9; Conclusions: We demonstrated no NAC necrosis and no significant delay of treatment in higher risk ND-NSM patients. ND may allow higher risk patients to undergo NSM with similar morbidity as lower risk patients.
Language	English
Publishing date	2023-01-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000004783
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Zs.A 7091: Show issues

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Article ; Online: Neurocognitive Driving Rehabilitation in Virtual Environments (NeuroDRIVE): A pilot clinical trial for chronic traumatic brain injury.

Ettenhofer, Mark L / Guise, Brian / Brandler, Brian / Bittner, Katie / Gimbel, Sarah I / Cordero, Evelyn / Nelson Schmitt, Shawn / Williams, Kathy / Cox, Daniel / Roy, Michael J / Chan, Leighton

NeuroRehabilitation

2019 Volume 44, Issue 4, Page(s) 531–544

Abstract: Background: Virtual reality (VR) technology may provide an effective means to integrate cognitive and functional approaches to TBI rehabilitation. However, little is known about the effectiveness of VR rehabilitation for TBI-related cognitive deficits. ... ...

Abstract	Background: Virtual reality (VR) technology may provide an effective means to integrate cognitive and functional approaches to TBI rehabilitation. However, little is known about the effectiveness of VR rehabilitation for TBI-related cognitive deficits. In response to these clinical and research gaps, we developed Neurocognitive Driving Rehabilitation in Virtual Environments (NeuroDRIVE), an intervention designed to improve cognitive performance, driving safety, and neurobehavioral symptoms. Objective: This pilot clinical trial was conducted to examine feasibility and preliminary efficacy of NeuroDRIVE for rehabilitation of chronic TBI. Methods: Eleven participants who received the intervention were compared to six wait-listed participants on driving abilities, cognitive performance, and neurobehavioral symptoms. Results: The NeuroDRIVE intervention was associated with significant improvements in working memory and visual search/selective attention- two cognitive skills that represented a primary focus of the intervention. By comparison, no significant changes were observed in untrained cognitive areas, neurobehavioral symptoms, or driving skills. Conclusions: Results suggest that immersive virtual environments can provide a valuable and engaging means to achieve some cognitive rehabilitation goals, particularly when these goals are closely matched to the VR training exercises. However, additional research is needed to augment our understanding of rehabilitation for driving skills, cognitive performance, and neurobehavioral symptoms in chronic TBI.
MeSH term(s)	Adult ; Attention/physiology ; Automobile Driving/psychology ; Brain Injuries, Traumatic/epidemiology ; Brain Injuries, Traumatic/psychology ; Brain Injuries, Traumatic/rehabilitation ; Chronic Disease ; Cognition Disorders/epidemiology ; Cognition Disorders/psychology ; Cognition Disorders/rehabilitation ; Female ; Follow-Up Studies ; Humans ; Male ; Memory, Short-Term/physiology ; Middle Aged ; Pilot Projects ; Virtual Reality ; Virtual Reality Exposure Therapy/methods
Language	English
Publishing date	2019-06-20
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1087912-2
ISSN	1878-6448 ; 1053-8135
ISSN (online)	1878-6448
ISSN	1053-8135
DOI	10.3233/NRE-192718
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Zs.A 3328: Show issues

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Article: A current perspective on local excision of rectal cancer.

Gimbel, Mark I / Paty, Philip B

Clinical colorectal cancer

2004 Volume 4, Issue 1, Page(s) 26–35; discussion 36–7

Abstract: Local excision of rectal cancer is appealing because of its technical ease and excellent functional results, but concern over inadequate pathologic staging and inferior treatment outcomes when compared with radical surgery remain a major hurdle for its ... ...

Abstract	Local excision of rectal cancer is appealing because of its technical ease and excellent functional results, but concern over inadequate pathologic staging and inferior treatment outcomes when compared with radical surgery remain a major hurdle for its widespread use. Local failure rates in modern series for local excision are 4%-18% for T1 rectal cancers and 22%-67% for T2 cancers, and cancer cure rates are only 70%-80%. In addition, data from the past decade suggest that preoperative staging with endorectal ultrasound, use of postoperative adjuvant chemotherapy/radiation therapy, and aggressive salvage surgery have not been reliable methods of limiting local tumor recurrence or improving long-term cure rates. At present, highly stringent criteria for patient selection are recommended, yet such stringency decreases the utility of the procedure. What are needed are new approaches to an old problem. Novel strategies under evaluation include enhanced imaging modalities for lymph node metastases, neoadjuvant chemotherapy/radiation therapy, and more liberal use of immediate salvage resection for high-risk pathologic features. Molecular profiling of tumors with genetic markers and better integration of traditional and gene-targeted systemic therapy are promising approaches for the future. This review of the literature evaluates the recent successes and failures of local excision of rectal cancer and provides a current perspective on the expanded use of local excision without compromising care.
MeSH term(s)	Chemotherapy, Adjuvant ; Humans ; Lymphatic Metastasis ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Patient Selection ; Radiotherapy, Adjuvant ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Salvage Therapy ; Surgical Procedures, Operative/methods
Language	English
Publishing date	2004-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2112638-0
ISSN	1533-0028
ISSN	1533-0028
DOI	10.3816/ccc.2004.n.007
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Zs.A 5798: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 435: Show issues

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