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Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021

,; Rautalin, Ilari; Volovici, Victor; Stark, Benjamin A; Johnson, Catherine O; Kaprio, Jaakko; Korja, Miikka; Krishnamurthi, Rita V; Nair, Balakrishnan Sukumaran; Ranta, Annemarei; Rinkel, Gabriel J E; Vergouwen, Mervyn D I; Abate, Yohannes Habtegiorgis; Abbastabar, Hedayat; Abd-Allah, Foad; Abdelkader, Atef; Abdi, Parsa; Abdollahi, Arash; Abdullahi, Auwal; Abiodun, Olugbenga Olusola; Aboagye, Richard Gyan; Abouzid, Mohamed; Abtahi, Dariush; Abu Rumeileh, Samir; Abualhasan, Ahmed; Abualruz, Hasan; Abukhadijah, Hana J; Abu-Zaid, Ahmed; Adamu, Lawan Hassan; Addo, Isaac Yeboah; Adedoyin, Rufus Adesoji; Adegboye, Oyelola A; Adra, Saryia; Adzigbli, Leticia Akua; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Danish; Ahmadzade, Amir Mahmoud; Ahmed, Ali; Ahmed, Haroon; Ahmed, Syed Anees; Aji, Budi; Akkaif, Mohammed Ahmed; Al-Ajlouni, Yazan; Al-Aly, Ziyad; Albashtawy, Mohammed; Ali, Mohammed Usman; Alif, Sheikh Mohammad; Alimohamadi, Yousef; Aljunid, Syed Mohamed; Alomari, Mahmoud A; Alrawashdeh, Ahmad; Alsabri, Mohammed A; Salman, Rustam Al-Shahi; Altaf, Awais; Al-Tammemi, Alaa B; Alvis-Guzman, Nelson; Alwafi, Hassan; Al-Wardat, Mohammad; Al-Worafi, Yaser Mohammed; Aly, Hany; Alyahya, Mohammad Sharif Ibrahim; Alzoubi, Karem H; Amani, Reza; Amin, Tarek Tawfik; Amindarolzarbi, Alireza; Amusa, Ganiyu Adeniyi; Anderlini, Deanna; Angappan, Dhanalakshmi; Anil, Abhishek; Anuoluwa, Boluwatife Stephen; Anwar, Saleha; Anyasodor, Anayochukwu Edward; Apostol, Geminn Louis Carace; Arabloo, Jalal; Areda, Demelash; Ärnlöv, Johan; Artamonov, Anton A; Artanti, Kurnia Dwi; Arumugam, Ashokan; Aryan, Zahra; Asghari-Jafarabadi, Mohammad; Ashemo, Mubarek Yesse; Ashraf, Tahira; Athar, Mohammad; Athari, Seyyed Shamsadin; Aujayeb, Avinash; Awotidebe, Adedapo Wasiu; Azadnajafabad, Sina; Aziz, Shahkaar; Azzam, Ahmed Y; Babu, Giridhara Rathnaiah; Bagheri, Nasser; Bahrami Taghanaki, Pegah; Bahramian, Saeed; Bai, Ruhai; Baig, Atif Amin; Bako, Abdulaziz T; Baltatu, Ovidiu Constantin; Bam, Kiran; Banach, Maciej; Bandyopadhyay, Soham; Banik, Biswajit; Bardhan, Mainak; Barker-Collo, Suzanne Lyn; Bärnighausen, Till Winfried; Barqawi, Hiba Jawdat; Barua, Lingkan; Bastan, Mohammad-Mahdi; Basu, Sanjay; Bell, Shelly L; Bensenor, Isabela M; Berhie, Alemshet Yirga; Beyene, Kebede A; Bhagavathula, Akshaya Srikanth; Bhaskar, Sonu; Bhat, Ajay Nagesh; Bhat, Vivek; Bhatti, Gurjit Kaur; Bhatti, Jasvinder Singh; Bijani, Ali; Bikbov, Boris; Birhan, Mekuriaw Mesfin; Birhanu, Mulugeta M; Bitra, Veera R; Boloor, Archith; Borhany, Hamed; Breitner, Susanne; Brenner, Hermann; Bugiardini, Raffaele; Bulamu, Norma B; Butt, Zahid A; Cabral, Lucas Scotta; Caetano Dos Santos, Florentino Luciano; Calina, Daniela; Cámera, Luis Alberto; Campos, Luciana Aparecida; Campos-Nonato, Ismael; Capodici, Angelo; Carvalho, Felix; Castañeda-Orjuela, Carlos A; Catapano, Alberico L; Cegolon, Luca; Chadwick, Joshua; Chakraborty, Chiranjib; Chakraborty, Promit Ananyo; Chakraborty, Sandip; Chandika, Rama Mohan; Chanie, Gashaw Sisay; Chattu, Vijay Kumar; Chaudhary, Anis Ahmad; Chi, Gerald; Chichagi, Fatemeh; Ching, Patrick R; Chopra, Hitesh; Choudhari, Sonali Gajanan; Chowdhury, Enayet Karim; Chu, Dinh-Toi; Chung, Sheng-Chia; Columbus, Alyssa; Criqui, Michael H; da Silva, Alanna Gomes; Dabbagh Ohadi, Mohammad Amin; Dadras, Omid; Dai, Xiaochen; Dalal, Koustuv; Dalli, Lachlan L; D'Amico, Emanuele; Dashti, Mohsen; Davletov, Kairat; De la Cruz-Góngora, Vanessa; Debopadhaya, Shayom; Delgado-Enciso, Ivan; Derviševic, Emina; Devanbu, Vinoth Gnana Chellaiyan; Dewan, Syed Masudur Rahman; Dhane, Amol S; Dibas, Mahmoud; Do, Thanh Chi; Do, Thao Huynh Phuong; Dohare, Sushil; Doheim, Mohamed Fahmy; Dokova, Klara Georgieva; Dongarwar, Deepa; D'Oria, Mario; Doshi, Ojas Prakashbhai; Doshi, Rajkumar Prakashbhai; Dowou, Robert Kokou; Dsouza, Haneil Larson; Dutta, Siddhartha; Dziedzic, Arkadiusz Marian; E'mar, Abdel Rahman; Edvardsson, David; Efendi, Defi; Efendi, Ferry; El Nahas, Nevine; Elgendy, Islam Y; Elhadi, Muhammed; Eltaha, Chadi; Eltahir, Mohd Elmagzoub; Emeto, Theophilus I; Fabin, Natalia; Fagbamigbe, Adeniyi Francis; Fahim, Ayesha; Fakhradiyev, Ildar Ravisovich; Fares, Jawad; Faris, Pawan Sirwan; Fauk, Nelsensius Klau; Fazylov, Timur; Fekadu, Ginenus; Ferreira, Nuno; Fetensa, Getahun; Fischer, Florian; Foschi, Matteo; Fridayani, Ni Kadek Yuni; Gaipov, Abduzhappar; Gajjar, Avi A; Gandhi, Aravind P; Ganesan, Balasankar; Garg, Ravindra Kumar; Gebregergis, Miglas Welay; Gebrehiwot, Mesfin; Gebremeskel, Teferi Gebru; Getie, Molla; Ghadimi, Delaram J; Ghadirian, Fataneh; Ghahramani, Sulmaz; Ghasemzadeh, Afsaneh; Ghazy, Ramy Mohamed; Gholamalizadeh, Maryam; Ghozy, Sherief; Gil, Artyom Urievich; Gilani, Jaleed Ahmed; Gnedovskaya, Elena V; Goleij, Pouya; Goulart, Alessandra C; Goulart, Barbara Niegia Garcia; Guan, Shi-Yang; Gupta, Sapna; Habibzadeh, Farrokh; Hadei, Mostafa; Hadi, Najah R; Hamidi, Samer; Hanifi, Nasrin; Hankey, Graeme J; Harlianto, Netanja I; Haro, Josep Maria; Hasan, Faizul; Hasani, Hamidreza; Hasnain, Md Saquib; Hassan Zadeh Tabatabaei, Mahgol Sadat; Haubold, Johannes; Havmoeller, Rasmus J; Hay, Simon I; Hbid, Youssef; Heidari, Golnaz; Heidari, Mohammad; Hemmati, Mehdi; Hiraike, Yuta; Hoan, Nguyen Quoc; Holla, Ramesh; Hosseinzadeh, Mehdi; Hostiuc, Sorin; Huang, Junjie; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Ikeda, Nayu; Ikiroma, Adalia; Ilaghi, Mehran; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Islam, Md Rabiul; Ismail, Nahlah Elkudssiah; Iso, Hiroyasu; Isola, Gaetano; Iwagami, Masao; Jacob, Louis; Jafarzadeh, Abdollah; Jain, Akhil; Jairoun, Ammar Abdulrahman; Jakovljevic, Mihajlo; Jatau, Abubakar Ibrahim; Jawaid, Talha; Jayapal, Sathish Kumar; Jonas, Jost B; Joseph, Nitin; Jürisson, Mikk; Kadashetti, Vidya; Kalani, Rizwan; Kamal, Vineet Kumar; Kamireddy, Arun; Kanchan, Tanuj; Kandel, Himal; Karami, Jafar; Karaye, Ibraheem M; Karimi, Yeganeh; Karimi Behnagh, Arman; Kashoo, Faizan Zaffar; Kayode, Gbenga A; Kazemi, Foad; Kesse-Guyot, Emmanuelle; Khader, Yousef Saleh; Khaing, Inn Kynn; Khan, Fayaz; Khan, Mohammad Jobair; Khatatbeh, Haitham; Khatatbeh, Moawiah Mohammad; Khayat Kashani, Hamid Reza; Kheirallah, Khalid A; Khidri, Feriha Fatima; Khormali, Moein; Khosla, Atulya Aman; Kim, Kwanghyun; Kim, Yun Jin; Kisa, Adnan; Kisa, Sezer; Kivimäki, Mika; Kolahi, Ali-Asghar; Kompani, Farzad; Korzh, Oleksii; Kostev, Karel; Kothari, Nikhil; Krishan, Kewal; Krishna, Varun; Krishnamoorthy, Vijay; Kuddus, Mohammed; Kulimbet, Mukhtar; Kunutsor, Setor K; Kurniasari, Maria Dyah; Kusuma, Dian; Kytö, Ville; La Vecchia, Carlo; Lahariya, Chandrakant; Lai, Daphne Teck Ching; Lai, Hanpeng; Laksono, Tri; Lallukka, Tea; Latief, Kamaluddin; Latifinaibin, Kaveh; Le, Nhi Huu Hanh; Le, Thao Thi Thu; Lee, Munjae; Lee, Seung Won; Lee, Wei-Chen; Lee, Yo Han; Lenzi, Jacopo; Leonardi, Matilde; Li, Ming-Chieh; Li, Xiaopan; Lim, Stephen S; Lin, Jialing; Liu, Xuefeng; Lohner, Valerie; Lorenzovici, László; Lotufo, Paulo A; Lucchetti, Giancarlo; Lusk, Jay B; Lutzky Saute, Ricardo; M Amin, Hawraz Ibrahim; Malhotra, Armaan K; Malhotra, Kashish; Malik, Ahmad Azam; Malta, Deborah Carvalho; Mansournia, Mohammad Ali; Mantovani, Lorenzo Giovanni; Manu, Emmanuel; Marateb, Hamid Reza; Marino, Mirko; Maroufi, Seyed Farzad; Martinez-Piedra, Ramon; Martini, Santi; Martorell, Miquel; Marzo, Roy Rillera; Mathangasinghe, Yasith; Mathews, Elezebeth; Maugeri, Andrea; McPhail, Steven M; Mehmood, Asim; Mehndiratta, Man Mohan; Mehrabani-Zeinabad, Kamran; Menezes, Ritesh G; Meo, Sultan Ayoub; Meretoja, Atte; Mestrovic, Tomislav; Mettananda, Chamila Dinushi Kukulege; Miazgowski, Tomasz; Micheletti Gomide Nogueira de Sá, Ana Carolina; Minervini, Giuseppe; Minh, Le Huu Nhat; Mirica, Andreea; Mirrakhimov, Erkin M; Mirza-Aghazadeh-Attari, Mohammad; Mishra, Ajay Kumar; Mithra, Prasanna; Mohamed, Abdalla Z; Mohamed, Ahmed Ismail; Mohammad, Ameen Mosa; Mohammadi, Soheil; Mohammadian-Hafshejani, Abdollah; Mohammed, Shafiu; Mokdad, Ali H; Molinaro, Sabrina; Momani, Shaher; Moni, Mohammad Ali; Moodi Ghalibaf, AmirAli; Moradi, Maryam; Moradi, Yousef; Moraga, Paula; Morawska, Lidia; Msherghi, Ahmed; Munjal, Kavita; Murray, Christopher J L; Nagarajan, Ahamarshan Jayaraman; Naik, Ganesh R; Najdaghi, Soroush; Nakhostin Ansari, Noureddin; Nargus, Shumaila; Davani, Delaram Narimani; Natto, Zuhair S; Nauman, Javaid; Nayak, Vinod C; Nazri-Panjaki, Athare; Negoi, Ruxandra Irina; Nematollahi, Soroush; Newton, Charles Richard James; Nguyen, Duc Hoang; Nguyen, Hau Thi Hien; Nguyen, Hien Quang; Nguyen, Phat Tuan; Nguyen, Van Thanh; Niazi, Robina Khan; Nigatu, Yeshambel T; Nikoobar, Ali; Nogueira de Sá, Antonio Tolentino; Nomura, Shuhei; Noubiap, Jean Jacques; Nugen, Fred; Nzoputam, Chimezie Igwegbe; Oancea, Bogdan; Oduro, Michael Safo; Ojo-Akosile, Tolulope R; Okati-Aliabad, Hassan; Okeke, Sylvester Reuben; Okekunle, Akinkunmi Paul; Olagunju, Andrew T; Olaiya, Muideen Tunbosun; Oliveira, Arão Belitardo; Oliveira, Gláucia Maria Moraes; Olorukooba, Abdulhakeem Abayomi; Olufadewa, Isaac Iyinoluwa; Ornello, Raffaele; Ortiz-Prado, Esteban; Osuagwu, Uchechukwu Levi; Ouyahia, Amel; Owolabi, Mayowa O; Ozair, Ahmad; P A, Mahesh Padukudru; Padron-Monedero, Alicia; Padubidri, Jagadish Rao; Panagiotakos, Demosthenes; Panos, Georgios D; Panos, Leonidas D; Pantazopoulos, Ioannis; Parikh, Romil R; Park, Seoyeon; Patel, Jay; Patel, Urvish K; Patoulias, Dimitrios; Pedersini, Paolo; Peprah, Emmanuel K; Pereira, Gavin; Perianayagam, Arokiasamy; Perico, Norberto; Perna, Simone; Petermann-Rocha, Fanny Emily; Philip, Anil K; Piradov, Michael A; Plotnikov, Evgenii; Polibin, Roman V; Postma, Maarten J; Pradhan, Jalandhar; Prasad, Manya; Puvvula, Jagadeesh; Qasim, Nameer Hashim; Qian, Gangzhen; Raggi, Alberto; Rahim, Fakher; Rahimi-Movaghar, Vafa; Rahman, Mosiur; Rahman, Muhammad Aziz; Rahmani, Amir Masoud; Rahmanian, Mohammad; Rajaa, Sathish; Rajabpour Sanati, Ali; Rajpoot, Pushp Lata; Rajput, Prashant; Ramadan, Mahmoud Mohammed; Ramasamy, Shakthi Kumaran; Ramazanu, Sheena; Rane, Amey; Rashedi, Sina; Rashidi, Mohammad-Mahdi; Rathish, Devarajan; Rawaf, Salman; Razo, Christian; Reddy, Murali Mohan Rama Krishna; Redwan, Elrashdy; Remuzzi, Giuseppe; Rezaei, Nazila; Rezaei, Negar; Rezaeian, Mohsen; Rocha, Hermano Alexandre Lima; Rodriguez, Jefferson Antonio Buendia; Roever, Leonardo; Romoli, Michele; Romozzi, Marina; Ross, Allen Guy; Rout, Himanshu Sekhar; Roy, Nitai; Roy, Priyanka; Saad, Aly M A; Saadatian, Zahra; Sabour, Siamak; Sacco, Simona; Saddik, Basema Ahmad; Sadeghi, Erfan; Saeed, Usman; Saheb Sharif-Askari, Fatemeh; Sahebkar, Amirhossein; Sahoo, Pragyan Monalisa; Sajib, Md Refat Uz Zaman; Salaroli, Luciane B; Saleh, Mohamed A; Samodra, Yoseph Leonardo; Samuel, Vijaya Paul; Samy, Abdallah M; Santric-Milicevic, Milena M; Saravanan, Aswini; Sarkar, Tanmay; Sarode, Gargi Sachin; Sarode, Sachin C; Sartorius, Benn; Satpathy, Maheswar; Schlaich, Markus P; Schneider, Ione Jayce Ceola; Schuermans, Art; Selvaraj, Siddharthan; Senthilkumaran, Subramanian; Sepanlou, Sadaf G; Sethi, Yashendra; Seylani, Allen; Shaaban, Ahmed Nabil; Shafie, Mahan; Shahwan, Moyad Jamal; Shaikh, Masood Ali; Shaikh, Summaiya Zareen; Shamim, Muhammad Aaqib; Shamsi, Anas; Shamsutdinova, Alfiya; Shanawaz, Mohd; Shannawaz, Mohammed; Sharifan, Amin; Sharifi Rad, Javad; Sharma, Vishal; Shashamo, Bereket Beyene; Shetty, Mahabalesh; Shetty, Premalatha K; Shigematsu, Mika; Shittu, Aminu; Shiue, Ivy; Shlobin, Nathan A; Shorofi, Seyed Afshin; Siddig, Emmanuel Edwar; Singh, Baljinder; Singh, Paramdeep; Singh, Puneetpal; Singh, Surjit; Sobia, Farrukh; Solanki, Ranjan; Solanki, Shipra; Soraneh, Soroush; Spartalis, Michael; Srinivasamurthy, Suresh Kumar; Stanaway, Jeffrey D; Stanikzai, Muhammad Haroon; Starodubova, Antonina V; Sun, Jing; Sun, Zhong; Swain, Chandan Kumar; Szarpak, Lukasz; Tabaee Damavandi, Payam; Tabatabaei, Seyyed Mohammad; Tabatabaeizadeh, Seyed-Amir; Tabche, Celine; Taiba, Jabeen; Talaat, Iman M; Tamuzi, Jacques Lukenze; Tan, Ker-Kan; Temsah, Mohamad-Hani; Teramoto, Masayuki; Thakur, Ramna; Thankappan, Kavumpurathu Raman; Thayakaran, Rasiah; Thirunavukkarasu, Sathish; Ticoalu, Jansje Henny Vera; Tiwari, Krishna; Tonelli, Marcello; Topor-Madry, Roman; Tovani-Palone, Marcos Roberto; Tran, An Thien; Tran, Jasmine T; Tran, Thang Huu; Tran Minh Duc, Nguyen; Truelsen, Thomas Clement; Truyen, Thien Tan Tri Tai; Tsai, Daniel Hsiang-Te; Ullah, Atta; Unim, Brigid; Unnikrishnan, Bhaskaran; Unsworth, Carolyn Anne; Usman, Jibrin Sammani; Vahdati, Sanaz; Vaithinathan, Asokan Govindaraj; Valizadeh, Rohollah; Van den Eynde, Jef; Varghese, Joe; Vasankari, Tommi Juhani; Venketasubramanian, Narayanaswamy; Vervoort, Dominique; Villafañe, Jorge Hugo; Vinayak, Manish; Vladimirov, Sergey Konstantinovitch; Wafa, Hatem A; Waheed, Yasir; Wahood, Waseem; Walde, Mandaras Tariku; Wang, Yanzhong; Wickramasinghe, Nuwan Darshana; Willeit, Peter; Wolde, Asrat Arja; Wolfe, Charles D A; Wubie, Yihun Miskir; Xiao, Hong; Xu, Suowen; Xu, Xiaoyue; Yamagishi, Kazumasa; Yano, Yuichiro; Yarahmadi, Amir; Yaribeygi, Habib; Yaya, Sanni; Ye, Pengpeng; Yon, Dong Keon; Yonemoto, Naohiro; Yu, Chuanhua; Zanghì, Aurora; Zare, Iman; Zastrozhin, Michael; Zhang, Chen; Zhang, Yunquan; Zhang, Zhi-Jiang; Zhang, Zhiqiang; Zhao, Hanqing; Zhou, Shang Cheng; Zhumagaliuly, Abzal; Zia, Hafsa; Zielinska, Magdalena; Zyoud, Samer H; Roth, Gregory A; Feigin, Valery L
IMPORTANCE/UNASSIGNED:Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. OBJECTIVE/UNASSIGNED:To estimate the worldwide burden of SAH. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. EXPOSURES/UNASSIGNED:SAH and 14 modifiable risk factors. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs). RESULTS/UNASSIGNED:In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. CONCLUSIONS AND RELEVANCE/UNASSIGNED:Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.
PMID: 40406922
ISSN: 2168-6157
CID: 5852552

Swallowing Function After Pioneering Partial Face and Whole Eye Transplant: Clinical Insights

Lico, Margaret; Hanley, Kaitlin; Shah, Alay; Chinta, Sachin; Ceradini, Daniel J; Rodriguez, Eduardo D
PURPOSE/UNASSIGNED:There is limited literature reporting swallowing outcomes in the pre- and postoperative period for patients undergoing facial transplantation. This case report aims to utilize a combination of objective and patient-reported outcome measures to highlight swallowing improvements following the world's first face with whole-eye transplantation. METHOD/UNASSIGNED:Outcome measures in jaw range of motion, anterior containment, texture progression, airway protection, and pharyngeal swallow function were collected pretransplantation by two speech-language pathologists (SLPs) and at multiple postoperative visits after the procedure was completed. Specific outcome measures included the Gothenburg Trismus Questionnaire, Maximal Incisor Opening, Modified Teachers Drooling Scale, Functional Oral Intake Scale, Eating Assessment Tool-10, The Penetration-Aspiration Scale, and the Modified Barium Swallow Study Impairment Profile. Measures were then compared over a 1-year time period to assess changes in swallow function. RESULTS/UNASSIGNED:Improvements in jaw range of motion, anterior containment, and airway protection were observed. The patient's stated goal of returning to full PO diet following face transplant was achieved within 1 year. CONCLUSIONS/UNASSIGNED:Swallowing and trismus outcome measures are an important tool for monitoring progress along a patient's recovery journey, especially following unique procedures such as face transplantation. Based on this single patient case study, facial transplantation can lead to improvements in both objective and patient-reported outcomes. Future goals for research should continue to explore this unique population due to the limited literature available for SLPs, as well as include development of valid and reliable assessment tools specific to the face transplantation population.
PMID: 40403408
ISSN: 1558-9110
CID: 5853442

Response to Andersen et al.'s "A genome-wide association meta-analysis links hidradenitis suppurativa to common and rare sequence variants causing disruption of the Notch and Wnt/β-catenin signaling pathways." [Letter]

Perez, Olivia D; Lin, Meng-Ju; Pomeranz, Miriam K; Chiu, Ernest S; Lu, Catherine P; Petukhova, Lynn
PMID: 40334920
ISSN: 1097-6787
CID: 5839282

Vascularized Composite Allotransplantation of the Uterus: A Systematic Review of Eligibility Criteria

Diaz, Allison L; Laspro, Matteo; Chinta, Sachin; Shah, Alay; Rodriguez, Eduardo D
BACKGROUND:Uterus transplantation (UTx) is the sole clinical treatment for patients with a diagnosis of uterine infertility factor to experience gestation and delivery. Following UTx, candidates who have been largely healthy must agree to extensively interface with the healthcare system and practice strict adherence to an immunosuppressive regimen to protect the allograft until delivery of a live birth. Aside from the risks associated with immunosuppression, UTx recipients often face complicated pregnancies, with a possibility of pregnancy loss and allograft failure. Therefore, appropriate recipient eligibility criteria are central to transplantation success. The objective of this study is to investigate eligibility criteria reported by UTx programs globally. METHODS:A systematic review of UTx literature was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, using PubMed, Cochrane, Ovid/MEDLINE, and Scopus. ClinicalTrials.gov entries and program websites were queried for eligibility criteria as well. RESULTS:Two hundred ninety-six studies were identified, 79 of which were included in the final review. Twenty-one clinical trials and 6 patient-facing websites were included. Most reported eligibility criteria included females of reproductive age, excellent in vitro fertilization candidacy, psychological stability, absence of systemic infection, and willingness to comply with all treatment protocols. The importance of factors such as social support and recipient relationship with their partner varied between centers. CONCLUSION/CONCLUSIONS:Although consensus exists across certain eligibility criteria, the importance of other criteria presents greater ambiguity across centers. As UTx programs expand, and more patients gain access to the procedure, the evolution of eligibility criteria must be documented to optimize best practices across centers.
PMID: 40272522
ISSN: 1536-3708
CID: 5830522

Early Steps of the Kidney Transplant Process: What Are the Experiences of Dialysis Social Workers?

Levan, Macey L; Kaplow, Katya; Downey, Max C; Sidoti, Carolyn N; Reed, Rhiannon D; Richards, Kristy; Liebman, Scott E; Gordon, Elisa J; Rudow, Dianne LaPointe; Segev, Dorry L; Kayler, Liise K; Lindower, Carrie; Kimberly, Laura L
INTRODUCTION/BACKGROUND:Dialysis social workers (DSWs) educate and advocate for end-stage kidney disease (ESKD) patients during the kidney transplantation (KT) process. However, little is known about the barriers DSWs face as they help patients get waitlisted and how to best support their efforts. We interviewed DSWs across New York (NY) State to examine their experiences, supports, and challenges in helping dialysis patients progress through KT education, referral, and evaluation. METHODS:We conducted semi-structured interviews with DSWs in NY State who had participated or expressed interest in a program designed to educate DSWs about KT and used rapid qualitative analysis to identify themes. FINDINGS/RESULTS:We interviewed 17 DSWs. Seven themes emerged: (1) DSWs report involvement in KT interest assessment, education, referral, and evaluation support, (2) DSWs report varying nephrologist support in helping patients progress to KT, (3) DSWs perceive social support and adherence as key factors in KT centers' eligibility determinations, (4) DSWs have knowledge gaps around living donation and appreciate learning about KT from transplant centers and non-profit organizations, (5) Patients express KT concerns and DSWs counsel them about these concerns, (6) DSWs report solutions to help patients complete KT evaluation appointments, and (7) DSWs report communication deficiencies between dialysis centers and transplant centers, and patients. CONCLUSIONS:Education for DSWs, support from nephrologists, and resources to help patients complete KT evaluation steps facilitated DSW engagement throughout the pre-transplant process, underscoring the need for multi-level, cross-disciplinary programs to support these efforts.
PMID: 40391920
ISSN: 1399-0012
CID: 5852962

Evaluating Nurses' Perceptions of Documentation in the Electronic Health Record: Multimethod Analysis

Jacques, Deborah; Will, John; Dauterman, Denise; Zavotsky, Kathleen Evanovich; Delmore, Barbara; Doty, Glenn Robert; O'Brien, Kerry; Groom, Lisa
BACKGROUND/UNASSIGNED:Nurses are one of the largest user groups of the electronic health record (EHR) system, relying on its tools to support patient care and nursing workflows. Recent studies suggested that the redesign of nursing documentation may reduce the time spent in the EHR system and improve nurse satisfaction. OBJECTIVE/UNASSIGNED:We aimed to assess nurses' perceptions of the redesigned EHR, evaluate the impact of documentation interventions, and identify future improvement needs. METHODS/UNASSIGNED:Guided by the American Nursing Informatics Association's Six Domains of Burden conceptual framework, this multimethod project combined both qualitative and quantitative approaches. Registered nurses across the academic health system were recruited via email invitations to participate in focus group discussions. The focus groups were conducted via a web conference and ranged from 60 to 90 minutes in duration. The focus group discussions were transcribed and analyzed through thematic analysis. The EHR vendor's time data were used to analyze nurses' time spent in documentation. RESULTS/UNASSIGNED:In total, 20 registered nurses participated in the focus group discussions, and 17 nurses completed the demographic survey; 88% (15/17) of participants had ≥3 years of EHR experience at the academic health system, and 53% (9/17) self-reported being competent in the EHR system. The following six themes emerged: positive feedback, usability and workflow opportunities, nuisance, training and education, communication, and time spent in the system. EHR vendor time data revealed that the time spent in flowsheets averaged 31.11% per 12-hour shift. CONCLUSIONS/UNASSIGNED:Overall, participants reported a positive experience and that the EHR supported patient care. There are opportunities to further reduce redundancies in documentation and implement programs that support continuous learning about EHR and health technology tools. Specific suggestions include optimizing the oral health assessment tool. Analyzing frontline nursing perspectives in the redesign of EHR workflows is imperative for identifying interventions that support nurses' satisfaction with the EHR.
PMID: 40294588
ISSN: 2562-7600
CID: 5833252

Comparative Evaluation of Bovine- and Porcine-Deproteinized Grafts for Guided Bone Regeneration: An In Vivo Study

Slavin, Blaire V; Nayak, Vasudev Vivekanand; Parra, Marcelo; Spielman, Robert D; Torquati, Matteo S; Iglesias, Nicholas J; Coelho, Paulo G; Witek, Lukasz
Guided bone regeneration (GBR) procedures have been indicated to enhance bone response, reliably regenerate lost tissue, and create an anatomically pleasing ridge contour for biomechanically favorable and prosthetically driven implant placement. The aim of the current study was to evaluate and compare the bone regenerative performance of deproteinized bovine bone (DBB) and deproteinized porcine bone (DPB) grafts in a beagle mandibular model for the purposes of GBR. Four bilateral defects of 10 mm × 10 mm were induced through the mandibular thickness in each of the 10 adult beagle dogs being studied. Two of the defects were filled with DPB, while the other two were filled with DBB, after which they were covered with collagen-based membranes to allow compartmentalized healing. Animals were euthanized after 6, 12, 24, or 48 weeks postoperatively. Bone regenerative capacity was evaluated by qualitative histological and quantitative microtomographic analyses. Microcomputed tomography data of the bone (%), graft (%), and space (%) were compared using a mixed model analysis. Qualitatively, no histomorphological differences in healing were observed between the DBB and DPB grafts at any time point. By 48 weeks, the xenografts (DBB and DPB) were observed to have osseointegrated with regenerating spongy bone and a close resemblance to native bone morphology. Quantitatively, a higher amount of bone (%) and a corresponding reduction in empty space (space (%)) were observed in defects treated by DBB and DPB grafts over time. However, no statistically significant differences in bone (%)were observed between DBB (71.04 ± 8.41 at 48 weeks) and DPB grafts (68.38 ± 10.30 at 48 weeks) (p > 0.05). GBR with DBB and DPB showed no signs of adverse immune response and led to similar trends in bone regeneration over 48 weeks of permitted healing.
PMCID:12108621
PMID: 40428078
ISSN: 2306-5354
CID: 5855242

Small and porous ossicles, with flat stapes footplate and incudal fractures in the oim mouse model of osteogenesis imperfecta

Ugarteburu, Maialen; Doube, Michael; Witek, Lukasz; Rau, Christoph; Cardoso, Luis; Richter, Claus-Peter; Carriero, Alessandra
Hearing loss affects approximately 70 % of individuals with osteogenesis imperfecta (OI), a genetic connective tissue disorder characterized by bone fragility and deformities. No effective treatments exist for OI hearing loss, and its etiology is unknown limiting the development of new targeted therapies. This work investigates the impact of OI type I collagen mutations on the ossicle bone properties in the homozygous oim mouse model of severe OI, which is known to exhibit hearing loss. The morphology and porosity of the ossicles of 14-week-old oim and wild-type mice were analyzed using high-resolution synchrotron radiation microtomography. Additionally, the collagen fibers structure, bone tissue composition and mechanical properties were evaluated through second harmonic generation microscopy, Raman spectroscopy, and nanoindentation. The results demonstrated that oim ossicles are small, highly porous with an elevated lacunar number density, a flat stapes footplate and a small malleal processus brevis. One-in-two oim ossicles had incudomalleal joint abnormalities, exhibiting either a localized fracture in the incus head or a joint space widening. No differences were observed in collagen fibers structure, bone tissue composition and mechanical properties. These findings suggest that bone fractures observed in the oim incus may contribute to their reported hearing loss. However, the underlying mechanism for these fracture development remains to be investigated, as they do not appear to result from changes in bone tissue properties (collagen fibers organization, tissue composition or mechanical properties). Instead, they may be associated with joint space widening, and possibly altered ossicle chain kinematics.
PMID: 40280254
ISSN: 1873-2763
CID: 5830762

Utility of Patient-Reported Outcomes in Prognosis of Corticosteroid Injection Treatment Success for Trigger Finger and de Quervain's Stenosing Tenosynovitis

Sobba, Walter D; Jacobi, Sophia; Sánchez-Navarro, Gerardo; Tedesco, Liana; Ayalon, Omri; Azad, Ali; Hacquebord, Jacques H
BACKGROUND:Corticosteroid injections are a first-line treatment of trigger finger and de Quervain's tenosynovitis. Little research has evaluated preinjection patient-reported outcomes as a predictive factor for treatment success following corticosteroid injection. We hypothesized that patients with less pretreatment impairment would demonstrate greater post-treatment improvement than patients whose function was more severely impaired. METHODS:We retrospectively reviewed prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) upper extremity (UE) scores in patients undergoing corticosteroid injection for trigger finger or de Quervain's tenosynovitis from 2017 to 2023. Independent variables were patient baseline characteristics, comorbidities, and baseline PROMIS UE. The primary outcome was treatment success between 30 days and 12 weeks, defined as achieving the minimal clinically important difference for PROMIS UE without undergoing surgery. RESULTS:= .44). CONCLUSION/CONCLUSIONS:Corticosteroid injection provides meaningful improvement for a subset of trigger finger and de Quervain's tenosynovitis patients. Corticosteroid injection remains a first-line treatment for trigger finger and de Quervain's tenosynovitis patients, especially for those with more severe functional impairment.
PMCID:11993545
PMID: 40219866
ISSN: 1558-9455
CID: 5824452

Balancing strength and translucency: The role of microstructure in additive and subtractive dental zirconia

Ruggiero, Mirelle M; Lim, Chek Hai; Giugliano, Thomas S; Choi, Mijin; Cury, Altair A Del Bel; Zhang, Yu
OBJECTIVES/OBJECTIVE:To elucidate the effect of microstructure on the strength and translucency of dental zirconia fabricated using additive (AM) and subtractive manufacturing (SM) technologies. METHODS:Twelve 3Y-TZP discs were fabricated using AM with two print orientations (0°: group AM0; 90°: group AM90; n = 6), and six via CAD/CAM machining (group SM). Density, composition, roughness, translucency parameter (TP), and biaxial flexural strength (σ) were evaluated. Fractographic analysis was conducted and defect size estimated. Based on the preliminary σ results (n = 6), the optimal print orientation was identified. Nine additional specimens were prepared for each of the AM90 and SM groups for Weibull σ analysis (n = 15). Differences in Weibull modulus were assessed via non-overlapping 95 % confidence intervals. An one-way ANOVA followed by Tukey's post-hoc test and an independent samples t-test were used (α = 0.05). RESULTS:The relative density was consistent across all groups (>99 %). The tetragonal and cubic phases were comparable among groups, with proportions exceeding 82 wt% and 17 wt%, respectively. Group SM exhibited significantly higher roughness (1.18 µm) than AM0 (0.71 µm) and AM90 (0.51 µm). Group SM exhibited the highest TP values, while groups AM0 and AM90 had statistically similar TP values. AM0 showed the lowest σ value (411.60 ± 73.99 MPa) and larger defects. Groups AM90 and SM (n = 15) possessed comparable σ values (969.85 ± 123.13 MPa and 989.72 ± 107.78 MPa, respectively) (p = 0.6417) and Weibull moduli (9.17 and 10.62, respectively). SIGNIFICANCE/CONCLUSIONS:SM zirconia showed higher translucency and roughness, while defects reduced translucency in AM zirconia. Flexural strength was lower for AM0 due to larger defects, whereas AM90 matched SM strength.
PMID: 40221334
ISSN: 1879-0097
CID: 5829372