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Background: Investigate retinal fluid changes via a novel deep-learning algorithm in real-world patients receiving faricimab for the treatment of neovascular age-related macular degeneration (nAMD)., Methods: Multicenter, retrospective chart review and optical coherence tomography (OCT) image upload from participating sites was conducted on patients treated with faricimab for nAMD from February 2022 to January 2024. The Notal OCT Analyzer (NOA) algorithm provided intraretinal, subretinal and total retinal fluid for each scan. Results were segregated based on treatment history and fluid compartments, allowing for multiple cross-sections of evaluation., Results: A total of 521 eyes were included at baseline. The previous treatments prior to faricimab were aflibercept, ranibizumab, bevacizumab, or treatment-naive for 52.3%, 21.0%, 13.3%, and 11.2% of the eyes, respectively. Of all 521 eyes, 49.9% demonstrated fluid reduction after one injection of faricimab. The mean fluid reduction after one injection was -60.7nL. The proportion of eyes that saw reduction in fluid compared to baseline after second, third, fourth and fifth faricimab injections were 54.4%, 51.9%, 51.4% and 52.2%, respectively. The mean (SD) retreatment interval after second, third, fourth and fifth faricimab injection were 53.4 (34.3), 56.6 (36.0), 57.1 (35.3) and 61.5 (40.2) days, respectively., Conclusion: Deep-learning algorithms provide a novel tool for evaluating precise quantification of retinal fluid after treatment of nAMD with faricimab. Faricimab demonstrates reduction of retinal fluid in multiple groups after just one injection and sustains this response after multiple treatments, along with providing increases in treatment intervals between subsequent injections., Competing Interests: Competing interests: AAA reports other from REGENXBIO INC, outside the submitted work; paid summer internship. AMK reports personal fees from AbbVie, grants and personal fees from Adverum Biotechnologies, personal fees from Alcon, personal fees from Amgen, personal fees from Annexin, personal fees from Annexon, grants and personal fees from Apellis Pharmaceuticals, grants, financial interest, and personal fees from Aviceda Therapeutics, personal fees from Beacon Therapeutics, personal fees from Clearside Biomedical, personal fees from Complement Therapeutics, grants and personal fees from Genentech, grants and personal fees from Gyroscope Therapeutics, personal fees from i-Lumen Scientific, grants and personal fees from Iveric Bio, grants and personal fees from Janssen Pharmaceuticals, grants from personal fees from Kodiak Sciences, personal fees from Kriya Therapeutics, personal fees from Nanoscope, personal fees from Novartis, grants and personal fees from Ocular Therapeutix, grants, financial interest, and personal fees from Oculis, personal fees from Ocuphire, grants and personal fees from OcuTerra, personal fees from Olive Biopharma, grants, financial interest and personal fees from Opthea, grants and personal fees from Oxular, grants and personal fees from Oxurion, personal fees from Perfuse, personal fees from Ray Therapeutics, financial interest and personal fees from Recens Medical, personal fees from Regeneron Pharmaceuticals, grants, financial interest, and personal fees from Regenexbio, personal fees from Revive, financial interest and personal fees from RevOpsis, grants and personal fees from Roche, personal fees from Sanofi, personal fees from Stealth BioTherapeutics, personal fees from Thea Pharma, grants and personal fees from Unity Biotechnology, grants from personal fees from Vanotech, financial interest and personal fees from Vial, grants from Aviceda, grants from Alexion, grants from 4DMT, grants from Eyepoint, grants from Exegenesis, grants from Neurotech, financial interest from PolyPhotonix. Ms. HK reports other from Genentech, outside the submitted work; paid summer internship. EL reports employment with Notal Vision. Mr. Khanani has nothing to disclose. OM has nothing to disclose. Ms. Khanani has nothing to disclose. Ms. Khan has nothing to disclose. GMG reports personal fees from REGENXBIO. Mr. Graff has nothing to disclose. AMA reports personal fees from Genentech, outside the submitted work. DRPA reports personal fees and other from ACELYRIN, personal fees from ALCON, personal tees and other from ALIMERA SCIENCES, personal fees and other from ALLERGAN/ABBVIE, personal fees from BAUSCH + LOMB, personal fees from BAYER, personal fees and other from BOEHRINGER INGELHEIM, personal fees, non-financial support and other from CITRUS THERAPEUTICS, personal fees, non-financial support and other from CLINICAL TRIALS NETWORK, personal fees and other from EYEPOINT PHARMACEUTICALS, personal fees and other from GENENTECH, personal fees and other from GYROSCOPE THERAPEUTICS, personal fees and other from NOVARTIS, personal fees from OCUGEN, personal fees and other from OPTHEA, personal fees from REGENERON, personal fees and other from REGENXBIO, personal fees and other from ROCHE, personal fees and other from SAMSARA VISION, personal fees from SPHERIX CONSULTING GROUP, outside the submitted work. MRB reports personal fees from Alcon, personal fees from Allegro, personal fees from Allergan, personal fees from Alimera, personal fees from Bausch & Lomb, grants and personal fees from Clearside Biomedical, grants and personal fees from EyePoint Pharmaceuticals, grants and personal fees from Kodiak Sciences, grants and personal fees from Genentech, grants and personal fees from Novartis, other from NeuBase, grants and personal fees from Ocular Therapeutix, grants and other from Oxurion, grants and personal fees from RegenxBio, grants and personal fees from Adverum Biotechnologies, personal fees from Regeneron, grants and personal fees from CalciMedica, personal fees from Palatin Technologies, personal fees from AbbVie Inc, grants from Annexon Biosciences, personal fees from Apellis, personal fees from Arctic Vision, personal fees from Biogen, personal fees from Coherus Biosciences, grants from Gemini Therapetucis, grants from Gyroscope Therapeutics, grants from Oxular, grants from Oculis, grants and personal fees from Opthea, personal fees from Outlook Therapeutics, grants from ReNeuron, personal fees and other from RevOpsis Therapeutics, grants from Ribomic, personal fees from Roche, grants and personal fees from Stealth Biotherapeutics, grants from Unity Biotechnology, personal fees from Astellas, personal fees from Cencora, personal fees from Biocryst, personal fees from Celltrion, grants from EyeBio, grants and personal fees from Janssen, grants from Kanghong/Vanotech, personal fees from Neurotech, grants from Perfuse, outside the submitted work. GC reports personal fees from Nidek. Dr Graff reports grants and personal fees from Genentech, grants and personal fees from Roche, grants and personal fees from RegenxBio, grants from Ocular Therapeutix, grants from Kyowa Kirin, personal fees from Hi-Health, personal fees from Alimera, personal fees from Regeneron, personal fees from IvericBio. SJH has nothing to disclose. JSN reports grants from AbbVie, personal fees from Alcon, grants from Alexion, grants and personal fees from Apellis, grants and personal fees from Astellas, grants from Bayer, personal fees from Bausch and Lomb, grants from Clearside Biomedical, grants and personal fees from Genentech/Roche, grants from Gyroscope Therapeutics, grants from Novartis, grants from NovoNordisk, grants from Ocular Therapeutics, grants and personal fees from Regeneron, grants from RegenexBio. VSS reports grants and personal fees from Genentech, grants and personal fees from Alimera, grants and personal fees from Novartis, grants and personal fees from Iveric Bio, grants and personal fees from Regeneron, grants from Gyroscope, grants from RegenXBio, grants from Chengdu Kanghong, grants from NGM Biopharmaceuticals, grants from SamChungDang, grants from Sandoz, grants from Alkahest, grants and personal fees from Apellis, grants from EyePoint, grants from Oxurion, grants from 4D Molecular Therapeutics, grants from Ashvattha Therapeutics, grants from NGM Biopharmaceuticals, grants from Olix Pharmaceuticals, grants from Janssen, from OcuTerra, outside the submitted work. SRS reports personal fees from Apellis, personal fees from Amgen, personal fees from Abbvie/Allergan, personal fees from Alexion, personal fees from Samsung Bioepis, personal fees from Biogen, personal fees from Boerhinger Ingelheim, personal fees from Astellas/IvericBio, personal fees from Novartis, personal fees from Roche/Genentech, personal fees from Bayer, personal fees from Regeneron, personal fees from Pfizer, personal fees from Nanoscope, personal fees from Jannsen, personal fees fees and research instruments from iCare, personal fees and research instruments from Optos, personal fees fees and research instruments from Heidelberg, personal fees from NotalVision, personal fees fees and research instruments from Topcon, personal fees from Eyepoint, personal fees from Character, personal fees from Ocular Therapeutics, personal fees from Neurotech, personal fees from Nidek, personal fees from RegenxBio, research instruments from Carl Zeiss Meditec, personal fees and research instruments from Nidek. IH reports employment with Notal Vision. Mr Benyamini reports employment with Notal Vision. KN reports employment with Notal Vision. NM reports employment with Notal Vision., (© 2024. The Author(s).)

Purpose: To evaluate for the presence, severity, and type of exudation at each study visit for a subgroup of patients with neovascular age-related macular degeneration from the Archway and Portal trials., Design: Retrospective analysis of prospectively obtained data., Methods: Spectral-domain optical coherence tomography scans from each study visit of 44 patients from the Port Delivery System (PDS) arm and 32 patients from the monthly injection arm of Archway were evaluated, and composites of horizontal scans through the fovea were created. Each composite was graded for the presence, type, and severity of exudation and impact on best-corrected visual acuity., Results: After PDS implantation, 20 of 44 eyes (45%) never showed any exudation in the fovea, 2 (5%) never showed exudation in the fovea but had several missed visits, whereas 15 (34%), 3 (7%), and 4 (9%) showed mild, moderate, or severe exudation at 1 or more study visits, respectively. When exudation was present, it was most commonly subretinal fluid (50%). Of 32 patients randomized to monthly injections, 15 (47%) had no exudation in the fovea during monthly injections or after PDS implantation. Fluctuation of exudation in the fovea over time was seen in some patients after PDS implantation or during monthly injections with little or no identifiable impact on best-corrected visual acuity. In the 7 eyes with moderate or severe exudation in the fovea after PDS implantation, final vision was good in 5 (20/25 in 3, 20/40 in 1, and 20/50 in 1) and 2 had reduced vision from submacular hemorrhage., Conclusions: The PDS provides excellent control of exudation in the fovea in patients with neovascular age-related macular degeneration, and when exudation occurs, it often resolves without a negative impact on vision., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Importance: Clear surgical margins reduce the risk of local recurrence, improve survival, and determine decision-making with regard to adjuvant treatment of squamous cell carcinoma of the head and neck (SCCHN). However, the definitions of clear, close, or positive surgical margins vary in both the literature and in practice., Objective: To examine whether the association between surgical margin distance and survival varies by primary tumor site., Design, Setting, and Participants: This was a secondary analysis of a multi-institutional, multinational randomized clinical trial. The trial enrolled patients from January 22, 2007, to March 29, 2013, with stage II to IVA resected SCCHN with extranodal extension (ENE) or positive margins (<5 mm from invasive tumor to the resected margin). The current analysis included those patients with known ENE and margin status and was conducted from April 29, 2022, to December 19, 2022., Interventions: Patients received adjuvant chemoradiotherapy plus either placebo or lapatinib., Main Outcomes and Measures: Overall survival (OS) was calculated to examine association with surgical margin distance, primary site, and survival, with stratification by ENE status., Results: Among 688 patients enrolled in the trial, 630 patients with known ENE and margin status were included. Exact patient ages were not made available; 523 (83%) patients were male, and 415 (66%) patients were White. Patients with 1 high-risk feature (positive margins or ENE) had significantly better OS vs 2 high-risk features (hazard ratio [HR], 0.65; 95% CI, 0.49-0.87), although most other results were not statistically significant. For example, in the cohort with ENE-negative disease, multivariable adjusted analysis showed nonsignificant improvements with shorter surgical margin distance (1- to 5-mm margins), and no association with OS was found in the cohort with ENE-positive status (either >5 mm margins or 1-5 mm margins). The association between survival and margin distance varied based on primary site, human papillomavirus (HPV) status, and ENE status. For example, HPV-positive status was associated with a significant and clinically meaningful increase in survival (adjusted HR, 0.33; 95% CI, 0.11-0.97). The improvement was greatest, although not significantly so, in patients with ENE- and HPV-negative oropharynx (OP), hypopharynx (HP), and larynx cancer (HR, 0.57; 95% CI, 0.30-1.10). No survival benefit was seen in ENE-negative oral cavity cancer (HR, 0.89; 95% CI, 0.45-1.77), nor was an association observed between margins and OS in HPV-positive OP cancer., Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, the presence of high-risk features (extranodal extension, positive margins, or both) was associated with worse survival; longer survival was observed with greater surgical margin distance among patients with oral cavity tumors and human papillomavirus-negative tumors of the OP, larynx, or HP. No other significant differences were found. These findings support variable interpretation of surgical margin distance based on the primary site and HPV status., Trial Registration: ClinicalTrials.gov Identifier: NCT00424255.

In this study, we sought to explore the feasibility of using ultrasonography to evaluate airway anomalies in awake children with previous airway reconstruction. For the month of December 2018, we reviewed the medical records of patients aged <18 years old with prior airway reconstruction who had an outpatient appointment and a microlaryngoscopy and bronchoscopy within 24 hours of each other. Four patients met inclusion criteria and were enrolled. Sonographic airway images and measurements were obtained during the outpatient appointment and compared with those obtained during endoscopy. Ultrasound identified extraluminal stents and glottic, subglottic, and tracheal pathology. Subglottic measurements obtained sonographically were within 0.1 to 0.5 mm of the outer diameter of the appropriate endotracheal tubes. Ultrasound did not visualize tracheotomy tubes or posterolateral pathology. Our findings lay the foundation for expanding the role of ultrasound in pediatric airway assessment, keeping in mind its apparent inability to visualize posterolateral airway pathology.

Background: Thrombelastography has become increasingly used in liver transplantation. The implications of thrombelastography at various stages of liver transplantation, however, remain poorly understood. Our goal was to examine thrombelastography-based coagulopathy profiles in liver transplantation and determine whether preoperative thrombelastography is predictive of transfusion requirements perioperatively., Methods: A retrospective review of 364 liver transplantations from January 2013 to May 2017 at a single institution was performed. Patients were categorized as hypocoagulable or nonhypocoagulable based on their preoperative thrombelastography profile. The primary outcome was intraoperative transfusion requirements., Results: Of patients undergoing liver transplantation, 47% ( n  = 170) were hypocoagulable and 53% ( n  = 194) were nonhypocoagulable preoperatively. Hypocoagulable patients had higher transfusion requirements compared to nonhypocoagulable patients, requiring more units of packed red blood cells (7 vs 4, P  < .01), fresh frozen plasma (14 vs 8, P  < .01), cryoprecipitate (2 vs 1, P  < .01), platelets (3 vs 2, P  < .01), and cell saver (3 vs 2 L, P  < .01). Additionally, these patients were more likely to receive platelets and cryoprecipitate in the first 24 hours following liver transplantation (both P  < .05). No differences were found between rates of intensive care unit length of stay, 30-day readmission, or mortality., Conclusion: Coagulation abnormalities are common among liver transplantation patients and can be identified using thrombelastography. Identification of a patient's coagulation state preoperatively aids in guiding transfusion during liver transplantation. This work serves to better direct clinicians during major surgery to improve perioperative resource utilization. Future prospective work should aim to identify specific thrombelastography values that may predict transfusion requirements., (© 2020 The Authors.)

Background: Despite the potential benefits of social media, health care providers are often hesitant to engage patients through these sites. Our aim was to explore how implementation of social media may affect patient engagement and satisfaction., Methods: In September 2016 a Facebook support group was created for liver transplant patients to use as a virtual community forum. Data including user demographics and group activity were reviewed. A survey was conducted evaluating users' perceptions regarding participation in the group., Results: Over 9 months, 350 unique users (50% liver transplant patients, 36% caregivers/friends, 14% health care providers) contributed 339 posts, 2,338 comments, and 6,274 reactions to the group; 98% of posts were reacted to or commented on by other group members. Patients were the most active users compared with health care providers and caregivers. A total of 95% of survey respondents reported that joining the group had a positive impact on their care; and 97% reported that their main motivation for joining was to provide or receive support from other patients., Conclusion: This pilot study indicates that the integration of social media into clinical practice can empower surgeons to synthesize effectively a patient support community that augments patient engagement and satisfaction., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The objective of the present study was to determine whether the development of behavioral sensitization to apomorphine could be blocked by either D1 or D2 selective dopamine antagonists. In three experiments, male rats received 10-21 daily injections of a selective D1 (SCH 23390; 0 or 0.5 mg/kg IP) or D2 (sulpiride; 0, 30, or 100 mg/kg IP) antagonist followed by an apomorphine (0 or 1.0 mg/kg SC) injection. In two experiments, the rats were tested for locomotor activity in photocell arenas after the daily injections. In all experiments, the rats were tested for sensitization to apomorphine following the training phase. The results indicated that apomorphine produced a progressively greater increase in locomotor activity with each injection, and this apomorphine-induced increase in activity was completely blocked by both sulpiride and SCH 23390 treatments. However, although both sulpiride and SCH 23390 blocked apomorphine-induced activity, only SCH 23390 injections prevented the development of sensitization to apomorphine. That is, rats pretreated with sulpiride and apomorphine displayed significant sensitization when subsequently tested with a challenge dose of apomorphine alone. These findings suggest that the development of behavioral sensitization to apomorphine is related specifically to the stimulation of dopamine D1 receptors.