Faculty Bibliography

SIGNIFICANCE/UNASSIGNED:Tracking changes in the vasculature of patients with peripheral arterial disease (PAD) may identify the need for follow-up treatment within only weeks after an initial intervention, enabling timely support and improving patient outcomes. AIM/UNASSIGNED:We aim to evaluate dynamic vascular optical spectroscopy's (DVOS's) ability to accurately monitor the hemodynamics of affected arteries in patients with PAD after a surgical intervention and predict long-term clinical outcomes. APPROACH/UNASSIGNED:A DVOS system non-invasively monitored the blood flow through 256 lower extremity arteries in 80 PAD patients immediately before, immediately after, and 3 to 4 weeks after they underwent a surgical intervention. RESULTS/UNASSIGNED: CONCLUSIONS/UNASSIGNED:The DVOS system was able to classify patient long-term clinical outcomes with high accuracy within one month after an RP and distinguish among different interventions. DVOS may be a promising alternative or adjunct to existing monitoring approaches.

BACKGROUND:Disorders of consciousness (DoC) are frequently encountered in both, acute and chronic brain injuries. In many countries, early withdrawal of life-sustaining treatments is common practice for these patients even though the accuracy of predicting recovery is debated and delayed recovery can be seen. In this review, we will discuss theoretical concepts of consciousness and pathophysiology, explore effective strategies for management, and discuss the accurate prediction of long-term clinical outcomes. We will also address research challenges. MAIN TEXT/METHODS:DoC are characterized by alterations in arousal and/or content, being classified as coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state, and confusional state. Patients with willful modulation of brain activity detectable by functional MRI or EEG but not by behavioral examination is a state also known as covert consciousness or cognitive motor dissociation. This state may be as common as every 4th or 5th patient without behavioral evidence of verbal command following and has been identified as an independent predictor of long-term functional recovery. Underlying mechanisms are uncertain but intact arousal and thalamocortical projections maybe be essential. Insights into the mechanisms underlying DoC will be of major importance as these will provide a framework to conceptualize treatment approaches, including medical, mechanical, or electoral brain stimulation. CONCLUSIONS:We are beginning to gain insights into the underlying mechanisms of DoC, identifying novel advanced prognostication tools to improve the accuracy of recovery predictions, and are starting to conceptualize targeted treatments to support the recovery of DoC patients. It is essential to determine how these advancements can be implemented and benefit DoC patients across a range of clinical settings and global societal systems. The Curing Coma Campaign has highlighted major gaps knowledge and provides a roadmap to advance the field of coma science with the goal to support the recovery of patients with DoC.

INTRODUCTION/BACKGROUND:Individuals with behavioral health conditions smoke at significantly higher rates and have been resistant to existing smoking cessation efforts. A clearer understanding of associations between vaping and daily cigarette consumption in this vulnerable population is warranted. METHODS:We analyzed data from the 2014-2018 National Health Interview Survey (NHIS) to examine whether vaping was associated with differences in number of cigarettes smoked per day (CPD) among adults who smoke daily and have varying levels of psychological distress. RESULTS:After adjustment for sociodemographic covariates, individuals who vaped every day smoked on average 1.48 fewer cigarettes per day than individuals who never vaped (p<0.01), while individuals who vaped some days and individuals who ever but no longer vaped smoked 0.77 and 1.48 more CPD, respectively, than individuals who never vaped. Differences between those who vaped every day and those who never vaped were even greater among those with moderate psychological distress (-2.21 CPD, p<0.01). CONCLUSIONS:Our findings suggest that use of vaping devices may be associated with lower daily cigarette use among individuals with psychological distress, potentially supporting smoking harm reduction efforts.

A multiscale modeling framework is adapted for the in silico prediction of nonlinear shear rheology of entangled polymer melts. This approach begins with an all-atom model and progresses to two coarser-grained models, the coarse-grained and slip-spring models, through a bottom-up parametrization process informed by the structure and dynamics of finer-grained models. The steady shear viscosity of entangled polymer melts is calculated by performing simple shear simulations with both the coarse-grained and slip-spring models. Using atactic polystyrene melts as a target, the steady shear viscosities are calculated under a wide range of shear rates and are found to be in quantitative agreement with experimental measurements, serving to provide an example of the prediction of nonlinear rheology of an entangled material starting from a purely atomistic model without freely adjustable parameters. At high shear rates, when the Weissenberg number is above unity, the steady shear viscosity exhibits a power law behavior with ∼ γ̇^-0.7, as captured by the coarse-grained model of slightly entangled melts. As the shear rate decreases, the transition from the power-law regime to the shear-rate-independent plateau regime depends on the molecular weight and is reproduced by the slip-spring model. Integrating the coarse-grained and slip-spring models permits the prediction of the steady shear viscosity of entangled polystyrene melts over 6 decades of time.

Dendropsophusis one of the most species-rich genera of hylid treefrogs. Recent studies integrating Sanger-generated mitochondrial and nuclear loci with phenomic characters (SP) have advanced understanding of this clade, but questions about its internal relationships and biogeographic history persist. To address these questions, we used anchored hybrid enrichment (AHE) to combine 432 nuclear loci for 78 taxa (72 % of species) with published data. Quantitatively, the impact of the AHE data was modest, with compositional differences in only three recognized clades and more than 80 % of the clades in the AHE + SP analyses also supported in the SP-only analyses. Nevertheless, the impact of AHE was crucial for resolving and increasing support for multiple nodes. We transferred one species of the formerD. ruschiigroup to theD. decipiensgroup and redefined theD. leucophyllatusgroup to avoid paraphyly. We estimated divergence times to reconstruct the clade's biogeographic history. We also examined evolution of oviposition sites and assessed its effect on lineage accumulation. Dendropsophuslikely originated ∼ 57 mya, predating the Andean uplift, with some taxa showing dispersal patterns less constrained by ecological changes than previously thought.

The subspecialty of neurocritical care has grown significantly over the past 40 years along with advancements in the medical and surgical management of neurological emergencies. The modern neuroscience intensive care unit (neuro-ICU) is grounded in close collaboration between neurointensivists and neurosurgeons in the management of patients with such conditions as ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, subdural hematomas, and traumatic brain injury. Neuro-ICUs are also capable of specialized monitoring such as serial neurological examinations by trained neuro-ICU nurses; invasive monitoring of intracranial pressure, cerebral oxygenation, and cerebral hemodynamics; cerebral microdialysis; and noninvasive monitoring, including the use of pupillometry, ultrasound monitoring of optic nerve sheath diameters, transcranial Doppler ultrasonography, near-infrared spectroscopy, and continuous electroencephalography. Neuro-ICUs are also capable of specialized neuroprotective management of medical complications, including sodium disorders, renal failure, respiratory failure, and hypertension. These units depend on an interdisciplinary team including speech and language pathologists, occupational and physical therapists, and social workers and case managers, who work to implement early mobilization and successful transition to rehabilitation centers. There are numerous models of neuro-ICUs ranging from "open" units in which patients are cared for in an ICU by an admitting attending, generally without involvement of an intensivist, to "semi-open" units in which intensivists act as consultants, to "closed" units in which the neurointensivist is the admitting attending. The utilization of neuro-ICUs is associated with improved outcomes including lower mortality rates, decreased ICU and hospital length of stay, and improved functional outcomes.

Machine learning interatomic potentials (MLIPs) are rapidly gaining interest for molecular modeling, as they provide a balance between quantum-mechanical level descriptions of atomic interactions and reasonable computational efficiency. However, questions remain regarding the stability of simulations using these potentials, as well as the extent to which the learned potential energy function can be extrapolated safely. Past studies have encountered challenges when MLIPs are applied to classical benchmark systems. In this work, we show that some of these challenges are related to the characteristics of the training datasets, particularly the inefficient exploration of the dynamical modes and the inclusion of rigid constraints. We demonstrate that long stability in simulations with MLIPs can be achieved by generating unconstrained datasets using unbiased classical simulations, provided that the important dynamical modes are correctly sampled. In addition, we emphasize that in order to achieve precise energy predictions, it is important to resort to enhanced sampling techniques for dataset generation, and we demonstrate that safe extrapolation of MLIPs depends on judicious choices related to the system's underlying free energy landscape and the symmetry features embedded within the machine learning models.

[This corrects the article DOI: 10.18332/tpc/189769.].

BACKGROUND:In the past decade, the transfibular approach to Total Ankle Replacement (TAR) has emerged as an alternative to anterior approach with reduced bone resection. The purpose of this systematic review is to report survival, complications, and reoperation rates of transfibular TAR. METHODS:We conducted a systematic search of studies that evaluated complications, reoperations, and survival of transfibular TAR following PRISMA guidelines across PubMed, Scopus and Web of Science. RESULTS:Our review included data from 12 cohorts, comprising 919 patients across 7 countries, with an average age of 62 years (59% posttraumatic). Over an average follow-up period of 3 years, adverse events occurred in 23% of cases, with 18% requiring surgical reintervention, mostly due to hardware removal. The survival rate of the transfibular TAR metal components was 97% at the final follow-up. CONCLUSION/CONCLUSIONS:Transfibular TAR demonstrates a 97% survival rate at a 3-year follow-up. LEVEL OF EVIDENCE/METHODS:Level II.