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Ryan Kipp,1 Lee-or Herzog,2 Rahul Khanna,3 Dongyu Zhang3 1Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; 2Franchise Health Economics and Market Access, Johnson and Johnson, Irvine, CA, USA; 3MedTech Epidemiology and Data Sciences, Johnson and Johnson, New Brunswick, NJ, USACorrespondence: Ryan Kipp, Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA, Tel +608-265-4188, Email rtkipp@medicine.wisc.eduBackground: Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment are critical in alleviating AF disease burden. There is significant heterogeneity in patterns of AF care. It is unclear whether there are racial and ethnic differences in treatment of AF following antiarrhythmic drug (AAD) prescription.Methods: Using the Optum Clinformatics Data Mart-Socioeconomic Status database from January, 2009, through March, 2022, multivariable logistic regression techniques were used to examine the impact of race and ethnicity on rate of AAD initiation, as well as receipt of catheter ablation within two years of initiation. We compared AAD discontinuation rate by race and ethnicity groups using Cox regression models. Log-rank analyses were used to examine the rate of AF-related hospitalization.Results: Among 143,281 patients identified with newly diagnosed AF, 30,019 patients (21%) were initiated on an AAD within 90 days. Patients identified as Non-Hispanic Black (NHB) were significantly less likely to receive an AAD compared to Non-Hispanic White patients (NHW) (Odds Ratio [OR] 0.90, 95% confidence interval [CI] 0.85– 0.94). Compared to NHW, Hispanic (Hazard Ratio [HR] 1.08, 95% CI 1.02– 1.14) and Asian patients (HR 1.17, 95% CI 1.06– 1.29) have a higher rate of AAD discontinuation. Following AAD initiation, NHB patients were significantly more likely to have an AF-related hospitalization (p < 0.01). However, NHB patients were significantly less likely to receive ablation compared to NHW (HR 0.83, 95% CI 0.70– 0.97), and less likely to change AAD (p < 0.01).Conclusion: Patients identified as NHB are 10% less likely to receive an AAD for treatment of newly diagnosed AF. Compared to NHW, Hispanic and Asian patients were more likely to discontinue AAD treatment. Once initiated on an AAD, NHB patients were significantly more likely to have an AF -related hospitalization, but were 17% less likely to receive ablation compared to NHW patients. The etiology of, and interventions to reduce, these disparities require further investigation.Keywords: atrial fibrillation, cardiovascular disease, health disparity, epidemiology, real-world data

Sanusi Umar,1– 3 Raveena Khanna,3,4 Alejandro Gonzalez,5 Kavish Chouhan,6 Juan Carlos Maldonado,7 Osman Tayfun Oguzoglu,8 Aron Nusbaum9 1Department of Medicine, Dermatology Division, University of California, Los Angeles, CA, USA; 2Division of Dermatology, Harbor-UCLA Medical Center, Torrance, CA, USA; 3Dr. U Hair and Skin Clinic, Manhattan Beach, CA, USA; 4Department of Dermatology, Howard University College of Medicine, Washington, DC, USA; 5Mxcapilar Clinic, Chulavista, Sonora, Mexico; 6Department of Dermatology, DermaClinix, New Delhi, India; 7Hair Evolution Robotics, Medellin, Colombia; 8Dr. T Hair Transplant, Istanbul, Turkey; 9Hair Transplant Institute, Miami, Coral Gables, FL, USACorrespondence: Sanusi Umar, Dr. U Hair and Skin Clinic, 2121 N Sepulveda Blvd, Suite 200, Manhattan Beach, CA, 90266, USA, Tel +1-310-480-0490, Fax +1-310-318-1590, Email drumar@dru.comBackground: Current no-shave long hair-follicular unit excision (LH-FUE) techniques employ recesses (slots, notches, or grooves) in punch tips to reduce the long-hair shaft break rate (SBR) and graft transection rate (GTR). However, these methods demand advanced skills and extended procedure time.Objective: We aimed to evaluate a skin-responsive FUE technique without the use of recess-tipped punches, accommodating diverse hair and skin types in LH-FUE procedures.Methods and Materials: We retrospectively analyzed patients who underwent this technique using a UGraft Zeus device at five multinational clinics (Mexico, Colombia, India, United States, and Türkiye) from August 9, 2021, to April 11, 2023. Donor zones were pre-operatively graded for expected difficulty using the Sanusi FUE Scoring (SFS) Scale, ranging from class I (low difficulty) to V (high difficulty).Results: Among 152 patients (mean age, 46 years; 146 straight-wavy, 6 curly-coiled hair), most (n=107) were class I donors. The GTR ranged 2.2%– 4.3%, and was highest in class IV donors and those with thick-firm scalps. The SBR was 12.2%, and the average graft excision rate (GER; speed) was 440 grafts/h. Only 19G and 18G punches were used. All patients were satisfied with the procedure, with 57.4% reporting that they were “very happy”. Surgeon willingness to perform no-shave LH-FUE significantly increased from 1.25 to 4.20 (on a scale of 1– 5) after adopting this device. SFS class, skin thickness, and firmness, more than hair curliness, influenced the GTR, SBR, torque, and punch movement duration.Conclusion: Our findings reveal consistent success in conducting no-shave LH-FUE using this skin-responsive device across diverse patients. Notably, success was achieved without recess-tipped punches, resulting in low GTR and SBR, along with a high GER and increased patient satisfaction. These outcomes suggest enhanced procedure speed and ease of use, contributing to a greater willingness among surgeons to adopt this technique.Plain Language Summary: Despite the increasing popularity of no-shave long-hair follicular unit excision (FUE) as a hair transplant technique for its advantages in preserving the donor area and immediately assessing results after implanting long hairs, its adoption by surgeons has been slow due to its demanding nature. It is time-consuming and skill-intensive because it requires specialized punches with recesses (slots, notches, or grooves) on their tips that must align to accommodate and protect the long hair shafts from breakage during each extraction.Our study reports a novel skin-responsive FUE device for performing nonshaven long-hair FUE called the UGraft Zeus, whose recess-free punch (The intelligent Punch) features a minimal-assist-navigation capability to simplify the procedure and enhances performance parameters, including speed, graft transection rate, hair shaft break rate, and its easy adoption rate by surgeons, including novices. Additionally, patient satisfaction is high.Additionally, skin characteristics, specifically thickness and firmness, play a more critical role than the degree of hair curliness. Thicker and firmer skin requires increased torque and a longer punch movement duration during surgery. Furthermore, the skin-responsive FUE device was successful in performing no-shave long hair FUE in patients with Afro-textured hair, a population typically considered to be a hair transplant challenge.Keywords: follicular unit extraction, nonshaven FUE, unshaven FUE, long-hair FUE, hair transplantation, hair restoration surgery

Chidubem AV Okeke,1 Ramona Khanna,2 Alison Ehrlich3 1Department of Dermatology, Howard University College of Medicine, Washington, DC, USA; 2Georgetown University School of Medicine, Washington, DC, USA; 3Foxhall Dermatology, Washington, DC, USACorrespondence: Chidubem AV Okeke, Department of Dermatology, Howard University College of Medicine, 520 W Street NW, Room 3035/3036, Washington, DC, USA, Email chidubem.okeke@bison.howard.eduAbstract: The recent global pandemic has resulted in increased use of quaternary ammonium compounds (QACs). Currently, QACs are active ingredients in 292 disinfectants recommended by the US EPA for use against SARS-CoV-2. Among QACs, benzalkonium chloride (BAK), cetrimonium bromide (CTAB), cetrimonium chloride (CTAC), didecyldimethylammonium chloride (DDAC), cetrimide, quaternium-15, cetylpyridinium chloride (CPC), and benzethonium chloride (BEC) were all identified as potential culprits of skin sensitivity. Given their widespread utilization, additional research is needed to better classify their dermal effects and identify other cross-reactors. In this review, we aimed to expand our knowledge about these QACs to further dissect its potential allergic and irritant dermal effects on healthcare workers during COVID-19.Keywords: patch test, systemic contact dermatitis, hypersensitivity, allergic contact dermatitis, COVID-19, healthcare

Larry R Jackson II,1 Daniel J Friedman,1 Diane M Francis,2 Sonia Maccioni,2 Vincent C Thomas,3 Paul Coplan,4 Rahul Khanna,4 Charlene Wong,4 Neloufar Rahai,4 Jonathan P Piccini1 1Division of Cardiology, Duke University Medical Center & Duke Clinical Research Institute, Durham, NC, USA; 2Health Economics and Market Access, Johnson & Johnson Medical Devices, Irvine, CA, USA; 3Medical Safety, Biosense Webster, Irvine, CA, USA; 4Medical Device Epidemiology and Real-World Data Sciences, Johnson & Johnson, New Brunswick, NJ, USACorrespondence: Larry R Jackson II, Duke Clinical Research Institute, 300 W. Morgan Street, Durham, NC, 27701, USA, Tel +1 919-684-9940, Email larry.jackson@duke.eduBackground: Atrial fibrillation (AF) is associated with considerable morbidity and mortality. Timely management and treatment is critical in alleviating AF disease burden. Variation in treatment by race and ethnic and sex could lead to inequities in health outcomes.Objective: To identify racial and ethnic and sex differences in rhythm treatment for patients with incident AF.Methods: Using 2010– 2019 Optum Clinformatics database, an administrative claims data for commercially insured patients in the United States (US), incident AF patients ≥ 20 years old who were continuously enrolled 12-months pre- and post-index diagnosis were identified. Rhythm control treatment (ablation, antiarrhythmic drugs [AAD], and cardioversion) for AF were compared by patient race and ethnicity (Asian, Hispanic, Black vs White) and sex (female vs male). Multivariable regression analysis was used to examine the relationship of race and ethnicity and sex with rhythm control AF treatment.Results: A total of 77,932 patients were identified with incident AF. Black and Hispanic female patients had the highest CHA2DS2VASc scores (4.3 ± 1.8) and Elixhauser scores (4.1 ± 2.8 and 4.0 ± 6.7), respectively. Black males were less likely to receive AAD treatment (adjusted odds ratio [aOR] 0.87; 95% confidence interval [CI], 0.79– 0.96) or ablation (aOR, 0.72; 95% CI, 0.58– 0.90). Compared to White males, all groups had lower likelihood of receiving cardioversion with Asian females having the lowest [aOR, 0.48; 95% CI, (0.37– 0.63)].Conclusion: Black patients were less likely to receive pharmacologic and procedural rhythm control therapies. Further research is needed to understand the drivers of undertreatment among racial and ethnic groups and females with AF.Keywords: race, sex, atrial fibrillation, catheter ablation

The long-term tolerability of linezolid is low because of mitochondrial toxicity, whereas tedizolid may represent a better option for suppressive therapy. We report a first presumed case of tedizolid-associated optic neuropathy after a very prolonged (18-month) intake and believe that screening for optic neuropathy should be considered for patients undergoing tedizolid suppression. [ABSTRACT FROM AUTHOR]

Xiaozhou Fan,1 Barbara H Johnson,1 Stephen S Johnston,1 Nivesh Elangovanraaj,2 Paul Coplan,1 Rahul Khanna1 1Medical Device Epidemiology and Real World Data Sciences, Johnson & Johnson, New Brunswick, NJ, USA; 2 Mu Sigma Inc, Bangalore, IndiaCorrespondence: Xiaozhou FanMedical Device Epidemiology and Real World Data Sciences, Johnson & Johnson, 410 George St, New Brunswick, NJ 08901, USATel +1 908 208-2625Fax +1 732 524-5242Email xfan9@its.jnj.comAbstract: We sought to examine the trend (April–July) in the treatment patterns among hospitalized COVID-19 patients using the Premier Healthcare Database (PHD). In the analysis, we identified 53,264 patients from 302 hospitalsthat continuously provided inpatient data from April 1, 2020 to July 31, 2020 to the PHD, a nationwide, population-based multihospital research database in the US. We used generalized estimating equations (GEE) models to assess changes in the proportion of therapies used during the study period. After adjusting for patient and provider factors, a decline in hydroxychloroquine and an increase in azithromycin and dexamethasone were observed among COVID-19 patients during the 4-month study period.Keywords: COVID-19, hospitalization, treatment pattern

These reports present the results of the 2013 Community Summer Study of theAPS Division of Particles and Fields ("Snowmass 2013") on the future program ofparticle physics in the U.S. Chapter 8, on the Instrumentation Frontier,discusses the instrumentation needs of future experiments in the Energy,Intensity, and Cosmic Frontiers, promising new technologies for particlephysics research, and issues of gathering resources for long-term research inthis area.

Larry Chinitz,1 Laura J Goldstein,2 Andrea Barnow,2 Sonia Maccioni,2 Mehmet Daskiran,3 Iftekhar Kalsekar,4 Rahul Khanna4 1NYU Langone Health, New York, NY, USA; 2Johnson & Johnson Medical Devices, Irvine, CA, USA; 3Janssen, Raritan, NJ, USA; 4Johnson & Johnson Medical Device Epidemiology, New Brunswick, NJ, USA Introduction: This study evaluated the real-world clinical and economic outcomes associated with the use of the ThermoCool® Surround Flow (SF) and ThermoCool® catheters in atrial fibrillation (AF) ablation.Methods: Adults with AF who underwent catheter ablation between January 1, 2013, and December 31, 2016, in a hospital outpatient setting were identified from the Premier Healthcare Database. Using a search strategy of hospital-charge descriptors, patients were classified into two mutually exclusive groups: ThermoCool® SF catheter and ThermoCool® catheter. A generalized estimating equation was used to compare index admission cost. Survey logistic regression was used to compare the incidence of inpatient readmission, direct-current cardioversion (DCCV), and repeat ablation. Multivariable analyses were adjusted for hospital clustering and demographic, procedural, hospital, and comorbidity characteristics.Results: There were 1,014 and 463 patients in the ThermoCool® SF and ThermoCool® groups, respectively. The ThermoCool® SF group had significantly lower odds of all-cause (odds ratio [OR] 0.45; 95% CI 0.27–0.76) and cardiovascular-related readmissions (OR 0.45; 95% CI 0.21–0.96), and DCCV (OR 0.61; 95% CI 0.42–0.88) than the ThermoCool® group. In patients susceptible to fluid overload, the ThermoCool® SF group had significantly lower odds of 12-month all-cause (OR 0.42; 95% CI 0.23–0.75), cardiovascular-related (OR 0.31; 95% CI 0.10–0.92), and AF-related readmissions (OR 0.18; 95% CI 0.04–0.80), and DCCV (OR 0.52; 95% CI 0.31–0.87) than the ThermoCool® group.Conclusions: Using the ThermoCool® SF catheter for AF ablation was significantly associated with improved clinical outcomes compared with the ThermoCool® catheter. Keywords: atrial fibrillation, radiofrequency ablation, irrigated-tip catheter, ThermoCool® Surround Flow catheter, ThermoCool® catheter

Raveena Khanna,1,2 Anshika Bakshi,3 Yasmin Amir,1 Gary Goldenberg1 1Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 2Creighton University School of Medicine, Omaha, NE, 3Rutgers Robert Wood Johnson Medical School, Piscataway Township, NJ, USA Abstract: Actinic keratosis (AK) is a common dermatologic condition in which hyperplastic epidermal lesions develop in response to excessive and chronic exposure to ultraviolet (UV) radiation. If left untreated, AK can progress to squamous cell carcinomas of the skin. Incidence is rising worldwide as a result of the progressive aging of populations and an increase in lifetime cumulative exposure to UV radiation. Currently, various treatment options exist, which range from topical medications to light-based therapies and procedural modalities. In this article, we will review the treatment options for AK with a focus on assessments of patient satisfaction with treatment. Keywords: actinic keratosis, treatment, outcomes, patient satisfaction, quality of life

This case presents with a unique clinical characteristic of an immunocompetent host with an unusual lower lobe predominant pulmonary tuberculosis infection and multifocal intra-cranial tuberculomas. The prognosis for brain tuberculoma is good, and effective treatment options are available. Enhanced brain and spine MRI should be taken into account for those with neurological sequelae, while those with persistent intracranial hypertension and lesions should only undergo craniotomies. [ABSTRACT FROM AUTHOR]