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Background: Patients admitted to tertiary centers are often transferred from long distances and thus follow-up care presents a significant challenge for these patients. The use of telehealth in outpatient visits has been shown to decrease travel costs and increase patient satisfaction, but many studies were performed in urban settings and did not address usability limitations for patients in rural settings. The purpose of the study was to understand the patient-perceived feasibility of utilizing telehealth in a large rural referral trauma center and assess patient's perceptions of telehealth. Prior studies on utilization of telehealth have been done at mostly urban locations and a true understanding of internet availability and accessibility for patients living in rural areas will enable successful implementation and utilization of telehealth in this population. Methods: We administered a brief questionnaire to patients >16 years old admitted to a single Level 1 academic trauma center's Trauma and Acute Care Surgery services prior to discharge or at the first clinic visit from June 2021 to December 2021. All patients who were eligible and able to complete the questionnaire were approached for voluntary participation in the study. Consent was obtained by the research staff and the questionnaire was completed independently by the participants. Results: 77 participants completed the questionnaire, 45 (58%) were male, 30 (39%) were female and 2 (3%) were missing and the mean age was 42 years (S.D =17.6). 46 (61%) were Black, 23 (32%) were White and 5 (7%) did not report a race. Regarding insurance status, 30 (40%) had commercial insurance, 8 (11%) had Medicare, 19 (25%) had Medicaid and 18 (24%) were uninsured. 87% of patients reported access to internet at home, and 87% use a smartphone as their primary device for internet access. 86% felt comfortable using telehealth at home. More than half of the respondents (59%) agreed or strongly agreed to use telehealth for their next health care provider visit. 16 (21%) of the respondents strongly agree that telehealth will improve the care they receive from their healthcare professional (HCP), 11(15%) of the respondents strongly disagree telehealth would decrease the care they receive from their HCP, and 14 (19%) of the respondents strongly agree that telehealth would provide faster access to an HCP. 9 (12%) of the respondents strongly agree that they would receive the same quality of care with telehealth compared to an office visit while 17 (23%) disagree. Blacks were more likely to report negative perceptions of telehealth compared to Whites patients. Conclusion: Majority of our patients were willing to utilize telehealth for their next health care provider visit and had access to internet. Telehealth is very feasible in rural locations inlight of a concern for internet availability and accessibility and offers attractive options for patients. However, there are still some disparities in perceptions such as the quality of care received being equivocal to an office visit that might be a significant barrier to utilization. Such perceptions may be improved with increased familiarization and education on telehealth services.

Liver transplant remains the definitive therapy for patients with end-stage liver disease. Outcomes have continued to improve, in part owing to interventions used to treat posttransplant complications involving the hepatic arteries, portal vein, hepatic veins or inferior vena cava (IVC), and biliary system. Significant hepatic artery stenosis can be treated with angioplasty or stent placement to prevent thrombosis and biliary ischemic complications. Hepatic arterioportal fistula and hepatic artery pseudoaneurysm are rare complications that can often be treated with endovascular means. Treatment of hepatic artery thrombosis can have mixed results. Portal vein stenosis can be treated with venoplasty or more commonly stent placement. The rarer portal vein thrombosis can also be treated with endovascular techniques. Hepatic venous outflow stenosis of the hepatic veins or IVC is amenable to venoplasty or stent placement. Complications of the bile ducts are the most encountered complication after liver transplant. When not amenable to endoscopic intervention, biliary stricture, bile leak, and ischemic cholangiopathy can be treated with percutaneous transhepatic cholangiography with biliary drainage and other interventions. New techniques have further improved care for these patients. Transsplenic portal vein recanalization has improved transplant candidacy for patients with chronic portal vein thrombosis. Spontaneous splenorenal shunt and splenic artery steal syndrome (nonocclusive hepatic artery hypoperfusion syndrome) remain complicated topics, and the role of endovascular embolization is developing. When patients have recurrence of cirrhosis after transplant, most commonly due to viral hepatitis, transjugular intrahepatic portosystemic shunt (TIPS) may be required to treat symptoms of portal hypertension. Online supplemental material is available for this article. © RSNA, 2022.

A variety of genetic techniques have been devised to determine cell lineage relationships during tissue development. Some of these systems monitor cell lineages spatially and/or temporally without regard to gene expression by the cells, whereas others correlate gene expression with the lineage under study. The G AL4 T echnique for R eal-time a nd C lonal E xpression (G-TRACE) system allows for rapid, fluorescent protein-based visualization of both current and past GAL4 expression patterns and is therefore amenable to genome-wide expression-based lineage screens. Here we describe the results from such a screen, performed by undergraduate students of the University of California, Los Angeles (UCLA) Undergraduate Research Consortium for Functional Genomics (URCFG) and high school summer scholars as part of a discovery-based education program. The results of the screen, which reveal novel expression-based lineage patterns within the brain, the imaginal disc epithelia, and the hematopoietic lymph gland, have been compiled into the G-TRACE Expression Database (GED), an online resource for use by the Drosophila research community. The impact of this discovery-based research experience on student learning gains was assessed independently and shown to be greater than that of similar programs conducted elsewhere. Furthermore, students participating in the URCFG showed considerably higher STEM retention rates than UCLA STEM students that did not participate in the URCFG, as well as STEM students nationwide., (Copyright © 2019 Olson et al.)