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1. Inbred SJL mice recapitulate human resistance to Cryptococcus infection due to differential immune activation

Author: M. J. Davis, R. E. Martin, G. M. Pinheiro, E. S. Hoke, S. Moyer, K. Ueno, J. L. Rodriguez-Gil, M. A. Mallett, J. S. Khillan, W. J. Pavan, Y. C. Chang, and K. J. Kwon-Chung
Subjects: complement, Cryptococcus neoformans, Th1/Th2, atopic immunity, QTL analysis, Microbiology, QR1-502
Abstract: ABSTRACT Cryptococcosis remains a significant threat to human health. While the popular C57BL/6J mouse model of cryptococcosis has some advantages, there are some serious shortcomings that limit the ability of researchers to address the disease. Since humans are resistant to environmental cryptococcal infection until rendered immunodeficient while C57BL/6J mice are innately susceptible, we screened 15 inbred mouse strains for resistance to Cryptococcus infection. The SJL/J mouse strain was unusually resistant to several virulent strains of Cryptococcus while the closely related FVB/J strain was susceptible. The infection pathobiology in SJL/J mice and susceptible mice was similar for the first 7–10 days then markedly diverged toward pathogen clearance. Interferon-gamma (IFN-γ) expression was critical for SJL/J resistance while tumor necrosis factor-alpha was also important. Both CD4 and CD8 T cells produced IFN-γ and were collectively critical. While IL-17 and associated cytokines were expressed in SJL/J mice, IL-17 inhibition did not affect the outcome of infection. Unlike the C57BL/6J, infected SJL/J mice failed to express Th2/atopy-type cytokines even when rendered susceptible by IFN-γ blockade or infection with an alternative fatal cryptococcal strain virulent in SJL/J. These data suggest that the atopic-type response typically associated with the C57BL/6J model is not critical for susceptibility. The productive immune response in SJL/J mice resulted in immune memory that protected mice from reinfection. The SJL/J cryptococcal resistance phenotype was associated with a strong genetic linkage from regions located in chromosomes 2 and 11 suggesting strain-specific modifiers contribute to disease severity. Thus, SJL/J mice are an exciting alternative animal model for cryptococcal pathobiology. IMPORTANCE Cryptococcosis studies often utilize the common C57BL/6J mouse model. Unfortunately, infection in these mice fails to replicate the basic course of human disease, particularly hampering immunological studies. This work demonstrates that SJL/J mice can recapitulate human infection better than other mouse strains. The immunological response to Cryptococcus infection in SJL/J mice was markedly different from C57BL/6J and much more productive in combating this infection. Characterization of infected mice demonstrated strain-specific genetic linkage and differential regulation of multiple important immune-relevant genes in response to Cryptococcus infection. While our results validate many of the previously identified immunological features of cryptococcosis, we also demonstrate limitations from previous mouse models as they may be less translatable to human disease. We concluded that SJL/J mice more faithfully recapitulate human cryptococcosis serving as an exciting new animal model for immunological and genetic studies.
Published: 2023
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2. The Role of Design Features in the Affordances of Digital Math Games

Author: Patricia S. Moyer-Packenham, Christina W. Lommatsch, Kristy Litster, M. Jill Harmon, and Allison Roxburgh
Abstract: This paper reports on a large clinical study with 193 children (Grades 3-6) who interacted with 12 digital math games during clinical interviews. Children completed a pretest, interacted with the digital math games, completed a posttest, and answered questions about their interactions with the games. During the interviews, researchers used two video perspectives to capture children's interactions and onscreen gestures. Mixed methods were employed to analyze pretest and posttest data and to examine how the design features in each digital game afforded learning opportunities for children. The results showed that children exhibited different levels of awareness of the design features, some features helped or hindered different children, and children who were able to connect the digital games with the mathematics in the games exhibited higher learning gains.
Published: 2023

3. An Assessment of LGBTQ+ Cultural Competency and Attitudes of US Otolaryngologists

Author: Anuj Umesh Patel and Jeffrey S. Moyer MD, MS
Subjects: Otorhinolaryngology, RF1-547, Surgery, RD1-811
Abstract: Otolaryngologists can play a significant role in the care of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) patients through gender-affirming care and routine care in everyday practice. To avoid stigmatizing LGBTQ+ patients, otolaryngologists should maintain high levels of LGBTQ+ cultural competency; however, US otolaryngology programs offer limited amounts of LGBTQ+ topics in didactic curricula, and the LGBTQ+ cultural competency of otolaryngologists remains unknown. A cross-sectional survey of demographics, attitude questions, and the 7-point Likert LGBT–Development of Clinical Skills Scale was distributed to otolaryngologists across the United States. Otolaryngologists (n = 176) had moderately high Overall LGBTQ+ cultural competency (mean, 5.82; range, 3.83-7.00), moderately high Basic Knowledge (mean, 5.43; range, 1.53-7.00), moderately high Clinical Preparedness (mean, 5.34; range, 2.00-7.00), and high Attitudinal Awareness (mean, 6.51; range, 2.42-7.00). Attending otolaryngologists had significantly lower LGBTQ+ Basic Knowledge than residents and fellows ( P = .002). Further education at all levels of practice, including attendings, is necessary to improve LGBTQ+ cultural competency among otolaryngologists.
Published: 2022
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4. Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Hospitalized Patients During the First Year of the COVID-19 Pandemic

Author: Anna M. Cervantes-Arslanian, MD, Chakradhar Venkata, MD, Pria Anand, MD, Joseph D. Burns, MD, Charlene J. Ong, MD, Allison M. LeMahieu, MS, Phillip J. Schulte, PhD, Tarun D. Singh, MD, Alejandro A. Rabinstein, MD, Neha Deo, BS, Vikas Bansal, MBBS, MPH, Karen Boman, BS, Juan Pablo Domecq Garces, MD, Donna Lee Armaignac, PhD, APRN, Amy B. Christie, MD, Roman R. Melamed, MD, Yasir Tarabichi, MD, MSCR, Sreekanth R. Cheruku, MD, MPH, Ashish K. Khanna, MD, FCCP, FCCM, FASA, Joshua L. Denson, MD, MS, Valerie M. Banner-Goodspeed, MPH, Harry L. Anderson, III, MD, FACS, FICS, FCCM, FCCP, FAIM, Ognjen Gajic, MD, MS, Vishakha K. Kumar, MD, MBA, Allan Walkey, MD, Rahul Kashyap, MD, MBA, on behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Rolando Claure-Del Granado, Jose A. Mercado, Esdenka Vega-Terrazas, Maria F. Iturricha-Caceres, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Danijel knežević, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Dimitrios Kantas, Vasileios Koulouras, Estela Pineda, Gabina María Reyes Guillen, Helin Archaga Soto, Ana Karen Vallecillo Lizardo, Csaba Kopitkó, Ágnes Bencze, István Méhész, Zsófia Gerendai,, Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Sridhar Papani, Mahesh Kamuram, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Anusha Cherian, Sreejith Parameswaran, Magesh Parthiban, Phaneendra Doddaga, Neethi Chandra, Puneet Rijhwani, Ashish Jain, Aviral Gupta, Ram Mohan Jaiswal, Ambika Tyagi, Nimish Mathur, Madhav Prabhu, Vishal Jakati, Mukur Petrolwala, Bharat Ladva, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Nooshin Dalili, Mohsen Nafa, Wataru Matsuda, Reina Suzuki, Michihito Kyo, Shu Tahara, Mineji Hayakawa, Kunihiko Maekawa, Masamitsu Sanui, Sho Horikita, Yuki Itagaki, Akira Kodate, Yuki Takahashi, Koyo Moriki, Takuya Shiga, Yudai Iwasaki, Hidenobu Shigemitsu, Yuka Mishima, Nobuyuki Nosaka, Michio Nagashima, Abdulrahman Al-Fares, Rene Rodriguez-Gutierrez, Jose Gerardo Gonzalez-Gonzalez, Alejandro Salcido-Montenegro, Adrian Camacho-Ortiz, Mariana Janeth Hermosillo Ulloa, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh,, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Razan K Alamoudi, Hassan M. AlSharif, Sarah A. Almazwaghi, Mohammed S Elsakran, Mohamed A Aid, Mouaz A Darwich, Omnia M Hagag, Salah A Ali, Alona rocacorba, Kathrine Supeña, Efren Ray Juane, Jenalyn Medina, Jowany Baduria, Marwa Ridha Amer, Mohammed Abdullah, Bawazeer, Talal I. Dahhan, Eiad Kseibi, Abid Shahzad Butt, Syed Moazzum Khurshid, Muath Rabee, Mohammed Abujazar, Razan Alghunaim, Maal Abualkhair, Abeer Turki AlFirm, Yaseen M Arabi, Sheryl Ann Abdukahil, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Ana Andrijevic, Srdjan Gavrilovic, Vladimir Carapic, Bojan Kovacevic, Jovana Bojicic, Stevanovic Predrag, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Santiago Y. Teruel, Belen C. Martin, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Varsha P Gharpure, Usman Raheemi, Kenneth W. Dodd, Nicholas Goodmanson, Kathleen Hesse, Paige Bird, Chauncey Weinert, Nathan Schoenrade, Abdulrahman Altaher, Esmael Mayar, Matthew Aronson, Tyler Cooper, Monica Logan, Brianna Miner, Gisele Papo, Eric M. Siegal, Phyllis Runningen, Suzanne Barry, Christopher Woll, Gregory Wu, Erin Carrole, Kathryn Burke, Mustafa Mohammed, Roman R. Melamed, David M. Tierney, Love A. Patel, Vino S. Raj, Barite U. Dawud, Narayana Mazumder, Abbey Sidebottom, Alena M. Guenther, Benjamin D. Krehbiel, Nova J. Schmitz, Stacy L. Jepsen, Lynn Sipsey, Anna Schulte, Whitney Wunderlich, Cecely Hoyt, Abhijit A Raval, Andrea Franks, Katherine Irby, Ronald C. Sanders, Jr., Glenda Hefley, Jennifer M. Jarvis, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Jarrod M Mosier, Karen Lutrick, Beth Salvagio Campbell, Cathleen Wilson, Patrick Rivers, Jonathan Brinks, Mokenge Ndiva Mongoh, Boris Gilson, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Mahesh Amin, Mary E Schelle, Amanda Steadham, Christopher M Howard, Cameron McBride, Jocelyn Abraham, Orlando Garner, Katherine Richards, Keegan Collins, Preethi Antony, Sindhu Mathew, Valerie C. Danesh, Gueorgui Dubrocq, Amber L. Davis, Marissa J Hammers, ill M. McGahey, Amanda C. Farris, Elisa Priest, Robyn Korsmo, Lorie Fares, Kathy Skiles, Susan M. Shor, Kenya Burns, Corrie A Dowell, Gabriela “Hope” Gonzales, Melody Flores, Lindsay Newman, Debora A Wilk, Jason Ettlinger, Jaccallene Bomar, Himani Darji, Alejandro Arroliga, Alejandro C Arroliga, Corrie A. Dowell, Gabriela Hope Conzales, Debora A. Wilk, Paras B. Khandhar, Elizabeth Kring, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Maj Andrew M. Hersh, CPT Stephanie L Wachs, Brittany S. Swigger, Stephanie L Wachs, Capt Lauren A. Sattler, Capt Michael N. Moulton, Kimberly Zammit, Patrick, J McGrath, William Loeffler, Maya, R. Chilbert, Aaron S. Miller, Edwin L. Anderson, Rosemary Nagy, Ravali R. Inja, Pooja A. Nawathe, Isabel Pedraza, Jennifer Tsing, Karen Carr, Anila Chaudhary, Kathleen Guglielmino, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Rayan E. Ihle, Shelda A. Martin, Elaine A. Davis, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Kathleen Chiotos, Allison M. Blatz, Giyoung Lee, Ryan H. Burnett, Guy I. Sydney, Danielle M. Traynor, Karissa Nauert, Annika Gonzalez, Mariel Bagley, Anita Santpurkar, Salim Surani, Joshua White, Aftab Khan, Rahul Dhahwal, Sreekanth Cheruku, Farzin Ahmed, Christopher Deonarine, Ashley Jones, Mohammad-Ali Shaikh, David Preston, Jeanette Chin, Vidula Vachharajani, Abhijit Duggal, Prabalini Rajendram, Omar Mehkri, Siddharth Dugar, Michelle Biehl, Gretchen Sacha, Stuart Houltham, Alexander King, Kiran Ashok, Bryan Poynter, Mary Beukemann, Richard Rice, Susan Gole, Valerie Shaner, Adarsh Conjeevaram, Michelle Ferrari, Narendrakumar Alappan, Steven Minear, Jaime Hernandez-Montfort, Syed Sohaib Nasim, Ravi Sunderkrishnan, Debasis Sahoo, Patrick S. Milligan, Sandeep K. Gupta, Joy M. Koglin, Regina Gibson, Lana Johnson, Felicia Preston, Crimson Scott, Bethany Nungester, Dana D Byrne, Christa A Schorr, Katie Grant, Katherine L Doktor, Maura C Porto, Olga Kaplan, James E. Siegler, III, Brian Schonewald, Ashley Woodford, Alan Tsai, Savina Reid, Kuntal Bhowmick, Saba Daneshpooy, Cyrus Mowdawalla, Trishna Akshay Dave, Wilhemina Kennedy, Connor Crudeli, Christopher Ferry, Long Nguyen, Sneha Modi, Niharika Padala, Pavan Jitendra Patel, Belle Lin, Lena Chatterjee, Jamie Qiuyun, Fan Mandi Liu, Rasagna Kota, Annesha Banerjee, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, Sidney Ontai, Brian Contreras, Uzoma Obinwanko, Nneka Amamasi, Amir Sharafi, Sarah Lee, Zahia Esber, Chetna Jinjvadia, Raquel R Bartz, Vijay Krishnamoorthy, Bryan Kraft, Aaron Pulsipher, Eugene Friedman, Sachin Mehta, Margit Kaufman, Gregg Lobel, Nisha Gandhi, Amr Abdelaty, Elizabeth Shaji, Kiana Lim, Juan Marte, Dani Ashley Sosa, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Nicholas Perkins, Prera J. Roth, Banu Sivaraj, Haley Fulton, Madison G Herin, Marissa Crum, Morgan E. Fretwell, Emily-Rose Zhou, Christine Waller, Kara Kallies, Jonean Thorsen, Alec Fitzsimmons, Haley Olsen, Heda R. Dapul, Sourabh Verma, Alan Salas, Ariel Daube, Michelle Korn, Michelle Ramirez, Logi Rajagopalan, Laura Santos, Héctor Collazo Santiago, Ricardo Alan Hernandez, Norma Smalls, Asher G Bercow, Mark Shlomovich, Christine Crandall, Sasko Stojanovski, Kristin Johnson, Kelly Michienzi, Steven Q. Davis, Valentina Jovic, Max Masuda, Amanda Hayes, Katharine Nault, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, Namrata Nag, Jeff Brauer, Ashwin Dharmadhikari, Sahib Singh, Franco Laghi, Ghania Naeem, Andrew Wang, Kevin Bliden, Amit Rout, Jaime Barnes, Martin Gesheff, Asha Thomas, Melbin Thomas, Alicia R. Liendo, Jovan Milosavljevic, Kenan Abbasi, Nicholas B. Burley, Nicole Rapista, Samuel Amankwah, Sanjay K Poude, Saroj Timilsina, Sauradeep Sarkar, Oluwasayo Akinyosoye, Shashi K. Yalamanchili, Sheena Moorthy, Sonia Sugumar, Jonathan Ford, Martin C. Taylor, Charlotte Dunderdale, Alyssa Henshaw, Mary K. Brunk, Jessica Hagy, Shehryar Masood, Sushrutha Sridhar, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Namrata Patil, Ruhi Patil, Rodrigo Cartin-Ceba, Ayan Sen, Fahimeh Talaei, Rahul Kashyap, Juan Pablo Domecq, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Romil Singh, Diana J. Valencia Morales, Abigail T. La Nou, Marija Bogojevic, Simon Zec, Devang Sanghavi, Pramod Guru, Pablo Moreno Franco, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu Lee Mateus, Siva Naga Yarrarapu, Nirmaljot Kaur, Abhisekh Giri, Mohammed Mustafa Hasan, Ashrita Donepudi, Syed Anjum Khan, Nitesh Kumar Jain, Thoyaja Koritala, Alexander Bastidas, Gabriela Orellana, Adriana Briceno Bierwirth, Eliana Milazzo, Juan Guillermo Sierra, Thao Dang, Rahul S Nanchal, Paul A Bergl, Jennifer L Peterson, Jessica Timmer, Kimberly Welker, Travis Yamanaka, Nicholas A. Barreras, Michael Markos, Anita Fareeduddin, Rohan Mehta, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Yasir Tarabichi, Adam Perzynski, Christine Wang, Dhatri Kotekal, Adriana C Briceno Bierwirth, Gabriela M Orellana, Gerardo Catalasan, Shohana Ahmed, Carlos F Matute, Ahmad Hamdan, Ivania Salinas, Genesis Del Nogal, Angel Tejada, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Jen-Ting Chen, Aluko Hope, Zoe Tsagaris, Elise Ruen, Aram Hambardzumyan, Nasar A Siddiqi, Lesly Jurado, Lindsey Tincher, Carolyn Brown, Prithvi Sendi, Meghana Nadiger, Balagangadhar Totapally, Bhagat S. Aulakh, Sandeep Tripathi, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Neha Gupta, Brent R Brown, Tracy L Jones, Kassidy Malone, Lauren A Sinko, Amy B Harrell, Shonda C Ayers, Lisa M Settle, Taylor J Sears, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Roberta E. Redfern, Jessica Shoemaker, Jennifer Micham, Lynn Kenney, Gabriel Naimy, Victoria Schauf, Sara Utley, Holly Balcer, Kerry P. J. Pulver, Jennifer Yehle, Alicia Weeks, Terra Inman, Majdi Hamarshi, Jeannette Ploetz, Nick Bennett, Kyle Klindworth, Moustafa Younis, Adham Mohamed, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Diane Barkas, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Shina Menon, John K McGuire, Deana Rich, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, John Lin, Cindy Terrill, Brock Montgomery, Sydney Reyes, Summer Reyes, Alex Plattner, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Umang Patel, Jordesha Hodge, Krunal Kumar Patel, Shivani Dalal, Himanshu Kavani, Sam Joseph, Michael A. Bernstein, Ian K. Goff, Matthew Naftilan, Amal Mathew, Deborah Williams, Sue Murdock, Maryanne Ducey, Kerianne Nelson, Jason Block, James Mitchel, Connor G O’Brien, Sylvan Cox, William Marx, Ioana Amzuta, Asad J. Choudhry, Mohammad T. Azam, Kristina L Carter, Michael A Olmos, Brittany M Parker, Julio Quintanilla, Tara A Craig, Brendon J Clough, Jeffrey T Jameson, Utpal S. Bhalala, Joshua Kuehne, Melinda Garcia, Morgan Beebe, Heather Herrera, Chris Fiack, Stephanie Guo, May Vawer, Beth Blackburn, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mary Barletta, Mark Steele, Laurie Kemble, Joshua L. Denson, A. Scott Gillet, Margo Brown, Rachael Stevens, Andrew Wetherbie, Kevin Tea, Mathew Moore, Abdurrahman Husain, Atul Malhotra, Qais Zawaydeh, Benjamin J Sines, Thomas J Bice, Emily A. Vail, Susannah Nicholson, Rachelle B. Jonas, AnnaRose E. Dement, William Tang, Mark DeRosa, Robert E. Villarreal, Rajany V. Dy, Alfredo Iardino, Jill Sharma, Richard Czieki, Julia Christopher, Ryan Lacey, Marwan Mashina, Kushal Patel, Erica C. Bjornstad, Nancy M. Tofil, Scott House, Isabella Aldana, Nikhil K. Meena, Jose D. Caceres, Nikhil K Meena, Sarenthia M. Epps, Harmeen Goraya, Kelsey R. Besett, Ryan James, Lana Y. Abusalem, Akash K. Patel, Lana S Hasan, Dina Gomaa, Michael Goodman, Devin Wakefield, Anthony Spuzzillo, John O. Shinn II, Robert MacLaren, Azra Bihorac, Tezcan Ozrazgat Baslanti, George Omalay, Haleh Hashemighouchani, Julie S. Cupka, Matthew M Ruppert, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Vicki Montgomery, Janice Sullivan, Sarah Morris, Jennifer Nason, Ozan Akca, Rainer Lenhardt, Rodrigo S. Cavallazzi, Ann Jerde, Alexa Black, Allison Polidori, Haily Griffey, Justin Winkler, Thomas Brenzel, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Pauline Park, Andrew Admon, Sinan Hanna, Rishi Chanderraj, Maria Pliakas, Ann Wolski, Jennifer Cirino, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Faraaz Ali Shah, Byron Chuan, Sagar L. Rawal, Manal Piracha, Joseph E. Tonna, Nicholas M. Levin, Kayte Suslavich, Rachel Tsolinas, Zachary T. Fica, Chloe R. Skidmore, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Nita Khandelwal, T. Eoin West, Ellen S. Caldwell, Lara Lovelace-Macon, Navya Garimella, Denisse B. Dow, Sreekanth R. Cheruku, Catherine Chen, Murtaza Akhter, Rania Abdul Rahman, Mary Mulrow, Erin M. Wilfong, Kelsi Vela, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Patrick G. Lyons, Andrew P Michelson, Sara S. Haluf, Lauren M. Lynch, Nguyet M. Nguyen, Aaron Steinberg, Nicholas Braus, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, Samuel Chakola, Kevin Sheth, Abdalla Ammar, Mahmoud Ammar, Victor Torres Lopez, Charles Dela Cruz,, Akhil Khosla, and Samir Gautam
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.
Published: 2022
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5. Variation in Use of Repurposed Medications Among Patients With Coronavirus Disease 2019. From The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: Coronavirus Disease 2019 Registry Investigator Group

Author: Michael A. Garcia, MD, Shelsey W. Johnson, MD, Nicholas A. Bosch, MD, MSc, Emily K. Sisson, MA, Christopher R. Sheldrick, PhD, Vishakha K. Kumar, MD, MBA, Karen Boman, BS, Scott Bolesta, PharmD, Vikas Bansal, MBBS, MPH, Neha Deo, BS, J. P. Domecq, MD, Amos Lal, MD, Amy B. Christie, MD, Valerie M. Banner-Goodspeed, MPH, Devang Sanghavi, MD, MHA, Girish Vadgaonkar, MBBS, Ognjen Gajic, MD, MSc, Rahul Kashyap, MBBS, MBA, Allan J. Walkey, MD, MSc, for the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study Investigators, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Dragana Markotić, Ivana Bošnjak, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Jose Luis Ramos Coello, Guillermo Perez, Ana Karen Vallecillo Lizardo, Gabina María Reyes Guillen, Helin Archaga Soto, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Sridhar Papani, Mahesh Kamuram, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Wataru Matsuda, Reina Suzuki, Michihito Kyo, Yuki Itagaki, Akira Kodate, Yuki Takahashi, Koyo Moriki, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Bojan Kovacevic, Jovana Bojicic, Predrag D Stevanovic, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Santiago Y. Teruel, Belen C. Martin, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Abhijit A Raval, Andrea Franks, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Kimberly Zammit, Patrick, J McGrath, William Loeffler, Maya, R Chilbert, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Norma Smalls, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Rodrigo Cartin-Ceba, Ayan Sen, Amanda Palacios, Giyth M. Mahdi, Rahul Kashyap, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Juan Pablo Domecq, Romil Singh, Alex Niven, Abigail La Nou, Marija Bogojevic, Barbara Mullen, Devang Sanghavi, Pablo Moreno Franco, Pramod Guru, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu, Lee Mateus, Siva Naga Yarrarapu, Nirmaljot Kaur, Abhisekh Giri, Syed Anjum Khan, Nitesh Kumar Jain, Thoyaja Koritala, Jessica Timmer, Kimberly Welker, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Bhagat S. Aulakh, Sandeep Tripathi, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Paul K Mohabir, Connor G O’Brien, Komal Dasani, Neha Gupta, Tracy L Jones, Shonda C Ayers, Amy B Harrell, Brent R Brown, Megan Edwards, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mary Barletta, Mary Ferranti, Benjamin J Sines, Thomas J Bice, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, Samuel Chakola, Kevin Sheth, Abdalla Ammar, Mahmoud Ammar, Victor Torres Lopez, Charles Dela Cruz, Akhil Khosla, and Samir Gautam
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: IMPORTANCE:. At the start of the coronavirus disease 2019 pandemic, medications repurposed for management of coronavirus disease 2019 were used in the absence of clinical trial evidence. OBJECTIVES:. To describe the variation and evolution in use of repurposed medications for coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Observational cohort study of adults hospitalized with coronavirus disease 2019 between February 15, 2020, and April 12, 2021, across 76 United States and international hospitals within the Society of Critical Care Medicine’s Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry. MAIN OUTCOMES AND MEASURES:. Hospital variation was quantified using multivariable adjusted random effects logistic regression models and unsupervised clustering. Repurposed medications included antivirals, corticosteroids, hydroxychloroquine, immunomodulators, and therapeutic dose anticoagulants. RESULTS:. Among 7,069 adults hospitalized with coronavirus disease 2019, 1,979 (28%) received antivirals, 2,876 (41%) received corticosteroids, 1,779 (25%) received hydroxychloroquine, 620 (9%) received immunomodulators, and 2,154 (31%) received therapeutic dose anticoagulants. Contribution of hospital site to risk-adjusted variation was 46% for antivirals, 30% for corticosteroids, 48% for hydroxychloroquine, 46% for immunomodulators, and 52% for therapeutic dose anticoagulants. Compared with the early pandemic, the later pandemic practice phenotypes converged with increased use of antivirals (odds ratio, 3.14; 95% CI, 2.40–4.10) and corticosteroids (odds ratio, 5.43; 95% CI, 4.23–6.97), with decreased use of hydroxychloroquine (odds ratio, 0.02; 95% CI, 0.01–0.04) and immunomodulators (odds ratio, 0.49; 95% CI, 0.34–0.70). There was no clinically significant change in the use of therapeutic dose anticoagulants (odds ratio, 1.01; 95% CI, 1.01–1.02). There were no differences in risk-adjusted mortality between hospitals with high rates of repurposed medication use compared with hospitals with low rates of use. CONCLUSIONS AND RELEVANCE:. Hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. Platforms developed for rapid activation and enrollment in clinical trials of repurposed medications are needed prior to the next pandemic to expedite effective, evidence-based practice.
Published: 2021
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6. Risk Factors for Critical Coronavirus Disease 2019 and Mortality in Hospitalized Young Adults: An Analysis of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) Coronavirus Disease 2019 Registry

Author: Sandeep Tripathi, MD, MS, Imran A. Sayed, MD, Heda Dapul, MD, Jeremy S. McGarvey, MS, Jennifer A. Bandy, RN, Karen Boman, BS, Vishakha K. Kumar, MD, MBA, Vikas Bansal, MBBS, MPH, Lynn Retford, CAE, Sreekanth Cheruku, MD, MPH, Margit Kaufman, MD, FASA, Smith F. Heavner, MS, RN, Valerie C. Danesh, PhD, RN, Catherine A. St. Hill, DVM, PhD, Ashish K. Khanna, MD, Utpal Bhalala, MD, Rahul Kashyap, MBBS, MBA, Ognjen Gajic, MD, MS, Allan J. Walkey, MD, MS, Katja M. Gist, DO, MSc, for The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group, Jean-Baptiste Mesland, Pierre Henin, Hélène Petre, Isabelle Buelens, Anne-Catherine Gerard, Philippe Clevenbergh, Rolando Claure-Del Granado, Jose A. Mercado, Esdenka Vega-Terrazas, Maria F. Iturricha-Caceres, Ruben Garza, Eric Chu, Victoria Chan, Oscar Y Gavidia, Felipe Pachon, Yeimy A Sanchez, Mohamed El Kassas, Mohamed Badr, Ahmed Tawheed, Hend Yahia, Sierra-Hoffman, Fernando Valerio, Oscar Diaz, Jose Luis Ramos Coello, Guillermo Perez, Ana Karen Vallecillo Lizardo, Gabina María Reyes Guillen, Helin Archaga Soto, Mradul Kumar Daga, Munisha Agarwal, Ishan Rohtagi, Anusha Cherian, Sreejith Parameswaran, Magesh Parthiban, Menu Priya A., Girish Vadgaonkar, Rekha Ediga, Shilpa Basety, Shwetha Dammareddy, Phani Sreeharsha Kasumalla, Sridhar Papani, Mahesh Kamuram, Smitha S. Segu, Tuhin Chakraborty, Epcebha Joyce, Umamaheswara Raju, Janaki Manduva, Naresh Kolakani, Shreeja Sripathi, Sheetal Chaitanya, Surapaneni Krishna Mohan, Ekambaram Jyothisree, Kamlesh Kumar Agrawal, Vijendra Baghel, Kirti Kumar Patel, Nooshin Dalili, Mohsen Nafa, Sandeep Tripathi, Yuki Itagaki, Akira Kodate, Reina Suzuki, Yuki Takahashi, Koyo Moriki, Michihito Kyo, Masamitsu Sanui, Sho Horikita, Wataru Matsuda, Shu Tahara, Mineji Hayakawa, Kunihiko Maekawa, Takuya Shiga, Yudai Iwasaki, Abdulrahman AlFares, Rene Rodriguez-Gutierrez, Jose Gerardo Gonzalez-Gonzalez, Alejandro Salcido-Montenegro, Adrian Camacho-Ortiz, Fatimah Hassan-Hanga, Hadiza Galadanci, Abubakar Shehu Gezawa, Halima M. S. Kabara, Taiwo Gboluwaga Amole, Halima Kabir, Dalha Gwarzo, Haliru, Abdullahi S Ibrahim, Muhammad Sohaib Asghar, Mashaal Syed, Syed Anosh Ali Naqvi, Igor Borisovich Zabolotskikh, Konstantin Dmitrievich Zybin, Sergey Vasilevich Sinkov, Tatiana Sergeevna Musaeva, Marwa Ridha Amer, Mohammed Abdullah Bawazeer, Talal I. Dahhan, Eiad Kseibi, Abid Shahzad Butt, Syed Moazzum Khurshid, Muath Rabee, Mohammed Abujazar, Razan Alghunaim, Maal Abualkhair, Abeer Turki AlFirm, Razan K Alamoudi, Hassan M. AlSharif, Sarah A. Almazwaghi, Mohammed S Elsakran, Mohamed A Aid, Mouaz A Darwich, Omnia M Hagag, Salah A Ali, Alona rocacorba, Kathrine Supeña, Efren Ray Juane, Jenalyn Medina, Jowany Baduria, Mohammed A Almazyad, Mohammed I Alarifi, Jara M Macarambon, Ahmad Abdullah Bukhari, Hussain A. Albahrani, Kazi N Asfina, Kaltham M Aldossary, Predrag D Stevanovic, Dejan S Stojakov, Duska K Ignjatovic, Suzana C Bojic, Marina M Bobos, Irina B Nenadic, Milica S Zaric, Marko D Djuric, Vladimir R Djukic, Bojan Kovacevic, Jovana Bojicic, Marija Zdravkovic, Zoran Todorovic, Viseslav Popadic, Slobodan Klasnja, Santiago Y. Teruel, Belen C. Martin, Himat Sulaimonov, Firuza Khudonazarova, Nabi Bakhtibekov, Nekruz Jamshedov, Uluhan Sili, Huseyin Bilgin, Pinar Ay, Varsha P Gharpure, Usman Raheemi, Kenneth W. Dodd, Nicholas Goodmanson, Kathleen Hesse, Paige Bird, Chauncey Weinert, Nathan Schoenrade, Abdulrahman Altaher, Esmael Mayar, Matthew Aronson, Tyler Cooper, Monica Logan, Brianna Miner, Gisele Papo, Eric M. Siegal, Phyllis Runningen, Catherine A. St. Hill, Roman R. Melamed, David M. Tierney, Love A. Patel, Vino S. Raj, Barite U. Dawud, Narayana Mazumder, Abbey Sidebottom, Alena M. Guenther, Benjamin D. Krehbiel, Nova J. Schmitz, Stacy L. Jepsen, Abhijit A Raval, Andrea Franks, Katherine Irby, Ronald C. Sanders, Jr., Glenda Hefley, Anmol Kharbanda, Sunil Jhajhria, Zachary Fyffe, Stephen Capizzi, Bethany Alicie, Martha Green, Lori Crockarell, Amelia Drennan, Kathleen Dubuque, Tonya Fambrough, Nikole Gasaway, Briana Krantz, Peiman Nebi, Jan Orga, Margaret Serfass, Alina Simion, Kimberly Warren, Cassie Wheeler, CJ Woolman, Andrew S. Moyer, George M. Verghese, Andrea Sikora Newsome, Christy C. Forehand, Rebecca Bruning, Timothy W. Jones, Moldovan Sabov, Fatema Zaidi, Fiona Tissavirasingham, Dhatri Malipeddi, Jarrod M Mosier, Karen Lutrick, Beth Salvagio Campbell, Cathleen Wilson, Patrick Rivers, Jonathan Brinks, Mokenge Ndiva Mongoh, Boris Gilson, Donna Lee Armaignac, Don Parris, Maria Pilar Zuniga, Ilea Vargas, Viviana Boronat, Anneka Hutton, Navneet Kaur, Prashank Neupane, Nohemi Sadule-Rios, Lourdes M. Rojas, Aashish Neupane, Priscilla Rivera, Carlos Valle Carlos, Gregory Vincent, Mahesh Amin, Mary E Schelle, Amanda Steadham, Christopher M Howard, Cameron McBride, Jocelyn Abraham, Orlando Garner, Katherine Richards, Keegan Collins, Preethi Antony, Sindhu Mathew, Valerie C. Danesh, Gueorgui Dubrocq, Amber L. Davis, Marissa J Hammers, ill M. McGahey, Amanda C. Farris, Elisa Priest, Robyn Korsmo, Lorie Fares, Kathy Skiles, Susan M. Shor, Kenya Burns, Corrie A Dowell, Melody Flores, Lindsay Newman, Debora A Wilk, Jason Ettlinger, Jaccallene Bomar, Himani Darji, Alejandro Arroliga, Alejandro C Arroliga, Corrie A. Dowell, Gabriela Hope Conzales, Debora A. Wilk, Paras B. Khandhar, Elizabeth Kring, Valerie M. Banner-Goodspeed, Somnath Bose, Lauren E. Kelly, Melisa Joseph, Marie McGourty, Krystal Capers, Benjamin Hoenig, Maria C. Karamourtopoulos, Anica C. Law, Elias N. Baedorf Kassis, Allan J. Walkey, Sushrut S. Waikar, Michael A. Garcia, Mia Colona, Zoe Kibbelaar, Michael Leong, Daniel Wallman, Kanupriya Soni, Jennifer Maccarone, Joshua Gilman, Ycar Devis, Joseph Chung, Munizay Paracha, David N. Lumelsky, Madeline DiLorenzo, Najla Abdurrahman, Shelsey Johnson, Andrew M. Hersh, Stephanie L Wachs, Brittany S. Swigger, Lauren A. Sattler, Michael N. Moulton, Kimberly Zammit, J Patrick, William McGrath, Maya Loeffler, R Chilbert, Aaron S. Miller, Edwin L. Anderson, Rosemary Nagy, Ravali R. Inja, Raghavendra Tirupathi, Alymer Tang, Arshad Safi, Cindy Green, Jackie Newell, Rayan E. Ihle, Shelda A. Martin, Elaine A. Davis, Katja M. Gist, Imran A Sayed, John Brinton, Larisa Strom, Kathleen Chiotos, Allison M. Blatz, Giyoung Lee, Ryan H. Burnett, Guy I. Sydney, Danielle M. Traynor, Karissa Nauert, Annika Gonzalez, Mariel Bagley, Anita Santpurkar, Salim Surani, Joshua White, Aftab Khan, Rahul Dhahwal, Sreekanth Cheruku, Farzin Ahmed, Christopher Deonarine, Ashley Jones, Mohammad-Ali Shaikh, David Preston, Jeanette Chin, Vidula Vachharajani, Abhijit Duggal, Prabalini Rajendram, Omar Mehkri, Siddharth Dugar, Michelle Biehl, Gretchen Sacha, Stuart Houltham, Alexander King, Kiran Ashok, Bryan Poynter, Mary Beukemann, Richard Rice, Susan Gole, Valerie Shaner, Adarsh Conjeevaram, Michelle Ferrari, Narendrakumar Alappan, Steven Minear, Jaime Hernandez-Montfort, Syed Sohaib Nasim, Ravi Sunderkrishnan, Debasis Sahoo, Patrick S. Milligan, Sandeep K. Gupta, Joy M. Koglin, Regina Gibson, Lana Johnson, Felicia Preston, Crimson Scott, Bethany Nungester, Steven K. Daugherty, Sam Atkinson, Kelly Shrimpton, Sidney Ontai, Brian Contreras, Uzoma Obinwanko, Nneka Amamasi, Amir Sharafi, Sarah Lee, Zahia Esber, Chetna Jinjvadia, Kimberly Welker, Francis M. Maguire, Jessica Timmer, Raquel R Bartz, Vijay Krishnamoorthy, Bryan Kraft, Aaron Pulsipher, Eugene Friedman, Sachin Mehta, Margit Kaufman, Gregg Lobel, Nisha Gandhi, Amr Abdelaty, Elizabeth Shaji, Kiana Lim, Juan Marte, Dani Ashley Sosa, David P. Yamane, Ivy Benjenk, Nivedita Prasanna, Smith F. Heavner-Sullivan, Prera J. Roth, Banu Sivaraj, Haley Fulton, Madison G Herin, Marissa Crum, Morgan E. Fretwell, Emily-Rose Zhou, Christine Waller, Kara Kallies, Jonean Thorsen, Alec Fitzsimmons, Haley Olsen, Heda R. Dapul, Sourabh Verma, Alan Salas, Ariel Daube, Michelle Korn, Michelle Ramirez, Logi Rajagopalan, Laura Santos, Orma Smalls, Atul Malhotra, Abdurrahman Husain, Qais Zawaydeh, J.H. Steuernagle, Steven Q. Davis, Valentina Jovic, Max Masuda, Amanda Hayes, Katharine Nault, Michael Smith, William Snow, Riley Liptak, Hannah Durant, Valerie Pendleton, Alay Nanavati, Risa Mrozowsk, LiManoj K Gupta, Franscene E. Oulds, Akshay Nandavar, Yuk Ming Liu, Sarah Zavala, Esther Shim, Ronald A. Reilkoff, Julia A. Heneghan, Sarah Eichen, Lexie Goertzen, Scott Rajala, Ghislaine Feussom, Ben Tang, Christine C. Junia, Robert Lichtenberg, Hasrat Sidhu, Diana Espinoza, Shelden Rodrigues, Maria Jose Zabala, Daniela Goyes, Ammu Susheela, Buddhi Hatharaliyadda, Naveen Rameshkumar, Amulya Kasireddy, Genessis Maldonado, Lisseth Beltran, Akshata Chaugule, Hassan Khan, Namrata Patil, Ruhi Patil, Rodrigo Cartin-Ceba, Ayan Sen, Amanda Palacios, Giyth M. Mahdi, Rahul Kashyap, Ognjen Gajic, Vikas Bansal, Aysun Tekin, Amos Lal, John C. O’Horo, Neha N. Deo, Mayank Sharma, Shahraz Qamar, Cory J. Kudrna, Juan Pablo Domecq Garces, Abigail T. La Nou, Marija Bogojevic, Devang Sanghavi, Pramod Guru, Karthik Gnanapandithan, Hollie Saunders, Zachary Fleissner, Juan Garcia, Alejandra Yu Lee Mateus, Siva Naga Yarrarapu, Syed Anjum Khan, Juan Pablo Domecq, Nitesh Kumar Jain, Thoyaja Koritala, Alexander Bastidas, Gabriela Orellana, Adriana Briceno Bierwirth, Eliana Milazzo, Juan Guillermo Sierra, Thao Dang, Amy B. Christie, Dennis W. Ashley, Rajani Adiga, Rahul S Nanchal, Paul A Bergl, Jennifer L Peterson, Travis Yamanaka, Nicholas A. Barreras, Michael Markos, Anita Fareeduddin, Rohan Mehta, Chakradhar Venkata, Miriam Engemann, Annamarie Mantese, Yasir Tarabichi, Adam Perzynski, Christine Wang, Dhatri Kotekal, Adriana C Briceno Bierwirth, Gabriela M Orellana, Gerardo Catalasan, Shohana Ahmed, Carlos F Matute, Ahmad Hamdan, Ivania Salinas, Genesis Del Nogal, Angel Tejada, Anna Eschler, Mary Hejna, Emily Lewandowski, Kristen Kusmierski, Clare Martin, Jen-Ting Chen, Aluko Hope, Zoe Tsagaris, Elise Ruen, Aram Hambardzumyan, Prithvi Sendi, Meghana Nadiger, Balagangadhar Totapally, Bhagat S. Aulakh, Jennifer A. Bandy, Lisa M. Kreps, Dawn R. Bollinger, Roger Scott Stienecker, Andre G. Melendez, Tressa A. Brunner, Sue M Budzon, Jessica L. Heffernan, Janelle M. Souder, Tracy L. Miller, Andrea G. Maisonneuve, Roberta E. Redfern, Jessica Shoemaker, Jennifer Micham, Lynn Kenney, Gabriel Naimy, Sara Utley, Holly Balcer, Kerry P. J. Pulver, Jennifer Yehle, Alicia Weeks, Terra Inman, Brian L. Delmonaco, Anthony Franklin, Mitchell Heath, Antonia L. Vilella, Sara B. Kutner, Kacie Clark, Danielle Moore, Shina Menon, John K McGuire, Deana Rich, Harry L. Anderson, III, Dixy Rajkumar, Ali Abunayla, Jerrilyn Heiter, Howard A. Zaren, Stephanie J. Smith, Grant C. Lewis, Lauren Seames, Cheryl Farlow, Judy Miller, Gloria Broadstreet, John Lin, Cindy Terrill, Brock Montgomery, Sydney Reyes, Summer Reyes, Alex Plattner, Anthony Martinez, Micheal Allison, Aniket Mittal, Rafael Ruiz, Aleta Skaanland, Robert Ross, Umang Patel, Jordesha Hodge, KrunalKumar Patel, Shivani Dalal, Himanshu Kavani, Sam Joseph, Michael A. Bernstein, Ian K. Goff, Matthew Naftilan, Amal Mathew, Deborah Williams, Sue Murdock, Maryanne Ducey, Kerianne Nelson, Paul K Mohabir, Connor G O’Brien, Komal Dasani, William Marx, Ioana Amzuta, Asad J. Choudhry, Mohammad T. Azam, Kristina L Carter, Michael A Olmos, Brittany M Parker, Julio Quintanilla, Tara A Craig, Brendon J Clough, Jeffrey T Jameson, Neha Gupta, Tracy L Jones, Shonda C Ayers, Amy B Harrell, Dr.Brent R Brown, Utpal S. Bhalala, Joshua Kuehne, Melinda Garcia, Morgan Beebe, Heather Herrera, Chris Fiack, Stephanie Guo, May Vawer, Beth Blackburn, Megan Edwards, Caleb Darby, Kristy Page, Amanda Brown, Jessie McAbee, Katherine A. Belden, Michael Baram, Devin M. Weber, Rosalie DePaola, Yuwei Xia, Hudson Carter, Aaron Tolley, Mark Steele, Laurie Kemble, Joshua L. Denson, A. Scott Gillet, Margo Brown, Rachael Stevens, Andrew Wetherbie, Kevin Tea, Mathew Moore, Benjamin J Sines, Thomas J Bice, Emily A. Vail, Susannah Nicholson, Rachelle B. Jonas, AnnaRose E. Dement, William Tang, Mark DeRosa, Robert E. Villarreal, Rajany V. Dy, Alfredo Iardino, Jill Sharma, Richard Czieki, Julia Christopher, Ryan Lacey, Marwan Mashina, Kushal Patel, Erica C. Bjornstad, Nancy M. Tofil, Scott House, Isabella Aldana, Nikhil K. Meena, Jose D. Caceres, Nikhil K Meena, Sarenthia M. Epps, Harmeen Goraya, Kelsey R. Besett, Ryan James, Lana Y. Abusalem, Akash K. Patel, Lana S Hasan, Dina Gomaa, Michael Goodman, Devin Wakefield, Anthony Spuzzillo, John O. Shinn, II, Azra Bihorac, Tezcan Ozrazgat Baslanti, George Omalay, Haleh Hashemighouchani, Julie S. Cupka, Matthew M Ruppert, Patrick W. McGonagill, Colette Galet, Janice Hubbard, David Wang, Lauren Allan, Aditya Badheka, Madhuradhar Chegondi, Usman Nazir, Garrett Rampon, Jake Riggle, Nathan Dismang, Vicki Montgomery, Janice Sullivan, Sarah Morris, Jennifer Nason, Roger A. Alvarez, Amarilys Alarcon-Calderon, Marie Anne Sosa, Sunita K. Mahabir, Mausam J. Patel, Pauline Park, Andrew Admon, Sinan Hanna, Rishi Chanderraj, Maria Pliakas, Ann Wolski, Jennifer Cirino, Dima Dandachi, Hariharan Regunath, Maraya N. Camazine, Grant. E. Geiger, Abdoulie O. Njai, Baraa M. Saad, Faraaz Ali Shah, Byron Chuan, Sagar L. Rawal, Manal Piracha, Joseph E. Tonna, Nicholas M. Levin, Kayte Suslavich, Rachel Tsolinas, Zachary T. Fica, Chloe R. Skidmore, Renee D. Stapleton, Anne E. Dixon, Olivia Johnson, Sara S. Ardren, Stephanie Burns, Anna Raymond, Erika Gonyaw, Kevin Hodgdon, Chloe Housenger, Benjamin Lin, Karen McQuesten, Heidi Pecott-Grimm, Julie Sweet, Sebastian Ventrone, Nita Khandelwal, T. Eoin West, Ellen S. Caldwell, Lara Lovelace-Macon, Navya Garimella, Denisse B. Dow, Murtaza Akhter, Rania Abdul Rahman, Mary Mulrow, Erin M. Wilfong, Kelsi Vela, Ashish K. Khanna, Lynne Harris, Bruce Cusson, Jacob Fowler, David Vaneenenaam, Glen McKinney, Imoh Udoh, Kathleen Johnson, Patrick G. Lyons, Andrew P Michelson, Sara S. Haluf, Lauren M. Lynch, Nguyet M. Nguyen, Aaron Steinberg, Nicholas Braus, Vishwanath Pattan, Jessica Papke, Ismail Jimada, Nida Mhid, and Samuel Chakola
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: IMPORTANCE:. Even with its proclivity for older age, coronavirus disease 2019 has been shown to affect all age groups. However, there remains a lack of research focused primarily on the young adult population. OBJECTIVES:. To describe the epidemiology and outcomes of coronavirus disease 2019 and identify the risk factors associated with critical illness and mortality in hospitalized young adults. DESIGN, SETTINGS, AND PARTICIPANTS:. A retrospective cohort study of the Society of Critical Care Medicine’s Viral Infection and Respiratory Illness Universal Study registry. Patients 18–40 years old, hospitalized from coronavirus disease 2019 from March 2020 to April 2021, were included in the analysis. MAIN OUTCOMES AND MEASURES:. Critical illness was defined as a composite of mortality and 21 predefined interventions and complications. Multivariable logistic regression was used to assess associations with critical illness and mortality. RESULTS:. Data from 4,005 patients (152 centers, 19 countries, 18.6% non-U.S. patients) were analyzed. The median age was 32 years (interquartile range, 27–37 yr); 51% were female, 29.4% Hispanic, and 42.9% had obesity. Most patients (63.2%) had comorbidities, the most common being hypertension (14.5%) and diabetes (13.7%). Hospital and ICU mortality were 3.2% (129/4,005) and 8.3% (109/1,313), respectively. Critical illness occurred in 25% (n = 996), and 34.3% (n = 1,376) were admitted to the ICU. Older age (p = 0.03), male sex (adjusted odds ratio, 1.83 [95% CI, 1.2–2.6]), and obesity (adjusted odds ratio, 1.6 [95% CI, 1.1–2.4]) were associated with hospital mortality. In addition to the above factors, the presence of any comorbidity was associated with critical illness from coronavirus disease 2019. Multiple sensitivity analyses, including analysis with U.S. patients only and patients admitted to high-volume sites, showed similar risk factors. CONCLUSIONS:. Among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.
Published: 2021
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7. Reducing Risks of Graft Failure for Composite Skin–Cartilage Grafts

Author: Alisa Yamasaki, Sarah M. Dermody, and Jeffrey S. Moyer
Subjects: Surgery
Published: 2023
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8. Prevalence of unmasked and improperly masked behavior in indoor public areas during the COVID-19 pandemic: Analysis of a stratified random sample from Louisville, Kentucky.

Author: Seyed M Karimi, Sonali S Salunkhe, Kelsey B White, Bert B Little, W Paul McKinney, Riten Mitra, YuTing Chen, Emily R Adkins, Julia A Barclay, Emmanuel Ezekekwu, Caleb X He, Dylan M Hurst, Martha M Popescu, Devin N Swinney, David A Johnson, Rebecca Hollenbach, Sarah S Moyer, and Natalie C DuPré
Subjects: Medicine, Science
Abstract: Wearing a facial mask can limit COVID-19 transmission. Measurements of communities' mask use behavior have mostly relied on self-report. This study's objective was to devise a method to measure the prevalence of improper mask use and no mask use in indoor public areas without relying on self-report. A stratified random sample of retail trade stores (public areas) in Louisville, Kentucky, USA, was selected and targeted for observation by trained surveyors during December 14-20, 2020. The stratification allowed for investigating mask use behavior by city district, retail trade group, and public area size. The total number of visited public areas was 382 where mask use behavior of 2,080 visitors and 1,510 staff were observed. The average prevalence of mask use among observed visitors was 96%, while the average prevalence of proper use was 86%. In 48% of the public areas, at least one improperly masked visitor was observed and in 17% at least one unmasked visitor was observed. The average prevalence of proper mask use among staff was 87%, similar to the average among visitors. However, the percentage of public areas where at least one improperly masked staff was observed was 33. Significant disparities in mask use and its proper use were observed among both visitors and staff by public area size, retail trade type, and geographical area. Observing unmasked and improperly masked visitors was more common in small (less than 1500 square feet) public areas than larger ones, specifically in food and grocery stores as compared to other retail stores. Also, the majority of the observed unmasked persons were male and middle-aged.
Published: 2021
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9. A Comparison of Pulsed Dye Laser and Dermabrasion After Nasal Reconstruction

Author: Natalie Justicz, C. Yoonhee Ryder, Shannon F. Rudy, Emily L. Bellile, Jennifer C. Kim, Shan Baker, and Jeffrey S. Moyer
Subjects: Surgery
Published: 2023
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10. Supplementary Figures 1-2, Table 1 from Cancer Stem Cell Vaccination Confers Significant Antitumor Immunity

Author: Qiao Li, Alfred E. Chang, Shiang Huang, Xiao-Lian Zhang, Yingxin Xu, Mark E.P. Prince, Jeffrey S. Moyer, Max S. Wicha, Christophe Ginestier, Mu Li, Ji Yet, Martin Egenti, Seagal Teitz-Tennenbaum, Fang Zheng, Qin Pan, and Ning Ning
Abstract: PDF file - 185K
Published: 2023
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11. Supplementary Table 2 from Cancer Stem Cell Vaccination Confers Significant Antitumor Immunity

Author: Qiao Li, Alfred E. Chang, Shiang Huang, Xiao-Lian Zhang, Yingxin Xu, Mark E.P. Prince, Jeffrey S. Moyer, Max S. Wicha, Christophe Ginestier, Mu Li, Ji Yet, Martin Egenti, Seagal Teitz-Tennenbaum, Fang Zheng, Qin Pan, and Ning Ning
Abstract: PDF file - 57K
Published: 2023
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12. Evaluation of a Virtual Sub-internship Experience for Senior Medical Students Applying to Otolaryngology During the COVID-19 Pandemic

Author: Janice L Farlow, Emily J Marchiano, Andrew J Neevel, Jeffrey S Moyer, Marc C Thorne, and Lauren A Bohm
Subjects: General Earth and Planetary Sciences, General Environmental Science
Abstract: BackgroundThe COVID-19 pandemic limited in-person medical experiences for senior medical students. To address the lack of visiting sub-internships, we created a one-day virtual overview of Otolaryngology-Head and Neck Surgery, incorporating discussion of important trainee topics and an introduction to our residency program.MethodsA one-day virtual event was hosted by a tertiary academic medical center. Sessions were structured as interviews with faculty and residents, with real-time question and answer sessions. A guide with presenter information and resident-curated resources for each sub-specialty was given, as well as a document of frequently asked questions. The event was advertised to senior medical students through online forums. Data were collected via registration and post-event anonymous surveys.ResultsThere were 327 participants representing 138 institutions, 34 states and territories, and 10 countries, with 90% of participants consisting of senior medical students. The event spanned 5 content hours, and participants were signed in for 4.1 hours on average. Participants (n = 102, 31% response rate) found the event helpful for learning about the field (96%), residency program (97%), and specialty-specific resources (86%). Hearing from residents (43%) and faculty (41%) were cited as the most helpful parts of the program. Getting to know residency programs remotely (28%), participating in virtual interviews (26%), and not having away rotations (20%) were most often noted as the biggest student concerns for the 2020–2021 application cycle. Finally, participants identified getting to know an institution’s culture (76%) as the most difficult aspect of a program to evaluate remotely.ConclusionsWe demonstrate that a virtual event can be valuable in the transition to residency by supplementing or partially substituting visiting sub-internships.
Published: 2023
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13. Convergent Alterations of a Protein Hub Produce Divergent Effects within a Binding Site

Author: Ali Imran, Brandon S. Moyer, Dan Kalina, Thomas M. Duncan, Kelsey J. Moody, Aaron J. Wolfe, Michael S. Cosgrove, and Liviu Movileanu
Subjects: Binding Sites, Multienzyme Complexes, Intracellular Signaling Peptides and Proteins, Humans, Molecular Medicine, Histone-Lysine N-Methyltransferase, General Medicine, Ligands, Peptides, Biochemistry, Protein Binding
Abstract: Progress in tumor sequencing and cancer databases has created an enormous amount of information that scientists struggle to sift through. While several research groups have created computational methods to analyze these databases, much work still remains in distinguishing key implications of pathogenic mutations. Here, we describe an approach to identify and evaluate somatic cancer mutations of WD40 repeat protein 5 (WDR5), a chromatin-associated protein hub. This multitasking protein maintains the functional integrity of large multi-subunit enzymatic complexes of the six human SET1 methyltransferases. Remarkably, the somatic cancer mutations of WDR5 preferentially distribute within and around an essential cavity, which hosts the WDR5 interaction (Win) binding site. Hence, we assessed the real-time binding kinetics of the interactions of key clustered WDR5 mutants with the Win motif peptide ligands of the SET1 family members (SET1
Published: 2022
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14. Interplay of Affinity and Surface Tethering in Protein Recognition

Author: Ali Imran, Brandon S. Moyer, Aaron J. Wolfe, Michael S. Cosgrove, Dmitrii E. Makarov, and Liviu Movileanu
Subjects: Intrinsically Disordered Proteins, Kinetics, General Materials Science, Physical and Theoretical Chemistry, Ligands, Peptides, Protein Binding
Abstract: Surface-tethered ligand-receptor complexes are key components in biological signaling and adhesion. They also find increasing utility in single-molecule assays and biotechnological applications. Here, we study the real-time binding kinetics between various surface-immobilized peptide ligands and their unrestrained receptors. A long peptide tether increases the association of ligand-receptor complexes, experimentally proving the fly casting mechanism where the disorder accelerates protein recognition. On the other hand, a short peptide tether enhances the complex dissociation. Notably, the rate constants measured for the same receptor, but under different spatial constraints, are strongly correlated to one another. Furthermore, this correlation can be used to predict how surface tethering on a ligand-receptor complex alters its binding kinetics. Our results have immediate implications in the broad areas of biomolecular recognition, intrinsically disordered proteins, and biosensor technology.
Published: 2022
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15. The People of Rose Hill: Black and White Life on a Maryland Plantation

Author: Teresa S. Moyer
Subjects: History, Agricultural and Biological Sciences (miscellaneous)
Published: 2023
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16. Introduction

Author: Paul J. Kosmin and Ian S. Moyer
Abstract: This introductory chapter reviews broad trends and new prospects in scholarship on revolts and resistance in the Hellenistic world since the publication of S. K. Eddy’s The King Is Dead: Studies in the Near Eastern Resistance to Hellenism, 334-31 bc (1961). Three broad trends are identified: (1) a long-standing tendency toward fragmentation into specialized studies of regions and major states has been overcome by relatively recent comparative studies; (2) scholars have generally downgraded the significance of ethnic and cultural differences as dimensions of conflict; and (3) there has been a correlative turn to social-scientific models that seek the causes of resistance and revolt in economic privations and state impingement on traditional social and institutional privileges. This essay urges a globalizing, comparative and connective approach to studying resistance in the Hellenistic world and seeks to complement social-scientific orientations with perspectives that are more attentive to local cultural, religious, and moral frameworks. In re-assessing these frameworks, the authors argue for moving beyond Greek/non-Greek binaries to examine resistance as complex and entangled: acts and articulations of resistance are not purely nativistic or ‘nationalist’, but conditioned by local expectations of government, historical memories of prior periods, as well as emergent trans-regional Hellenistic political and cultural idioms. The essay concludes by summarizing the ways that contributions to the volume advance these goals.
Published: 2022
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17. Revolts, Resistance, and the Materiality of the Moral Order in Ptolemaic Egypt

Author: Ian S. Moyer
Abstract: As a counterpoint to socio-economic explanations of revolts in Ptolemaic Egypt as ‘natural’ responses to material and social privations, Chapter 6 re-examines material and documentary evidence that illuminates the indigenous cultural and moral frameworks through which historical actors justified and articulated resistance. In documentary reports, and damaged documents themselves, it is possible to catch a glimpse of meaningful symbolic actions, undertaken in public ways and places in order to contest the legality or legitimacy of the regime. Such actions are a more humble counterpart to recondite prophetic texts such as the Demotic Chronicle or the Oracle of the Potter. The withdrawal of farmers from unfair contracts and the issuance of their refusal from the precinct of a temple suggests not irrational flight, but the quasi-formal registration of protest in a place that was often used for the administration of justice. Evidence of the intentional defacement of inscribed versions of the Canopus decree, erected in the open areas of Egyptian temples, likewise suggests a public rejection of loyal priests’ praise for the Ptolemies as good pharaohs. Rebels who forced a guardian of contracts publicly to burn them intended not only to disrupt legal agreements, but also to reject the authority backing them. Though fleeting, these bits of evidence offer insights into the local ethical orientations of specific acts of resistance, acts that should be read as far as possible in their own terms.
Published: 2022
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18. Béatrix LE WITA (J.A. UNDERWOOD, translator), French Bourgeois Culture, Cambridge: Cambridge University Press and Paris: Éditions de la Maison des Sciences de l’Homme, 1994: 168 pages

Author: David S. Moyer
Published: 2021
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19. Relationships Between Semiotic Representational Transformations and Performance Outcomes in Digital Math Games

Author: Joseph S. Kozlowski, Kristy Litster, Patricia S. Moyer-Packenham, and Allison L. Roxburgh
Subjects: Register (sociolinguistics), 05 social sciences, Educational technology, 050301 education, 050801 communication & media studies, Representation (arts), Science education, Transformation (music), Computer Science Applications, Education, Test (assessment), Human-Computer Interaction, 0508 media and communications, Mathematics (miscellaneous), Mathematics education, Semiotics, 0503 education, Gesture
Abstract: The purpose of this study was to examine relationships between students’ semiotic representational transformations and students’ mathematics performance outcomes in digital math games. The study employed a convergent parallel mixed methods design. Students in Grades 4, 5, and 6 (ages 9–12) played nine digital math games. Researchers administered pretests and posttests and gathered video data. Researchers coded the video data to identify the representations used and students’ representational transformations to understand how these related to mathematics performance outcomes. The video data revealed that the most frequent type of semiotic representation used by students was images, followed by symbols. The most common type of representational transformation students made was a conversion (i.e., transforming across two different representational registers), which is more complex than a treatment (i.e., transforming within the same representational register). A difference in proportions test revealed significant differences in test scores when students made representational transformations using language, images, symbols, and gestures. The results showed that some of the digital math games prompted more representational transformations than others; However, all of the games prompted the conversion type of representational transformation. Students who progressed between the pretest and posttest were much more likely to make representational transformations. Students who did not recognize and use representations or make transformations were much more likely to regress between the pretest and posttest. These results show the importance of the recognition and use of semiotic representations and representational transformations to mathematics outcomes when students play digital math games.
Published: 2021
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20. To be Welcome without Reservation: Seeing a Future for Archaeology at Mount Clare

Author: Teresa S. Moyer
Subjects: Black history, Archeology, History, Anthropology, Reservation, Community service, Archaeology, humanities, Mount
Abstract: The Mount Clare Museum House in Baltimore, Maryland has potential to offer a new approach to community service in Baltimore inspired by archaeological findings, but one that is different from a tra...
Published: 2020
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21. Connecting the dots: Understanding the interrelated impacts of type, quality and children's awareness of design features and the mathematics content learning goals in digital math games and related learning outcomes

Author: Emma P. Bullock, Joseph S. Webster, Patricia S. Moyer-Packenham, Kathleen A. Bullock, Elif Bektas, and Allison L. Roxburgh
Subjects: media_common.quotation_subject, Mathematics education, Educational technology, Computer system design, Game based learning, Quality (business), Type (model theory), Mathematics instruction, Content learning, Computer Science Applications, Education, media_common
Published: 2020
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22. Nasal Ulceration in Trigeminal Trophic Syndrome

Author: Terrence K. Pleasant, Andrew Benvenuto, and Jeffrey S. Moyer
Subjects: Soft Tissue Injuries, Humans, Surgery, Nose, Skin Diseases
Published: 2022

23. Adoption of Remote Patient Monitoring for COPD Patients in a Resource-Limited Rural Healthcare Setting

Author: F.D. Seifer, C. Lovelett, S. Moyer, N. Moraveji, R.K. Murray, and G. Hansen
Published: 2022
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24. The Role of Gender on the Associations among Children’s Attitudes, Mathematics Knowledge, Digital Game Use, Perceptions of Affordances, and Achievement

Author: Joshua R. Novak, M. Jill Harmon, Kristy Litster, Christina W. Lommatsch, Patricia S. Moyer-Packenham, Allison L. Roxburgh, Emma P. Bullock, and Springer Netherlands
Subjects: Digital games, General Mathematics, media_common.quotation_subject, education, behavioral disciplines and activities, Science education, Education, Developmental psychology, Perception, Teacher Education and Professional Development, Mathematics education, 0501 psychology and cognitive sciences, Affordance, Path analysis (statistics), media_common, 05 social sciences, Direct effects, Gender, 050301 education, Attitude, human activities, 0503 education, Mathematics, psychological phenomena and processes, 050104 developmental & child psychology
Abstract: This study explored associations among children’s prior attitudes, prior mathematics knowledge, and frequency of digital game use, with children’s perceptions of game affordances, and transfer to out-of-game performance when interacting with digital math games, with respect to gender. Participants were 187 children (ages 8–12). An SEM mediation path analysis using MPLUS software showed significant direct effects for all pathways for all children, and significant indirect effects on all pathways for male children and five of six pathways for female children. More favorable attitudes, prior math knowledge, and perception of the helping affordances were associated with increased posttest performance, while increased frequency of digital game use and stronger perception of the hindering affordances was associated with decreased posttest performance. The model showed stronger connections for male children between frequency of digital game use, prior mathematics knowledge, and hindering affordances to the posttest, while female children showed stronger connections between attitude and perception of helping affordances to the posttest.
Published: 2020
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25. 'Our Stories Are Powerful': The Use of Youth Storytelling in Policy Advocacy to Combat the School-to-Prison Pipeline

Author: Jeffrey S. Moyer, Andrew R. King, and Mark R. Warren
Subjects: business.industry, 05 social sciences, Youth leaders, Social change, 050401 social sciences methods, 050301 education, Public policy, Public relations, Education, Grassroots, 0504 sociology, Policy advocacy, Narrative, Sociology, School-to-prison pipeline, business, 0503 education, Storytelling
Abstract: The use of narratives and storytelling has become an increasingly common strategy in grassroots organizing and advocacy efforts to influence policy change. Drawing on qualitative interviews and observations, Jeffrey Moyer, Mark Warren, and Andrew King present a case study of the successful campaign by Voices of Youth in Chicago Education (VOYCE) to pass SB100, a progressive Illinois law aimed at ending the school-to-prison pipeline. The authors show that personal storytelling, when combined with other approaches, constitutes an effective strategy for youth organizing groups in low-income communities of color to achieve racial equity and educational justice policy goals. In this case, youth leaders involved in VOYCE told legislators their personal stories of the harm done to them and their friends by zero-tolerance school discipline and spoke to the racial inequities they faced. In doing so, they countered previously held narratives of youth of color as troublemakers and violence-prone and created a moral urgency for legislators to act. Youth leaders used storytelling and data to build a larger alliance of supporters, which contributed to the passage of a bill that limited harsh discipline, promoted restorative justice alternatives, and took steps to close racial gaps in suspensions and expulsions.
Published: 2020
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26. Nasal Obstruction after Mohs Surgery: Prevention and Correction

Author: Jeffrey S. Moyer and Shannon F. Rudy
Subjects: medicine.medical_specialty, Reconstructive surgery, Skin Neoplasms, business.industry, medicine.medical_treatment, Nose Neoplasms, Esthetics, Dental, respiratory system, Mohs Surgery, medicine.disease, Micrographic surgery, Surgical Flaps, Surgery, medicine.anatomical_structure, Carcinoma, Basal Cell, otorhinolaryngologic diseases, Mohs surgery, medicine, Humans, Nasal Obstruction, Skin cancer, business, Nose
Abstract: As rates of Mohs micrographic surgery (MMS) have risen over recent decades in the setting of increased incidence of nonmelanoma skin cancer, so too has the need for post-Mohs reconstruction. The nose is one of the most common sites of post-MMS nasal reconstruction and presents unique challenges that often require expertise in facial plastic and reconstructive surgery. In addition to the aesthetic importance of the nose, preserving nasal function and preventing nasal obstruction are paramount to successful nasal reconstruction. This article will provide a brief review of nasal anatomy, with a focus on particular anatomic risk factors for post-MMS reconstruction nasal obstruction, strategies to prevent nasal obstruction, as well as techniques to correct the problem when it arises.
Published: 2020
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27. Relationships among Semiotic Representational Transformations and Math Outcomes in Digital Games

Author: Patricia S. Moyer-Packenham
Published: 2022
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28. Orbiter space vision system on space shuttle flight STS-80.

Author: Daniel P. Goodwin, Laura E. Hembree, Joseph P. Curran, David S. Moyer, Russell L. Strachan, Ian Mills, and Jean-Sebastien Valois
Published: 1997
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29. Reducing line clutter in software engineering diagrams.

Author: Todd S. Moyer and Ephraim P. Glinert
Published: 1991
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30. Addressing the Impact of COVID‐19 on the Residency Application Process Through a Virtual Subinternship

Author: Ilana P Fischer, Janice L. Farlow, Jeffrey S. Moyer, Lauren A. Bohm, Marc C. Thorne, and Emily Marchiano
Subjects: Students, Medical, Coronavirus disease 2019 (COVID-19), Process (engineering), Pneumonia, Viral, Experiential learning, Otolaryngology, 03 medical and health sciences, 0302 clinical medicine, Mentorship, Humans, Medicine, 030223 otorhinolaryngology, Pandemics, Curriculum, Medical education, business.industry, Event (computing), Virtual Reality, Equity (finance), COVID-19, Internship and Residency, Otorhinolaryngology, Education, Medical, Graduate, 030220 oncology & carcinogenesis, Surgery, Clinical education, Coronavirus Infections, business, Education, Medical, Undergraduate
Abstract: Senior medical students are facing an unparalleled experiential gap left by COVID-19 restrictions. Due to a shared commitment to safety, equity, and well-being, away rotations are actively being discouraged or even prohibited. As a result, students transitioning to residency encounter reduced clinical training experiences and decreased access to advising, mentorship, and research opportunities. In addition, limited exposure to residency life across subspecialties and institutions poses unique challenges during the current residency application cycle. The otolaryngology-head and neck surgery community has met these unprecedented challenges by producing diverse electronic resources for specialty-specific clinical education, as well as discussing ways to increase access to advising. In this commentary, we review these initiatives and propose an institutional virtual event as a platform for meeting goals previously achieved by visiting subinternships.
Published: 2020
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31. Base-10 Blocks: a study of iPad virtual manipulative affordances across primary-grade levels

Author: Kristy Litster, Patricia S. Moyer-Packenham, and Rachel Reeder
Subjects: General Mathematics, Teaching method, media_common.quotation_subject, 05 social sciences, Primary education, 050301 education, Education, Learning opportunities, Perception, mental disorders, Mathematics education, 0501 psychology and cognitive sciences, Affordance, 0503 education, Preschool education, Mobile device, 050104 developmental & child psychology, Coding (social sciences), media_common
Abstract: The purpose of the inquiry was to understand how children in primary grades (i.e., preschool, kindergarten, and second grade) engaged with affordances and constraints of features in a Base-10 Blocks virtual manipulative mathematics app designed to promote learning opportunities. Researchers conducted one-to-one interviews with 100 primary grade children as they interacted with the Montessori Number Base-10 Blocks iPad app. The video data were qualitatively analyzed using open descriptive, thematic, and structured coding. Results show that children’s actions when interacting with app features can affect their engagement with designed mathematics constraints and affordances. Results also identified three emergent themes around children’s engagement with the app’s simultaneous linking features: verification, self-correction, and making connections. Findings suggest the importance of helping children identify and reflect on affordances within virtual manipulative mathematics apps. These findings also indicate that as designers, educators and researchers design or select virtual manipulative mathematics apps for classroom use; they should to consider children’s prior achievement as well as in-app perceptions and engagement with design features in the apps.
Published: 2019
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32. Edmund LEACH, Social Anthropology, New York and Oxford, Oxford University Press, 1982. $22.31 (cloth)

Author: David S. Moyer
Published: 2021
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33. Variations of Reasoning in Equal Sharing of Children Who Experience Low Achievement in Mathematics: Competence in Context

Author: Jessica Hunt, Arla Westenskow, and Patricia S. Moyer-Packenham
Subjects: mathematics learning difficulties, low achievement, fractions, reasoning, informal knowledge, Education
Abstract: For children with persistent mathematics difficulties, research and practice espouses that an altered kind of mathematics instruction is necessary due to sustained performance differences. Yet, a critical issue in mathematics education rests in the question of why research locates the problem within these children. In this paper, we challenge a longstanding assumption about the type of mathematics children with low achievement in mathematics “need” along with how these children are positioned in terms of mathematical thinking and reasoning. Our aim in this work is to identify ways of reasoning evident in the partitioning activity of 43 fifth-grade children as they solved equal sharing situations independent of instruction over ten sessions. Results reveal three themes of reasoning that show a resemblance between these children’s reasoning and existing frameworks of reasoning in equal sharing problems found in prior research among children who did not show low achievement in mathematics. We discuss the results in terms of the problem of a continued conceptualization of low achieving students’ need for specific kinds of teaching and learning experiences and/or detached instructional experiences in school. We advocate for an increase in research that examines how teachers can support participation of these children in mathematics classrooms such that children might develop powerful mathematics conceptions.
Published: 2017
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34. Kinetics of the multitasking high-affinity Win binding site of WDR5 in restricted and unrestricted conditions

Author: Aaron J. Wolfe, Liviu Movileanu, Michael S. Cosgrove, Ashley J. Canning, Ali Imran, Kelsey Moody, Thomas M. Duncan, Brandon S. Moyer, and Dan Kalina
Subjects: Methyltransferase, Protein Conformation, Quantitative proteomics, Amino Acid Motifs, Computational biology, Biochemistry, Article, WD40 repeat, Histone methylation, WDR5, Humans, Protein Interaction Domains and Motifs, Binding site, Molecular Biology, Binding Sites, biology, Chemistry, Intracellular Signaling Peptides and Proteins, Cell Biology, Methylation, Histone-Lysine N-Methyltransferase, Peptide Fragments, Kinetics, Histone, biology.protein, Protein Binding
Abstract: Recent advances in quantitative proteomics show that WD40 proteins play a pivotal role in numerous cellular networks. Yet, they have been fairly unexplored and their physical associations with other proteins are ambiguous. A quantitative understanding of these interactions has wide-ranging significance. WD40 repeat protein 5 (WDR5) interacts with all members of human SET1/MLL methyltransferases, which regulate methylation of the histone 3 lysine 4 (H3K4). Here, using real-time binding measurements in a high-throughput setting, we identified the kinetic fingerprint of transient associations between WDR5 and 14-residue WDR5 interaction (Win) motif peptides of each SET1 protein (SET1Win). Our results reveal that the high-affinity WDR5-SET1Win interactions feature slow association kinetics. This finding is likely due to the requirement of SET1Win to insert into the narrow WDR5 cavity, also named the Win binding site. Furthermore, our explorations indicate fairly slow dissociation kinetics. This conclusion is in accordance with the primary role of WDR5 in maintaining the functional integrity of a large multisubunit complex, which regulates the histone methylation. Because the Win binding site is considered a key therapeutic target, the immediate outcomes of this study could form the basis for accelerated developments in medical biotechnology.
Published: 2021

35. Ancestors of Worthy Life : Plantation Slavery and Black Heritage at Mount Clare

Author: Teresa S. Moyer and Teresa S. Moyer
Abstract: Recognizing the lives of the enslaved at the historic site of Mount ClareEnslaved African Americans helped transform the United States economy, culture, and history. Yet these individuals'identities, activities, and sometimes their very existence are often all but expunged from historically preserved plantations and house museums. Reluctant to show and interpret the homes and lives of the enslaved, many sites have never shared the stories of the African Americans who once lived and worked on their land. One such site is Mount Clare near Baltimore, Maryland, where Teresa Moyer pulls no punches in her critique of racism in historic preservation.In her balanced discussion, Moyer examines the inextricably entangled lives of the enslaved, free Black people, and white landowners. Her work draws on evidence from archaeology, history, geology, and other fields to explore the ways that white privilege continues to obscure the contributions of Black people at Mount Clare. She demonstrates that a landscape's post-emancipation history can make a powerful statement about Black heritage. Ultimately she argues that the inclusion of enslaved persons in the history of these sites would honor these'ancestors of worthy life,'make the social good of public history available to African Americans, and address systemic racism in America.Publication of the paperback edition made possible by a Sustaining the Humanities through the American Rescue Plan grant from the National Endowment for the Humanities.
Published: 2023

36. Greek and Latin sources

Author: Ian S. Moyer
Subjects: Papyrology, Latin literature, History, Egyptology, Greek literature, Classics, Epigraphy
Abstract: A wealth of Latin and Greek sources is available for the study of Egypt, both literary texts preserved in manuscripts, and historical documents inscribed on stone, or written on papyrus, pottery shards, and other writing materials. Though literary texts, including ancient Greek accounts of Egyptian history, ethnography and geography must be read in the cultural context for which they were produced, they can also provide useful information on Egyptian history in the periods contemporary with classical Greek and Roman civilization, as well as evidence of how Egypt was remembered and represented by Greek and Roman authors, as well as by Egyptians themselves. The volume of Greek and Latin papyrus documents and inscriptions is enormous and provides an invaluable resource for the study of Egyptian history, especially its economic and social aspects, but also for the study of cultural and ethnic relations between Egyptians and immigrant populations. Collaboration between specialists in Greek, Latin, and Egyptian materials is vital to getting the full benefit of these resources for the study of ancient Egypt.
Published: 2020
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37. Exploring the Phenomenon of Distance in Children's Interactions with Touchscreen Digital Mathematics Games

Author: Patricia S. Moyer-Packenham, Stephen I. Tucker, and Taylor & Francis
Subjects: Distance, InformationSystems_INFORMATIONINTERFACESANDPRESENTATION(e.g.,HCI), mathematics, Applied Mathematics, 010102 general mathematics, 05 social sciences, digital games, ComputingMilieux_PERSONALCOMPUTING, Educational technology, 050301 education, educational technology, 01 natural sciences, Degree (music), Education, law.invention, Mathematics (miscellaneous), Touchscreen, law, Phenomenon, Mathematics education, Teacher Education and Professional Development, touchscreen, 0101 mathematics, Construct (philosophy), 0503 education
Abstract: This study examines the construct of distance – the degree of difficulty of interacting with something – as part of activity involving children using touchscreen digital games to learn mathematics. Ten fifth-grade children engaged in video-recorded semi-structured task-based interviews in which they used two touchscreen digital mathematics games on a touchscreen tablet and responded to semi-structured follow-up questions. Qualitative data analysis was iterative, featuring analytic memoing and eclectic coding techniques to identify themes related to distance. In advanced coding stages, magnitude coding was used to characterize the degree of distance present. Findings provide evidence of the presence of distance, changes in distance, and interactions between distance types throughout the activity. In particular, both mathematical distance and technological distance were present, changed in various ways, and often influenced each other. Implications include the relevance of distance for designing, implementing, and researching educational technology.
Published: 2020

38. Characterizing the Growth of One Student's Mathematical Understanding in a Multi-Representational Learning Environment

Author: Hilal Gulkilik, H. Hüseyin Uğurlu, Patricia S. Moyer-Packenham, Nejla Yürük, and Elsevier Ltd
Subjects: Mathematical thinking, Computer science, Semiotic representation theory, Applied Mathematics, Learning environment, 05 social sciences, Geometric transformation, Pirie-Kieren model, 050301 education, Mathematical learning, Education, Variety (cybernetics), Task (project management), Dilation, Mathematical understanding, Mathematics (miscellaneous), Transformation (function), 0502 economics and business, Mathematics education, Teacher Education and Professional Development, Semiotics, Multiple representations, 0503 education, 050203 business & management, Mathematics
Abstract: The purpose of this study was to characterize the growth of one student’s mathematical understanding and use of different representations about a geometric transformation, dilation. We accomplished this purpose by using the Pirie-Kieren model jointly with the Semiotic Representation Theory as a lens. Elif, a 10th- grade student, was purposefully chosen as the case for this study because of the growth of mathematical understanding about dilation she exhibited over time. Elif participated in task-based interviews before, during and after participating in a variety of transformation lessons where she used multiple representations, including physical and virtual manipulatives. The results revealed that Elif was able to progress in her mathematical understanding from informal levels to the formal levels in the Pirie-Kieren model as she performed treatments and conversions, movements involving different registers of representations. The results also showed numerous examples of Elif’s mathematical understanding based on folding back activities, complementary aspects of acting and expressing, and interventions. Using the two theories together provides a powerful and holistic approach to a deeper understanding of mathematical learning by characterizing and articulating the growth of mathematical understanding and the way of mathematical thinking.
Published: 2020

39. Exploring the kinetics of the Win-site of WDR5

Author: Ali Imran, Brandon S. Moyer, Ashley Canning, Dan Kalina, Thomas Duncan, Kelsey J. Moody, Aaron Wolfe, Michael S. Cosgrove, and Liviu Movileanu
Subjects: Biophysics
Published: 2022
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40. The Spider Limb Positioner in subscapular system free flaps

Author: Andrew J. Rosko, Kelly M. Malloy, Chaz L. Stucken, Mark E. Prince, Douglas B. Chepeha, Keith A. Casper, Steven B. Chinn, Jeffrey S. Moyer, Emily Marchiano, Cate Haring, Matthew E. Spector, and Jayne R. Stevens
Subjects: Adult, Male, Cancer Research, Reconstructive surgery, medicine.medical_specialty, Adolescent, Operative Time, Free Tissue Flaps, Patient Positioning, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Ablative case, Humans, Medicine, 030223 otorhinolaryngology, Head and neck, Aged, Aged, 80 and over, Spider, business.industry, Middle Aged, Plastic Surgery Procedures, Surgery, Dissection, Oncology, 030220 oncology & carcinogenesis, Orthopedic surgery, Superficial Back Muscles, Tissue and Organ Harvesting, Head and neck surgery, Operative time, Female, Oral Surgery, business
Abstract: Background The subscapular system is a versatile vascular network that can provide multiple flaps for reconstruction of the head and neck. A significant drawback of using the subscapular system is that patient positioning can preclude the use of simultaneous two-team ablative and reconstructive surgery. Herein, we describe a novel use of an upper extremity limb positioner (Spider Limb Positioner) used primarily in orthopedic surgery to facilitate concurrent two-team technique in head and neck surgery. Methods Using a bean bag and the Spider Limb Positioner for the upper extremity, a semidecubitus position was used for subscapular donor site dissection. Ablative and reconstructive teams worked concurrently in all cases. Results This technique was utilized 78 times on 73 patients, with chimeric flaps used in 38% of cases. The average operative time was 466 min. Only one patient required repositioning intraoperatively due to a change in the subscapular donor site side. There were no nerve compression injuries or positioning related complications. Conclusion Scapular and parascapular free flaps are useful tools for reconstruction of the head and neck. In a two-team approach, the use of a semidecubitus position in conjunction with the Spider Limb Positioner facilitates exposure for the reconstructive team without compromising access for the ablative team.
Published: 2018
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41. Author response for 'Connecting the dots: Understanding the interrelated impacts of type, quality and children's awareness of design features and the mathematics content learning goals in digital math games and related learning outcomes'

Author: null Emma P. Bullock, null Allison L. Roxburgh, null Patricia S. Moyer‐Packenham, null Elif Bektas, null Joseph S. Webster, and null Kathleen A. Bullock
Published: 2019
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42. IRX-2 natural cytokine biologic for immunotherapy in patients with head and neck cancers

Author: Michael J. Kaplan, Jason G. Newman, James E. Egan, Jeffrey S. Moyer, Neil L. Berinstein, Gregory T. Wolf, and Theresa L. Whiteside
Subjects: Cyclophosphamide, medicine.medical_treatment, T cells, Review, head and neck squamous cell carcinoma, 03 medical and health sciences, 0302 clinical medicine, Immune system, lymphocytic infiltration, medicine, Pharmacology (medical), dendritic cells, business.industry, Immunosuppression, Immunotherapy, Dendritic cell, medicine.disease, Head and neck squamous-cell carcinoma, cytokines, Cytokine, Oncology, 030220 oncology & carcinogenesis, Cancer research, head and neck cancer, Tumor necrosis factor alpha, immunotherapy, business, 030215 immunology, medicine.drug
Abstract: Head and neck squamous cell carcinoma (HNSCC) is an immunosuppressive malignancy characterized by tumor-driven immune-system abnormalities that contribute to disease progression. For patients with surgically resectable HNSCC, treatment is often curative surgery followed by irradiation or chemoradiation in high-risk settings to reduce the risk of recurrence. Poor survival and considerable morbidity of current treatments suggest the need for new therapeutic modalities that can improve outcomes. Defects in antitumor immunity of HNSCC patients include suppressed dendritic cell (DC) maturation, deficient antigen-presenting cell function, compromised natural killer (NK)-cell cytotoxicity, increased apoptosis of activated T lymphocytes, and impaired immune-cell migration to tumor sites. Strategies for relieving immunosuppression and restoring antitumor immune functions could benefit HNSCC patients. IRX-2 is a primary cell-derived biologic consisting of physiologic levels of T-helper type 1 cytokines produced by stimulating peripheral blood mononuclear cells of normal donors with phytohemagglutinin. The primary active components in IRX-2 are IL2, IL1β, IFNγ, and TNFα. In vitro, IRX-2 acts on multiple immune-system cell types, including DCs, T cells, and NK cells, to overcome tumor-mediated immunosuppression. In clinical settings, IRX-2 is administered as part of a 21-day neoadjuvant regimen, which includes additional pharmacologic agents (low-dose cyclophosphamide, indomethacin, and zinc) to promote anticancer immunoresponses. In a Phase IIA trial in 27 patients with surgically resectable, previously untreated HNSCC, neoadjuvant IRX-2 increased infiltration of T cells, B cells, and DCs into tumors and was associated with radiological reductions in tumor size. Event-free survival was 64% at 2 years, and overall 5-year survival was 65%. Follow-up and data analysis are under way in the multicenter, randomized, Phase IIB INSPIRE trial evaluating the IRX-2 regimen as a stand-alone therapy for activating the immune system to recognize and attack tumors.
Published: 2018
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43. RPtag as an Orally Bioavailable, Hyperstable Epitope Tag and Generalizable Protein Binding Scaffold

Author: Aaron J. Wolfe, Meegan B. Sleeper, Jennifer R. DeRosa, Connor McGuigan, Kelsey Moody, Brandon S. Moyer, Ashleigh Crawford, Anthony H Bianchi, Adam R. Blanden, Danique Wortel, Ellie Lumen, and Cheyanne Fisher
Subjects: Models, Molecular, medicine.medical_treatment, Peptide, Plasma protein binding, Protein Engineering, Biochemistry, Antibodies, Epitope, law.invention, Epitopes, law, medicine, Denaturation (biochemistry), Amino Acid Sequence, Peptide sequence, chemistry.chemical_classification, Protease, biology, Reproducibility of Results, chemistry, biology.protein, Recombinant DNA, Antibody, Peptides, Protein Binding
Abstract: Antibodies are the most prolific biologics in research and clinical environments because of their ability to bind targets with high affinity and specificity. However, antibodies also carry liabilities. A significant portion of the life-science reproducibility crisis is driven by inconsistent performance of research-grade antibodies, and clinical antibodies are often unstable and require costly cold-chain management to reach their destinations in active form. In biotechnology, antibodies are also limited by difficulty integrating them in many recombinant systems due to their size and structural complexity. A switch to small, stable, sequence-verified binding scaffolds may overcome these barriers. Here we present such a scaffold, RPtag, based on a ribose-binding protein (RBP) from extremophile Caldanaerobacter subterraneus. RPtag binds an optimized peptide with pM affinity, is stable to extreme temperature, pH, and protease treatment, readily refolds after denaturation, is effective in common laboratory applications, was rationally engineered to bind bioactive PDGF-β, and was formulated as a gut-stable orally bioavailable preparation.
Published: 2018
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44. Cultures of Resistance in the Hellenistic East

Author: Paul J. Kosmin, Ian S. Moyer, Paul J. Kosmin, and Ian S. Moyer
Subjects: Revolutions--Middle East--History--To 1500, Revolutions--Asia, Central--History--To 1500, Revolutions--Turkey--History--To 1500, Government, Resistance to--Turkey--History--To 1500, Hellenism, Government, Resistance to--Middle East--History--To 1500, Government, Resistance to--Asia, Central--History--To 1500
Abstract: This collaborative volume examines revolts and resistance to the successor states, formed after Alexander the Great's conquest of the Persian empire, as a transregional phenomenon. The editors have assembled an array of specialists in the study of the various regions and cultures of the Hellenistic world - Judea, Egypt, Babylonia, Central Asia, and Asia Minor - in an effort to trace comparisons and connections between episodes and modes of resistance. The volume seeks to unite the currently dominant social-scientific orientation to ancient resistance and revolt with perspectives, often coming from religious studies, that are more attentive to local cultural, religious, and moral frameworks. In re-assessing these frameworks, contributors move beyond Greek/non-Greek binaries to examine resistance as complex and entangled: acts and articulations of resistance are not purely nativistic or'nationalist', but conditioned by local traditions of government, historical memories of prior periods, as well as emergent transregional Hellenistic political and cultural idioms. Cultures of Resistance in the Hellenistic East is organized into three parts. The first part investigates the Great Theban Revolt and the Maccabean Revolt, the central cases for large, organized, and prolonged military uprisings against the Hellenistic kingdoms. The second part examines the full gamut of indigenous self-assertion and resistant action, including theologies of monarchic inadequacy, patterns of historical periodization and textual interpretation, and claims to sites of authority. The volume's final part turns to the more ambiguous assertions of local autonomy and identity that emerge in the frontier regions that slipped in and out of the grasp of the great Hellenistic powers.
Published: 2022

45. Taming Silylium Ions for Synthesis: N-Heterocycle Synthesis via Stereoselective C–C Bond Formation

Author: Brandon S. Moyer and Michel R. Gagné
Subjects: 010405 organic chemistry, Organic Chemistry, Prins reaction, 010402 general chemistry, 01 natural sciences, Enol, Pyrrolidine, 0104 chemical sciences, chemistry.chemical_compound, chemistry, Nucleophile, Silylium ion, Organic chemistry, Reactivity (chemistry), Azide, Lewis acids and bases
Abstract: Silylium ions (formally [R3Si]+) have long been the subject of investigations and significant debate in both theoretical and experimental chemistry, but few catalytic, synthetic applications have been reported due to the exceptionally high reactivity and Lewis acidity of these elusive species. Results to be discussed include the application of easily accessible silylium ion catalysts to the stereoselective synthesis of various N-heterocyclic pyrrolidine and piperidine scaffolds. The tested substrates are derived from the chiral pool and can be obtained in three high-yielding steps from amino alcohols; subsequent stereoselective silylium ion catalyzed Prins cyclization and trapping with R3Si–Nu nucleophiles (e.g., Nu = H, allyl, azide, and enol ethers) results in novel nitrogen-containing polycyclic scaffolds with potential medicinal chemistry applications.
Published: 2017
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46. Reconstruction of Cheek Defects Secondary to Mohs Microsurgery or Wide Local Excision

Author: Jeffrey S. Moyer, John E. Hanks, and Michael Brenner
Subjects: Male, medicine.medical_specialty, Skin Neoplasms, medicine.medical_treatment, Dermatologic Surgical Procedures, Surgical Flaps, 030207 dermatology & venereal diseases, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, stomatognathic system, Medical Illustration, Photography, medicine, Humans, 030223 otorhinolaryngology, Nose, business.industry, Wide local excision, Local flap, Cheek, Microsurgery, Mohs Surgery, Surgery, stomatognathic diseases, medicine.anatomical_structure, Facial reconstruction, Female, Eyelid, business, Cutaneous malignancy
Abstract: Successful reconstruction of the cheek following excision for cutaneous malignancy requires careful consideration of defect location, size, and depth in relation to the anatomic properties of the affected cheek unit. Various reconstructive options are available to the surgeon, ranging from simple excisions to complex cervicofacial advancements to meet the needs for functional and aesthetically pleasing reconstructive outcomes. The surgeon must prevent distortion of mobile structures, such as the eyelid, nose, and lips; respect aesthetic subunits; and avoid blunting natural creases. This discussion covers choice of flap, techniques, and technical considerations for medial/perinasal, perilabial, preauricular, lateral, and zygomatic cheek defects.
Published: 2017
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47. Reconstruction of Mohs Defects of the Lips and Chin

Author: Jeffrey S. Moyer and Yuna C. Larrabee
Subjects: Male, Chin, medicine.medical_treatment, Dermatologic Surgical Procedures, Lower lip, Micrographic surgery, Surgical Flaps, Lip Neoplasm, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Lip reconstruction, Medical Illustration, Photography, Mohs surgery, Humans, Medicine, 030223 otorhinolaryngology, business.industry, Anatomy, Mohs Surgery, Lip, Tissue transfer, stomatognathic diseases, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Lip Neoplasms, Female, Surgery, business, Cutaneous malignancy
Abstract: Reconstruction of defects of the lips after Mohs micrographic surgery should encompass functional and aesthetic concerns. The lower lip and chin compose two-thirds of the lower portion of the face. The focus of this article is local tissue transfer for primarily cutaneous defects after Mohs surgery. Various flaps exist for repair. For small defects, elliptical excision with primary closure is a viable option. During reconstruction of the lip, all of the involved layers need to be addressed, including mucosa, muscle, and the vermillion or cutaneous lip. It is especially important to realign the vermillion border precisely for optimal results.
Published: 2017
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48. Osteotomies Demystified

Author: Kyle K, VanKoevering, Andrew J, Rosko, and Jeffrey S, Moyer
Subjects: 030207 dermatology & venereal diseases, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Preoperative Care, Photography, Humans, Anesthesia, Surgery, Nose, Rhinoplasty, 030223 otorhinolaryngology, Osteotomy
Abstract: Osteotomies are critical techniques in rhinoplasty. There are a variety of approaches, trajectories, and tools used with no widely standardized classification or nomenclature. Percutaneous osteotomies are gaining in popularity, and picture framing the nasomaxillary bone is crucial for predictable fracture and reproducible results. This is best accomplished with medial, lateral, and transverse osteotomies. Intermediate osteotomies are used less frequently, but provide more mobility. With a detailed understanding of anatomy and a thorough approach to nasal osteotomies, the contour and function of the bony vault can be reshaped with a successful outcome for both the surgeon and patient.
Published: 2017
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49. Contemporary Management of Early-Stage Melanoma

Author: Timothy M. Johnson, Jeffrey S. Moyer, Kyle K. VanKoevering, Scott A. McLean, and Andrew J. Rosko
Subjects: Oncology, medicine.medical_specialty, Pathology, Skin Neoplasms, Melanoma in situ, MEDLINE, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Neoplasm Recurrence, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Melanoma, neoplasms, Neoplasm Staging, Sentinel Lymph Node Biopsy, business.industry, Incidence, Patient Selection, Incidence (epidemiology), medicine.disease, 030220 oncology & carcinogenesis, Surgery, Neoplasm staging, Invasive Melanoma, Neoplasm Recurrence, Local, business, Stage melanoma
Abstract: The incidence of melanoma is increasing, with 76 380 new cases of invasive melanoma and 68 480 new cases of melanoma in situ expected in 2016.To review the contemporary management of early-stage melanoma.We searched PubMed, MEDLINE, and the Cochrane Database of Systematic Reviews databases from January 1, 2011, to May 1, 2016, yielding 966 articles. We focused our search on early-stage (melanoma in situ, stage I, and stage II) cutaneous melanoma. After excluding articles, 41 articles were manually reviewed. A review of the bibliographies of selected articles generated additional references.While the majority of recent advances have been in the treatment of advanced melanoma, surgical excision with margins based on the presence and depth of invasion continues to be the cornerstone of management. Sentinel lymph node biopsy plays a central role in the staging and treatment of melanoma.Accurate diagnosis and adequate surgical excision are critical in reducing local recurrences and improving outcomes. Sentinel lymph node biopsy is useful in staging the regional nodal basin and guiding treatment in appropriately selected patients.
Published: 2017
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50. Affordance Access Matters: Preschool Children’s Learning Progressions While Interacting with Touch-Screen Mathematics Apps

Author: Patricia S. Moyer-Packenham, Christina Watts, Jessica F. Shumway, and Emma P. Bullock
Subjects: Multimedia, Computer science, media_common.quotation_subject, Multimethodology, 05 social sciences, Educational technology, 050301 education, 050109 social psychology, Qualitative property, computer.software_genre, Science education, Computer Science Applications, Education, Human-Computer Interaction, Mathematics (miscellaneous), Perception, Mathematics education, 0501 psychology and cognitive sciences, Affordance, 0503 education, computer, Mobile device, Pre and post, Mathematics, media_common
Abstract: The purpose of this study was to contribute to the research on mathematics app use by very young children, and specifically mathematics apps for touch-screen mobile devices that contain virtual manipulatives. The study used a convergent parallel mixed methods design, in which quantitative and qualitative data were collected in parallel, analyzed separately, and then merged. During the study, 35 children, ages 3–4, interacted with four touch-screen mathematics apps on iPad devices during one-on one clinical interviews while learning seriation and counting. Researchers administered pre and post assessments of learning during the interviews. Each interview was videotaped using a wall-mounted camera and a GoPro camera to provide different views of the interview. Videos were analyzed to examine children’s learning progressions, access of affordances, and patterns of behavior while interacting with the mathematics apps. The results suggest that different affordances of the individual apps were perceived in different ways, depending on the age of the child, and that these perceptions were observable in young children’s patterns of behavior. Implications are discussed for iPad app use in young children’s educational settings.
Published: 2017
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