748 results on '"W. Grossman"'
Search Results
2. Candidate Experience: How to Improve Talent Acquisition to Drive Business Performance
- Author
-
Kevin W. Grossman, Adela Schoolderman and Kevin W. Grossman, Adela Schoolderman
- Published
- 2022
3. Percutaneous transluminal angioplasty and/or stenting for the treatment of basilar artery stenosis: a systematic review and meta-analysis
- Author
-
Paolo Palmisciano, Samer S. Hoz, Hagar A. Algburi, Giancarlo Ventre, Seth Street, Nana Agyeman, Michael W. Robinson, Matthew S. Smith, Peyman Shirani, Aaron W. Grossman, and Charles J. Prestigiacomo
- Subjects
Radiology, Nuclear Medicine and imaging ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
4. Inferior Alveolar Nerve Dysfunction following Embolization of Inferior Alveolar Artery Pseudoaneurysm
- Author
-
Yotom A. Rabinowitz, Wallace S. McLaurin, Aaron W. Grossman, and Deepak G. Krishnan
- Subjects
Inferior alveolar nerve ,Inferior alveolar artery ,Pseudoaneurysm ,Embolization ,Third molar extraction ,Surgery ,RD1-811 - Abstract
We report a case of left inferior alveolar nerve dysfunction following management of left inferior alveolar artery pseudoaneurysm in a 32-year old female following third molar extractions. After failing to manage the bleeding with conservative methods, embolization of the left inferior alveolar artery and the anastomosing branches of the facial artery was performed by interventional neuroradiology utilizing a fibered coil and N-butyl cyanoacrylate. Immediate hemostasis was achieved without major complications. The patient suffered transient anesthesia of left inferior alveolar nerve but recovered fully after two months.
- Published
- 2020
- Full Text
- View/download PDF
5. Complex Morphologic Analysis of Cerebral Aneurysms Through the Novel Use of Fractal Dimension as a Predictor of Rupture Status: A Proof of Concept Study
- Author
-
James A. Castiglione, Austin W. Drake, Ahmed E. Hussein, Mark D. Johnson, Paolo Palmisciano, Matthew S. Smith, Michael W. Robinson, Trisha L. Stahl, Roman A. Jandarov, Aaron W. Grossman, Peyman Shirani, Jonathan A. Forbes, Norberto Andaluz, Mario Zuccarello, and Charles J. Prestigiacomo
- Subjects
Surgery ,Neurology (clinical) - Published
- 2023
6. The Trinity River in Texas – Muddy and Emblematic
- Author
-
Irene J. Klaver, David J. Hoeinghaus, Jacob W. Grossman, Aaron J. Frith, Samuel F. Atkison, and James H. Kennedy
- Published
- 2023
7. 388 Percutaneous Transluminal Angioplasty and/or Stenting for the Treatment of Basilar Artery Stenosis: A Systematic Review and Meta-Analysis
- Author
-
Paolo Palmisciano, Samer Saad Hoz, Hagar A. Algburi, Giancarlo Javier Ventre, Seth Street, Nana Agyeman, Michael Robinson, Matthew Smith, Peyman Shirani, Aaron W. Grossman, and Charles J. Prestigiacomo
- Subjects
Surgery ,Neurology (clinical) - Published
- 2023
8. The number of shortest paths in the arrangement graph.
- Author
-
Eddie Cheng 0001, Jerrold W. Grossman, Ke Qiu 0001, and Zhizhang Shen
- Published
- 2013
- Full Text
- View/download PDF
9. Massive Orofacial Hemorrhage Treated with the Micro Vascular Plug System
- Author
-
Ashkan Mowla, Charles J. Prestigiacomo, Ameneh Zare-Shahabadi, Rohitha Moudgal, Aaron W. Grossman, and Peyman Shirani
- Subjects
medicine.medical_specialty ,business.industry ,Treatment options ,Cancer ,Vascular plug ,Case description ,medicine.disease ,Surgery ,Vehicle accident ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Hemostasis ,Medicine ,In patient ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Background This case series describes the use of the Medtronic Micro Vascular Plug (MVP) system in the treatment of acute massive orofacial hemorrhages in patients with cancer and trauma, resulting in successful hemostasis in these emergent cases. Case Description The first case describes a patient who presented with life-threatening oropharyngeal hemorrhage after a motor vehicle accident. In the second case, a patient with oropharyngeal cancer presented with life-threatening bleeding from an ulcerated tumor. Patients were successfully treated with a combination of MVP and coils. Immediate postprocedural imaging confirmed that homeostasis was achieved. Conclusions These cases demonstrate that the MVP as an embolic device is a valuable transarterial embolic treatment option in cases of acute orofacial bleeding where rapid, effective hemostasis is required.
- Published
- 2020
10. Association between underlying autoimmune disease and small aneurysm size at rupture
- Author
-
Abhijith V. Matur, Ali S. Yamani, Michael W. Robinson, Matthew S. Smith, Peyman Shirani, Aaron W. Grossman, and Charles J. Prestigiacomo
- Subjects
General Medicine - Abstract
OBJECTIVE Although the role of inflammation in the development of aneurysms is established, less is known about the development of intracranial aneurysms in the setting of underlying autoimmune disease. The underlying systemic inflammatory characteristics of disorders such as systemic lupus erythematosus, rheumatoid arthritis, and Sjögren’s syndrome may influence the development of intracranial aneurysms through common inflammatory pathways. The authors hypothesized that there is an association between underlying autoimmune disease and aneurysm growth and rupture. METHODS Medical records of patients who underwent cerebral angiography between August 2018 and August 2021 were manually reviewed. Autoimmune diseases as defined for this study are those known to have systemic inflammatory effects on the central nervous system or multiple other organ systems. Statistical analysis, including construction of multivariable linear and logistic regression models, was performed using R version 4.1.0. RESULTS Chart review identified 190 patients with 469 ruptured and unruptured saccular intracranial aneurysms. There were 31 patients with 44 aneurysms identified as having an autoimmune disease. The mean size of a ruptured aneurysm was significantly smaller among patients with autoimmune disease compared with patients without autoimmune disease (4.14 mm vs 5.34 mm, p = 0.03). The multivariate logistic regression model did not identify any significant association between rupture and autoimmune disease when controlling for other variables (p = 0.49). In the multivariate linear regression model, autoimmune disease was still significantly associated with a smaller size at rupture (p = 0.04), and smoking was associated with a larger size at rupture (p = 0.03) when controlling for other variables. A second multivariate logistic regression model found autoimmune disease to be independently associated with rupture at a size smaller than 7 mm (p = 0.02), while smoking was independently associated with rupture at a size larger than 7 mm (p = 0.01). CONCLUSIONS Autoimmune disease is associated with a smaller aneurysm size at rupture, although it is not associated with rupture itself. This association may be due to inflammatory pathways that are common to autoimmune diseases as well as aneurysm wall development. Although the authors were unable to identify any association between rupture status and the presence of autoimmune disease, the association between smaller size at rupture and autoimmune disease warrants further studies, as autoimmune disease may influence the trajectory of aneurysm development and the decision to treat.
- Published
- 2022
11. Abstract WP107: Differences In Automated Perfusion Softwares: Do They Matter Clinically?
- Author
-
Robert J Stanton, Lily Wang, Matthew Smith, Yasmin Aziz, Bin Zhang, Peyman Shirani, Charles Prestigiacomo, Aaron W Grossman, Achala Vagal, and Pooja Khatri
- Subjects
Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: Treatment of acute ischemic stroke in the late window changed with the positive results of DAWN and DEFUSE III. Both trials required the use of automated perfusion software for inclusion. Because differences in the predicted core or penumbra between software can lead to differences in eligibility for endovascular thrombectomy (EVT), we sought to compare whether these potential differences would have changed eligibility for EVT by DAWN or DEFUSE III criteria. Methods: Patients presenting or transferred to the University of Cincinnati Medical Center between April 23 rd 2019 and July 22 nd 2019 with acute ischemic stroke secondary to large vessel occlusions within the anterior circulation in the extended time window (>6-24 hours) who underwent CT perfusion (CTP) imaging were prospectively tracked. CTP findings, clinical course, age and initial NIHSS were retrospectively reviewed. The primary outcome was EVT eligibility using DAWN or DEFUSE criteria. Secondary outcomes were penumbra (Tmax>6s) and core (CBF Results: Of 46 included patients, the Viz CTP and RAPID software provided discordant EVT eligibility in 5 cases (4 by DEFUSE criteria and 1 by DAWN). By DAWN criteria, agreement was almost perfect between the software packages (kappa 0.96, 95% CI 0.87-1.00, p Discussion: We observed no difference in eligibility for EVT using either software when both DEFUSE and DAWN criteria were considered. If using only one trial’s criteria, 10.6% of patients would have had differing eligibility for EVT depending on the package used, although this difference did not demonstrate statistical significance.
- Published
- 2022
12. Distance formula and shortest paths for the (n, k)-star graphs.
- Author
-
Eddie Cheng 0001, Jerrold W. Grossman, László Lipták, Ke Qiu 0001, and Zhizhang Shen
- Published
- 2010
- Full Text
- View/download PDF
13. Endovascular Therapy for Patients With Acute Ischemic Stroke During the COVID-19 Pandemic: A Proposed Algorithm
- Author
-
Opeolu Adeoye, Achala Vagal, Pooja Khatri, Anne Housholder, Joseph P. Broderick, Jordan Bonomo, Christopher T Richards, Evan Ramser, Peyman Shirani, Aaron W. Grossman, Charles J. Prestigiacomo, Dawn Kleindorfer, William A. Knight, Matthew S. Smith, Carl J. Fichtenbaum, and Stuart Bertsch
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.disease ,Endovascular therapy ,Brain ischemia ,Pneumonia ,Internal medicine ,Pandemic ,Cardiology ,Medicine ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Acute ischemic stroke - Published
- 2020
14. An algorithm to improve lateralization accuracy of inferior petrosal sinus sampling: procedural nuances for complex patterns of venous drainage. Patient series
- Author
-
Jonathan Forbes, Ruchi Bhabhra, Mark D. Johnson, Emily J. Lester, Trisha L. Stahl, Charles J. Prestigiacomo, Alaina Body, Peyman Shirani, Aaron W. Grossman, Abhijith V. Matur, and Matthew S. Smith
- Subjects
Series (stratigraphy) ,medicine.medical_specialty ,business.industry ,Endovascular neurosurgery ,Medicine ,Venous drainage ,General Medicine ,Radiology ,business ,Pituitary surgery ,Lateralization of brain function ,Inferior petrosal sinus sampling - Abstract
BACKGROUND Inferior petrosal sinus sampling (IPSS) is a useful technique in the diagnosis of Cushing’s disease (CD) when the imaging finding is negative or equivocal. Different authors have reported considerable variability in the ability to determine tumor laterality with IPSS. Here the authors present a retrospective case series of 7 patients who underwent IPSS using a systematic algorithm to improve lateralization accuracy by identifying optimal sampling sites on the basis of individual cavernous sinus drainage patterns in each patient. OBSERVATIONS Of the 7 patients identified, 6 were determined to have CD and subsequently underwent surgery. IPSS was accurate in all patients from whom laterality was predicted. Arterial and venous angiography were used to define cavernous sinus drainage patterns and determine optimal sampling sites. All patients who underwent surgery achieved hormonal cure. LESSONS All IPSS predictions of lateralization were correct when available, and all patients who underwent surgery achieved hormonal cure. Advances in angiographic techniques for identification of the site of primary drainage from the cavernous sinus and subsequent optimization of microcatheter placement may improve the ability to predict tumor laterality.
- Published
- 2021
15. Time-stamped Graphs and Their Associated Influence Digraphs.
- Author
-
Eddie Cheng 0001, Jerrold W. Grossman, and Marc J. Lipman
- Published
- 2003
- Full Text
- View/download PDF
16. Influence Digraphs Induced by Time-Stamped Graphs (Extended Abstract).
- Author
-
Eddie Cheng 0001, Jerrold W. Grossman, and Marc J. Lipman
- Published
- 2002
- Full Text
- View/download PDF
17. [untitled].
- Author
-
Jerrold W. Grossman
- Published
- 2000
18. Automated CT perfusion imaging for acute ischemic stroke
- Author
-
Kambiz Nael, Mark W Parsons, Max Wintermark, Pooja Khatri, Andrew Bivard, Aaron W. Grossman, and Achala Vagal
- Subjects
medicine.medical_specialty ,Perfusion Imaging ,Perfusion scanning ,Automation ,03 medical and health sciences ,0302 clinical medicine ,Image Interpretation, Computer-Assisted ,Image Processing, Computer-Assisted ,Medical imaging ,medicine ,Humans ,030212 general & internal medicine ,Cerebral perfusion pressure ,Stroke ,Acute ischemic stroke ,business.industry ,Patient Selection ,Penumbra ,Endovascular Procedures ,Brain ,medicine.disease ,Cerebral blood flow ,Neurology (clinical) ,Radiology ,Tomography, X-Ray Computed ,business ,Perfusion ,030217 neurology & neurosurgery - Abstract
Recent positive trials have thrust acute cerebral perfusion imaging into the routine evaluation of acute ischemic stroke. Updated guidelines state that in patients with anterior circulation large vessel occlusions presenting beyond 6 hours from time last known well, advanced imaging selection including perfusion-based selection is necessary. Centers that receive patients with acute stroke must now have the capability to perform and interpret CT or magnetic resonance perfusion imaging or provide rapid transfer to centers with the capability of selecting patients for a highly impactful endovascular therapy, particularly in delayed time windows. Many stroke centers are quickly incorporating the use of automated perfusion processing software to interpret perfusion raw data. As CT perfusion (CTP) is being assimilated in real-world clinical practice, it is essential to understand the basics of perfusion acquisition, quantification, and interpretation. It is equally important to recognize the common technical and clinical diagnostic challenges of automated CTP including ischemic core and penumbral misclassifications that could result in underestimation or overestimation of the core and penumbra volumes. This review highlights the pitfalls of automated CTP along with practical pearls to address the common challenges. This is particularly tailored to aid the acute stroke clinician who must interpret automated perfusion studies in an emergency setting to make time-dependent treatment decisions for patients with acute ischemic stroke.
- Published
- 2019
19. Abstract P121: Update on Regional Stroke Activation Trends During Covid-19 Mitigation
- Author
-
Opeolu Adeoye, Katrina Peariso, Pooja Khatri, Matthew L. Flaherty, Joseph P. Broderick, Peyman Shirani, Heidi Sucharew, Aaron W. Grossman, Natalie Kreitzer, Kyle B Walsh, Stacie L Demel, Jessica Hsiao, Charles J. Prestigiacomo, Robert J Stanton, Emily Sayles, Holly Lampton, Eleni Antzoulatos, and Charles Kircher
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Iv thrombolysis ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Stroke team ,medicine.disease ,symbols.namesake ,Emergency medicine ,symbols ,medicine ,Neurology (clinical) ,Poisson regression ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,Acute stroke - Abstract
Background: The University of Cincinnati Stroke Team provides acute stroke care to the southwest Ohio, northern Kentucky, and southeast Indiana catchment area of ~2 million people and 30 healthcare facilities. We previously published a significant decline in stroke activations and reperfusion treatment (IV thrombolysis and EVT) rates following state announcements of COVID-19 mitigation measures. Here, we update these trends after state reopening guidelines. Methods: We compared Stroke Team activations and reperfusion treatments logged in a prospectively collected database, comparing the same period in 2020 versus 2019. Kentucky and Ohio announced school and restaurant closures on March 12 and 13, respectively, followed by Indiana. A stepwise reopening of our tristate area started on May 1, 2020. We also compared trends in activations and treatment rates before (Weeks 1-10), during (Weeks 11-17), and after (Weeks 18-26) the lifting of COVID-19 mitigation efforts using the Poisson test, and graphically with segmented regression analysis. Results: Compared to 2019, stroke team activations declined by 12% in 2020 (95% CI 7 - 16%; p Conclusion: The initial decline in stroke team activations during COVID-19 mitigation efforts was followed by an increase in activations after reopening. Hospital capacity and 911 services remained fully intact, suggesting that the reduction in activations were related to reduced presentation by patients for emergent stroke care.
- Published
- 2021
20. Dominating sets whose closed stars form spanning trees.
- Author
-
Jerrold W. Grossman
- Published
- 1997
- Full Text
- View/download PDF
21. On weakly connected domination in graphs.
- Author
-
Jean E. Dunbar, Jerrold W. Grossman, Johannes H. Hattingh, Stephen T. Hedetniemi, and Alice A. McRae
- Published
- 1997
- Full Text
- View/download PDF
22. Constrained Reconstruction Applied to 2-D Chemical Shift Imaging.
- Author
-
Keith A. Wear, Kyle J. Myers, Sunder S. Rajan, and Laurence W. Grossman
- Published
- 1997
- Full Text
- View/download PDF
23. Spanning Star Trees in Regular Graphs.
- Author
-
Jerrold W. Grossman
- Published
- 1997
- Full Text
- View/download PDF
24. Fractional Arboricity, Strength, and Principal Partitions in Graphs and Matroids.
- Author
-
Paul A. Catlin, Jerrold W. Grossman, Arthur M. Hobbs, and Hong-Jian Lai
- Published
- 1992
- Full Text
- View/download PDF
25. Effect of COVID-19 on Emergent Stroke Care: A Regional Experience
- Author
-
Joseph P. Broderick, Opeolu Adeoye, Peyman Shirani, Katrina Peariso, Eleni Antzoulatos, Holly Lampton, Robert J Stanton, Matthew L. Flaherty, Charles J. Prestigiacomo, Aaron W. Grossman, Charles Kircher, Stacie L Demel, Emily Sayles, Pooja Khatri, Jessica Hsiao, Heidi Sucharew, Kyle B Walsh, and Natalie Kreitzer
- Subjects
medicine.medical_specialty ,Indiana ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Time to treatment ,Kentucky ,restaurants ,030204 cardiovascular system & hematology ,Stroke care ,pandemics ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Pandemic ,medicine ,Humans ,Thrombolytic Therapy ,viruses ,Prospective Studies ,Intensive care medicine ,Stroke ,Referral and Consultation ,Anecdotal evidence ,Ohio ,Thrombectomy ,Advanced and Specialized Nursing ,Patient Care Team ,Patient care team ,business.industry ,Brief Report ,COVID-19 ,medicine.disease ,stroke ,reperfusion ,Treatment Outcome ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Coronavirus Infections ,030217 neurology & neurosurgery - Abstract
Supplemental Digital Content is available in the text., Background and Purpose: Anecdotal evidence suggests that the coronavirus disease 2019 (COVID-19) pandemic mitigation efforts may inadvertently discourage patients from seeking treatment for stroke with resultant increased morbidity and mortality. Analysis of regional data, while hospital capacities for acute stroke care remained fully available, offers an opportunity to assess this. We report regional Stroke Team acute activations and reperfusion treatments during COVID-19 mitigation activities. Methods: Using case log data prospectively collected by a Stroke Team exclusively serving ≈2 million inhabitants and 30 healthcare facilities, we retrospectively reviewed volumes of consultations and reperfusion treatments for acute ischemic stroke. We compared volumes before and after announcements of COVID-19 mitigation measures and the prior calendar year. Results: Compared with the 10 weeks prior, stroke consultations declined by 39% (95% CI, 32%–46%) in the 5 weeks after announcement of statewide school and restaurant closures in Ohio, Kentucky, and Indiana. Results compared with the prior year and time trend analyses were consistent. Reperfusion treatments also appeared to decline by 31% (95% CI, 3%–51%), and specifically thrombolysis by 33% (95% CI, 4%–55%), but this finding had less precision. Conclusions: Upon the announcement of measures to mitigate COVID-19, regional acute stroke consultations declined significantly. Reperfusion treatment rates, particularly thrombolysis, also appeared to decline qualitatively, and this finding requires further study. Urgent public education is necessary to mitigate a possible crisis of avoiding essential emergency care due to COVID-19.
- Published
- 2020
26. P16.07 ARC-10: Phase 3 Study of Zimberelimab ± Domvanalimab vs Standard Chemotherapy in Front-Line, PD-L1-High, Metastatic NSCLC
- Author
-
K. Krishnan, P. Phuong, Houston Gilbert, W. Grossman, D. Colburn, X. He, and Y. Li
- Subjects
Pulmonary and Respiratory Medicine ,Chemotherapy ,biology ,business.industry ,medicine.medical_treatment ,Phases of clinical research ,Front line ,Arc (geometry) ,Oncology ,PD-L1 ,biology.protein ,Medicine ,business ,Nuclear medicine - Published
- 2021
27. Diminishing returns with successive device passes in mechanical thrombectomy for stroke
- Author
-
Rimal H Dossani, Zachary Plummer, Sandeep Kandregula, Christopher P. Carroll, Andrew J. Ringer, Aaron W. Grossman, Jennifer A. Kosty, and Todd A. Abruzzo
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Revascularization ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,Internal medicine ,medicine ,Humans ,Stroke ,Aged ,Retrospective Studies ,Thrombectomy ,business.industry ,Cerebral infarction ,Mortality rate ,Brain ,Retrospective cohort study ,General Medicine ,Thrombolysis ,Middle Aged ,medicine.disease ,Treatment Outcome ,030220 oncology & carcinogenesis ,Cardiology ,Female ,Surgery ,Neurology (clinical) ,Tomography, X-Ray Computed ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND Multiple device passes are associated with complications and poor functional outcomes following mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO). OBJECTIVE To characterize the relationship between number of device passes, complications, angiographic outcomes, and clinical outcomes in MT for ELVO. METHODS This is a single-center, retrospective cohort study. Individual device passes for MT were evaluated for any change in Thrombolysis in Cerebral Infarction (TICI) score, successful revascularization (TICI 2b or 3), and complications. Outcomes were compared among groups requiring multiple passes with various cut-off points. Risk factors for unfavorable clinical outcome [90 day modified Rankin Scale > 2] were assessed using multivariate analysis. RESULTS Successful revascularization was achieved in 75% of 163 patients and 36% required only one device pass. After the second pass, the likelihood of angiographic improvement significantly decreased (p
- Published
- 2021
28. Association Between Acute Kidney Disease and Intravenous Dye Administration in Patients With Acute Stroke
- Author
-
Sharyl Martini, Opeolu Adeoye, Matthew L. Flaherty, Charles J Moomaw, Felipe De Los Rios La Rosa, Jane Khoury, Jason Mackey, Aaron W. Grossman, Brett M. Kissela, Dawn Kleindorfer, Kathleen Alwell, Simona Ferioli, Stacie L Demel, and Daniel Woo
- Subjects
Male ,medicine.medical_specialty ,Halogenation ,Contrast Media ,Kentucky ,030204 cardiovascular system & hematology ,Article ,Brain Ischemia ,Brain ischemia ,03 medical and health sciences ,0302 clinical medicine ,Iodinated contrast ,Internal medicine ,Epidemiology ,Humans ,Medicine ,Stroke ,Aged ,Cerebral Hemorrhage ,Ohio ,Aged, 80 and over ,Advanced and Specialized Nursing ,medicine.diagnostic_test ,business.industry ,Acute kidney injury ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Cerebral Angiography ,Surgery ,Angiography ,Cardiology ,Administration, Intravenous ,Female ,Kidney Diseases ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Kidney disease ,Cerebral angiography - Abstract
Background and Purpose— Computed tomographic angiography and conventional angiography provide timely vascular anatomic information in patients with stroke. However, iodinated contrast dye may cause acute kidney injury (AKI). Within a large, biracial population, we examined in-hospital incidence of new or worsening kidney disease in patients with stroke and its association with administration of intravenous dye. Methods— All adult residents of the Greater Cincinnati/Northern Kentucky region with acute ischemic stroke or intracerebral hemorrhage who presented to an emergency department in 2010 were included. Prevalence of unsuspected kidney disease at the time of emergency department presentation and the incidence of AKI after admission in 2 groups of patients—those who did and those who did not receive intravenous dye—were determined. Results— In 2010, 2299 patients met inclusion criteria (89% ischemic stroke and 11% intracerebral hemorrhage); mean age 69 years (SD 15), 22% black, and 54% women. Among these patients, 37% had kidney disease at baseline, including 22% (516/2299) in whom this was unsuspected. Two percent (2%; 15/853) of patients with baseline kidney disease developed AKI during the hospital stay. Of those with no baseline kidney disease, 1% (14/14 467) developed AKI. There was no association between dye administration and new or worsening kidney disease. Conclusions— Although 22% of patients in the Greater Cincinnati/Northern Kentucky stroke population had unsuspected kidney disease, the incidence of new or worsening kidney disease was low, and AKI was not associated with dye administration. These findings confirm single-center reports that the risk of severe renal complications after contrast dye is small.
- Published
- 2017
29. Identifying Critical Design Parameters for Improved Body Temperature Measurements: A Clinical Study Comparing Transient and Predicted Temperature Measurements
- Author
-
Nadeesri Wijekoon, Laurence W. Grossman, L. D. Timmie Topoleski, Jon P. Casamento, Alireza Chamani, Oleg Vesnovsky, and Liang Zhu
- Subjects
Clinical study ,Materials science ,Steady state (electronics) ,Biomedical Engineering ,Medicine (miscellaneous) ,Transient (oscillation) ,Mechanics ,Temperature measurement - Abstract
Readily available store brand, or “home,” thermometers are used countless times in the home and clinic as a first diagnostic measure of body temperature. Measurement inaccuracies may lead to unnecessary medical visits or medication (false positives), or, potentially worse, lack of intervention when a person is truly sick (false negatives). A critical first step in the design process is to determine the shortcomings of the existing designs. For this project, we evaluated the accuracy of three currently available store brand thermometers in a pediatric population. The accuracies of the thermometers were assessed by comparing their body temperature predictions to those measured by a specially designed and calibrated and fast-responding reference thermometer. The reference thermometer was placed at the measurement site simultaneously with the store brand thermometer and recorded the temperature at the measurement site continuously. More than 300 healthy or sick pediatric subjects were enrolled in this study. Temperatures were measured at both the oral and axillary (under the arm) sites. The store brand thermometer measurements characteristically deviated from the reference thermometer temperature after 120 s, and the deviations did not follow a consistent pattern. The Brand C thermometers had the greatest deviations of up to 3.7 °F (2.1 °C), while the Brand A thermometers had the lowest deviations; however, they still deviated by up to 1.9 °F (1.1 °C). The data showed that the tested store brand thermometers had lower accuracy than the ±0.2 °F (0.1 °C) indicated in their Instructions for Use. Our recorded reference (transient) data showed that there was a wide variation in the transient temperature profiles. The store brand thermometers tested stated in their documentation that they are able to predict a body temperature based on transient temperature values over the first 5–10 s of measurements, implying that they use an embedded algorithm to extrapolate to the steady-state temperature. Significant deviations from the maximum temperature after time t = 4.6t0.63 illustrated that the transient temperature profiles may not be represented by an exponential function with a single time constant, t0.63. The accuracy of those embedded algorithms was not confirmed by our study, since the predicted body temperatures do not capture the large variations observed over the initial 10 s of the measurements. A thermometer with an error of several degrees Fahrenheit may result in a false positive or negative diagnosis of fever in children. The transient temperature measurements from our clinical study represent unique and critical data for helping to design the next generation of readily available, highly accurate, home thermometers.
- Published
- 2018
30. Stenting in High-Grade Internal Carotid Artery Stenosis: 2-Dimensional Operative Video
- Author
-
Peyman Shirani, Juan C. Mejia-Munne, Joel M Kaye, Aaron W. Grossman, Matthew S Smith, and Charles J. Prestigiacomo
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Carotid endarterectomy ,medicine.artery ,Angioplasty ,medicine ,Humans ,Carotid Stenosis ,cardiovascular diseases ,Stroke ,Interventional neuroradiology ,Endarterectomy, Carotid ,business.industry ,Stent ,medicine.disease ,Stenosis ,Stents ,Surgery ,Neurology (clinical) ,Radiology ,Carotid stenting ,Internal carotid artery ,business ,Carotid Artery, Internal - Abstract
Carotid artery stenosis is implicated in up to 40% of all ischemic strokes. Accordingly, symptomatic, high-grade carotid artery stenosis portends an especially high risk of future stroke. Intervention via open or endovascular approaches drastically reduces this risk. Under the appropriate conditions, carotid artery stenting serves as a safe and effective alternative to carotid endarterectomy. We present the case of a 57-yr-old male with symptomatic, high-grade stenosis of his right internal carotid artery, for whom a history of radiation to the head and neck represented a relative contraindication to carotid endarterectomy, and thus endovascular treatment with angioplasty and stenting was performed. Informed consent was obtained prior to the procedure. Intraprocedurally, stent delivery past the area of stenosis proved somewhat challenging. However, by employing several nuanced maneuvers, we utilized our guiding catheter in a nonconventional manner in order to successfully perform the procedure. As the field of neuroendovascular surgery evolves, each case provides us unique lessons, which in turn expands our interventional capabilities and adds to the armamentarium of neuroendovascular techniques. We present this surgical video both as a means to provide a general overview of carotid artery stenting, and to share a lesson learned through the implementation of an interesting technical nuance.
- Published
- 2021
31. Avoiding Uncountably Many Subsets: 10667.
- Author
-
Zoltán Sasvári, Jerrold W. Grossman, and Sung Soo Kim
- Published
- 2000
32. Distinguishing between the Partite Sets of a Bipartite Graph: 10740.
- Author
-
Charles Vanden Eynden and Jerrold W. Grossman
- Published
- 2001
33. Miscellanea
- Author
-
J. W. Grossman
- Published
- 2017
34. In-Vitro Pulsatile Flow Measurement in Prosthetic Heart Valves: An Inter-Laboratory Comparison
- Author
-
Stephen M, Retta, Jeff, Kepner, Salvador, Marquez, Bruce A, Herman, Mark C, S Shu, and Laurence W, Grossman
- Subjects
Heart Valve Prosthesis ,Pulsatile Flow ,Materials Testing ,Prosthesis Design ,Heart Valves - Abstract
One of the first steps in qualifying a new prosthetic valve for eventual clinical use is preclinical flow performance testing in vitro. Such testing is typically performed in an in-vitro test system that simulates the pumping mechanics of the left ventricle of the heart, generally referred to as a pulse duplicator or duplicator. Historically, test results in these systems have varied from duplicator to duplicator. This collaborative effort between heart valve manufacturers and the Food and Drug Administration (FDA) was designed to evaluate the variability of the pulse duplicator test technology for pulsatile flow performance measurement in an interlaboratory round robin.The participants jointly developed and followed a limited test protocol based on accepted methods outlined in the International Standards Organization 5840: Cardiovascular Implants - Cardiac Valve Prostheses, and in the FDA Replacement Heart Valve Guidance. One 25 mm valve, each of four basic designs, was circulated to test centers which included four manufacturers and two FDA duplicators. The pressure drop and regurgitation data were then collected and summarized by the FDA.Considerable variation was observed in hydrodynamic performance measures of pressure drop across the valve and back flow leakage through the valve among the different duplicators. Despite the variations seen in these measures, the results from all centers showed that the valves conformed to certain minimum performance criteria.Despite the fact that the valves would have been judged to have met Minimum Performance Requirements of effective orifice area and regurgitant fraction, as specified in the international standard, variations in measurements existed among duplicators. Valve manufacturers should use a reference valve of similar design in hydrodynamic performance testing to assess the individual measurement conditions in the duplicator.
- Published
- 2017
35. Abstract TP217: Intra-arterial Verapamil Can Help Differentiate Reversible From Non-reversible Vasculopathy
- Author
-
Eileen C Vallin, Aaron M Betts, Aaron W. Grossman, Joseph C. Serrone, Todd Abruzzo, Andrew J. Ringer, and Ryan D. Tackla
- Subjects
Advanced and Specialized Nursing ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Intra arterial ,Cardiology ,Verapamil ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Introduction: Cerebral angiography (DSA) is commonly used to characterize small vessel vasculopathy, yet it is difficult to establish etiology by angiographic patterns alone. Hypothesis: Responsiveness to intra-arterial verapamil (IA-V) can help differentiate etiology of small vessel vasculopathy by characterizing it as reversible or non-reversible. Methods: We performed a retrospective analysis from 2013-15 of patients referred for DSA to evaluate cerebral vasculopathy. We characterized symptoms, radiographic findings, angiographic pattern and responsiveness to IA-V, if given, as well as biopsy and follow-up angiography. Results: Thirty-three patients were identified (70% female; mean age 47.7). Presenting symptoms were headache (48%), focal neurologic deficit (45%), cognitive impairment (30%) and seizure (18%). Three patients presented in the post-partum period. Radiographic findings included infarct (42%), cortical subarachnoid hemorrhage (33%) and cerebral edema (3%). Arteriopathy was present on DSA in 19 of 33 patients (58%). Twelve patients had smooth segmental narrowing, 6 had irregular narrowing, 1 had diffuse narrowing. IA-V was administered in 12 of the 19 patients with arteriopathy (63%), including 9 of 12 with smooth segmental, 2 of 6 with irregular, and the patient with diffuse narrowing. Of 9 patients with smooth segment narrowing that received IA-V, 8 exhibited a vasodilatory response (89%). In 1 of these patients, superficial temporal artery biopsy was normal. Follow-up DSA was performed in 4 of the 8 patients with verapamil-responsive arteriopathy at a median time of 86 days. All 4 had angiographic resolution of their arteriopathy, consistent with reversible cerebral vasoconstriction syndrome. The 3 patients with irregular or diffuse narrowing who received IA-V did not exhibit vasodilatory response or have follow-up angiography. In 3 patients with irregular narrowing, brain biopsy was performed; 1 revealed CNS vasculitis, 2 were normal, consistent with atherosclerosis. Conclusion: Our series is consistent with reports of patients with reversible vasculopathy exhibiting a response to IA vasodilators. Response to IA-V may better characterize small vessel vasculopathy than angiographic pattern alone.
- Published
- 2017
36. Vertebrobasilar Fusiform Aneurysms
- Author
-
Norberto Andaluz, Mario Zuccarello, Todd Abruzzo, Yair M. Gozal, Joseph C. Serrone, Aaron W. Grossman, and Andrew J. Ringer
- Subjects
medicine.medical_specialty ,Subarachnoid hemorrhage ,Fusiform Aneurysm ,Aneurysm ,Internal medicine ,medicine ,Berry Aneurysm ,Humans ,cardiovascular diseases ,Vertebral Artery ,Medical treatment ,Flow diversion ,business.industry ,Incidence ,Endovascular Procedures ,Intracranial Aneurysm ,General Medicine ,medicine.disease ,Flow reduction ,Radiography ,Basilar Artery ,Ischemic stroke ,cardiovascular system ,Cardiology ,Surgery ,Neurology (clinical) ,business - Abstract
Unlike saccular or berry aneurysms, which present more often with subarachnoid hemorrhage, fusiform aneurysms present more often with ischemic stroke or mass effect. The most time-tested treatment of fusiform vertebrobasilar aneurysms consists of flow reduction or flow reversal. Recently, flow diversion has been attempted with mixed results in the posterior circulation. Given the described pathophysiologic processes of fusiform aneurysms that may be altered with modern medical therapies, future investigators may look to medical treatment of these lesions, especially in cases of poor surgical candidates.
- Published
- 2014
37. Advances and challenges in treatment and prevention of ischemic stroke
- Author
-
Joseph P. Broderick and and Aaron W. Grossman Md
- Subjects
Research design ,medicine.medical_specialty ,business.industry ,MEDLINE ,Atrial fibrillation ,medicine.disease ,Vascular occlusion ,law.invention ,Clinical trial ,Neurology ,Randomized controlled trial ,law ,Ischemic stroke ,medicine ,Physical therapy ,cardiovascular diseases ,Neurology (clinical) ,medicine.symptom ,Intensive care medicine ,business ,Stroke - Abstract
We review recent advances in the treatment and prevention of acute ischemic stroke, including the current state of endovascular therapy, in light of 5 randomized controlled trials published this past year. Although no benefit of endovascular therapy over intravenous (IV) recombinant tissue plasminogen activator (rt-PA) has been demonstrated, endovascular therapy is an appropriate treatment for acute ischemic stroke patients within the t-PA window who are ineligible for IV t-PA but have a large vascular occlusion. These trials reveal promises and current limitations of endovascular therapy, and comparison of reperfusion therapies remains an important area of research. One common theme is the strong association between a faster time to reperfusion, improved outcome, and reduced mortality. Primary and secondary stroke prevention trials emphasize the importance of aggressive management of medical risk factors as part of any preventative strategy. New oral anticoagulants, for example, offer cost-effective risk reduction in patients with atrial fibrillation, and may represent an opportunity for those with cryptogenic stroke. We highlight areas of unmet need and promising research in stroke, including the need to deliver proven therapies to more patients, and the need to recruit patients into clinical trials that better define the role of endovascular and other stroke therapies. Finally, improvement in strategies to recover speech, cognition, and motor function has the potential to benefit far more stroke patients than any acute stroke therapy, and represents the greatest opportunity for research in the coming century.
- Published
- 2013
38. The number of shortest paths in the arrangement graph
- Author
-
Jerrold W. Grossman, Ke Qiu, Eddie Cheng, and Zhizhang Shen
- Subjects
Discrete mathematics ,Mathematics::Combinatorics ,Information Systems and Management ,Floyd–Warshall algorithm ,Computer Science Applications ,Theoretical Computer Science ,Graph enumeration ,Combinatorics ,Permutation ,Artificial Intelligence ,Control and Systems Engineering ,Shortest path problem ,Bijection ,Path graph ,K shortest path routing ,Software ,Distance ,MathematicsofComputing_DISCRETEMATHEMATICS ,Mathematics - Abstract
A solution to the shortest path enumeration problem can find numerous applications in studying issues related to interconnection networks. In this paper, we enumerate the number of shortest paths between any two vertices in an arrangement graph by establishing a bijection between these shortest paths and a collection of ordered forests of certain bi-colored trees, via minimum factorizations of permutations corresponding to such vertices in terms of so-called arrangement transpositions, and then count the number of these forests with the help of an existing result on the enumeration of such bi-colored trees. Our result generalizes previous ones and can be applied to solve the same problem for other related graphs such as the alternating group graph. On the other hand, the techniques applied to derive such an enumeration result further extend the ongoing work of counting the number of minimum factorizations of a permutation in terms of a certain type of transposition, a rather interesting problem in the area of algebraic combinatorics.
- Published
- 2013
39. Evaluating Accuracy of Digital Thermometers Using a Tissue Phantom Mimicking Normal and Fever Environments1
- Author
-
Laurence W. Grossman, L. D. Timmie Topoleski, Oleg Vesnovsky, Liang Zhu, and Jon P. Casamento
- Subjects
medicine.medical_specialty ,Digital thermometers ,business.industry ,Biomedical Engineering ,Medicine (miscellaneous) ,Medicine ,Radiology ,business ,Nuclear medicine ,Tissue phantom - Published
- 2016
40. Aneurysm growth and de novo aneurysms during aneurysm surveillance
- Author
-
Bryan M Krueger, Calen A. Steiner, Jennifer Kosty, Joseph C. Serrone, Shawn M. Vuong, Aaron W. Grossman, Andrew J. Ringer, Ryan D. Tackla, Steven L. Gogela, Dennis J. Hanseman, and Yair M. Gozal
- Subjects
Male ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Younger age ,Time Factors ,De novo aneurysm ,Risk Assessment ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Risk Factors ,medicine ,Humans ,cardiovascular diseases ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Retrospective cohort study ,Intracranial Aneurysm ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Cerebral Angiography ,Population Surveillance ,cardiovascular system ,Disease Progression ,Female ,Radiology ,Risk assessment ,business ,030217 neurology & neurosurgery ,Cerebral angiography ,Follow-Up Studies - Abstract
OBJECTIVE Many low-risk unruptured intracranial aneurysms (UIAs) are followed for growth with surveillance imaging. Growth of UIAs likely increases the risk of rupture. The incidence and risk factors of UIA growth or de novo aneurysm formation require further research. The authors retrospectively identify risk factors and annual risk for UIA growth or de novo aneurysm formation in an aneurysm surveillance protocol. METHODS Over an 11.5-year period, the authors recommended surveillance imaging to 192 patients with 234 UIAs. The incidence of UIA growth and de novo aneurysm formation was assessed. With logistic regression, risk factors for UIA growth or de novo aneurysm formation and patient compliance with the surveillance protocol was assessed. RESULTS During 621 patient-years of follow-up, the incidence of aneurysm growth or de novo aneurysm formation was 5.0%/patient-year. At the 6-month examination, 5.2% of patients had aneurysm growth and 4.3% of aneurysms had grown. Four de novo aneurysms formed (0.64%/patient-year). Over 793 aneurysm-years of follow-up, the annual risk of aneurysm growth was 3.7%. Only initial aneurysm size predicted aneurysm growth (UIA < 5 mm = 1.6% vs UIA ≥ 5 mm = 8.7%, p = 0.002). Patients with growing UIAs were more likely to also have de novo aneurysms (p = 0.01). Patient compliance with this protocol was 65%, with younger age predictive of better compliance (p = 0.01). CONCLUSIONS Observation of low-risk UIAs with surveillance imaging can be implemented safely with good adherence. Aneurysm size is the only predictor of future growth. More frequent (semiannual) surveillance imaging for newly diagnosed UIAs and UIAs ≥ 5 mm is warranted.
- Published
- 2016
41. Stroke
- Author
-
Sharyl Martini, Thomas A. Kent, and Aaron W. Grossman
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,business.industry ,medicine ,business ,medicine.disease ,Stroke - Published
- 2016
42. Contributing Authors
- Author
-
Catherine C. Roberts, Theodore T. Miller, Cheryl Petersilge, William B. Morrison, Carol L. Andrews, Jefrey W. Grossman, and Zehava Sadka Rosenberg
- Published
- 2016
43. The Use of Neuroimaging Studies and Neurological Consultation to Evaluate Dizzy Patients in the Emergency Department
- Author
-
S. Andrew Josephson, Christine Wong, S. Claiborne Johnston, Hooman Kamel, William D. Whetstone, Maulik P. Shah, Anthony S. Kim, Sharon N. Poisson, Aaron W. Grossman, and Babak B. Navi
- Subjects
medicine.medical_specialty ,neuroimaging ,referral and consultation ,biology ,business.industry ,Neurosciences ,Emergency department ,medicine.disease ,biology.organism_classification ,Emergency Care ,Brain Disorders ,vertigo ,Neuroimaging ,emergency medicine ,Clinical Research ,Vertigo ,Neurological ,medicine ,Biomedical Imaging ,Original Article ,Neurology (clinical) ,Medical emergency ,Psychiatry ,business ,dizziness - Abstract
Background and Purpose: Dizziness is a frequent reason for neuroimaging and neurological consultation, but little is known about the utility of either practice. We sought to characterize the patterns and yield of neuroimaging and neurological consultation for dizziness in the emergency department (ED). Methods: We retrospectively identified consecutive adults presenting to an academic ED from 2007 to 2009, with a primary complaint of dizziness, vertigo, or imbalance. Neurologists reviewed medical records to determine clinical characteristics, whether a neuroimaging study (head computed tomography [CT] or brain magnetic resonance imaging [MRI]) or neurology consultation was obtained in the ED, and to identify relevant findings on neuroimaging studies. Two neurologists assigned a final diagnosis for the cause of dizziness. Logistic regression was used to evaluate bivariate and multivariate predictors of neuroimaging and consultation. Results: Of 907 dizzy patients (mean age 59 years; 58% women), 321 (35%) had a neuroimaging study (28% CT, 11% MRI, and 4% both) and 180 (20%) had neurological consultation. Serious neurological disease was ultimately diagnosed in 13% of patients with neuroimaging and 21% of patients with neurological consultation, compared to 5% of the overall cohort. Headache and focal neurological deficits were associated with both neuroimaging and neurological consultation, while age ≥60 years and prior stroke predicted neuroimaging but not consultation, and positional symptoms predicted consultation but not neuroimaging. Conclusion: In a tertiary care ED, neuroimaging and neurological consultation were frequently utilized to evaluate dizzy patients, and their diagnostic yield was substantial.
- Published
- 2012
44. The Geography of the Mathematics Research Collaboration Graph
- Author
-
Jerrold W. Grossman
- Subjects
Geography ,Geography, Planning and Development ,Humanities ,Earth-Surface Processes ,Collaboration graph - Abstract
Social networks have become a hot topic for research in the last decade or so. I study one such network in considerable detail: the graph of research collaborations among mathematicians. This graph displays many of the characteristics that various authors have found common to social networks in general. My “geographical” analysis includes the size of this graph, the distribution of the degrees of its vertices, its connectivity, the distances between its vertices, and its clustering coefficient. I also discuss the playful concept of Erdős numbers. Las redes sociales se han convertido en un tema de gran interes de investigacion durante la ultima decada mas o menos. El autor analiza una de esas redes a detalle: el grafo de las colaboraciones de investigacion entre matematicos. Este grafo muestra muchas de las caracteristicas comunes que varios autores han encontrado en redes sociales en general. El analisis “geografico” incluye el tamano de este grafo, la distribucion de los grados de sus vertices, su conectividad, las distancias entre sus vertices, y su coeficiente de concentracion o clustering. El estudio tambien trata el concepto ludico de los numeros de Erdos. 社会网络已成为近十年来研究的热点。作者详尽地研究了数学家间研究合作图。该图显示了不同作者间常拥有一般社会网络共有的许多特性。本文的地理分析包括图的大小、顶点的分布度与连结性,不同边之间的距离以及聚类指数。同时还讨论了有趣的Erdős 数的概念。
- Published
- 2011
45. Understanding the complex pathophysiology of idiopathic intracranial hypertension and the evolving role of venous sinus stenting: a comprehensive review of the literature
- Author
-
Nisha Giridharan, Joseph S. Cheng, Aaron W. Grossman, Amanda Ojugbeli, Aria Nouri, Mario Zuccarello, Peyman Shirani, Smruti K. Patel, and Charles J. Prestigiacomo
- Subjects
medicine.medical_specialty ,Pseudotumor cerebri ,Population ,Disease ,Cranial Sinuses ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Cerebrospinal fluid ,Internal medicine ,medicine ,Animals ,Humans ,education ,Sinus (anatomy) ,Pseudotumor Cerebri ,education.field_of_study ,business.industry ,General Medicine ,medicine.disease ,Pathophysiology ,Stenosis ,medicine.anatomical_structure ,Etiology ,Cardiology ,Stents ,Surgery ,Neurology (clinical) ,Comprehension ,business ,030217 neurology & neurosurgery - Abstract
Idiopathic intracranial hypertension (IIH) is a disease defined by elevated intracranial pressure without established etiology. Although there is now consensus on the definition of the disorder, its complex pathophysiology remains elusive. The most common clinical symptoms of IIH include headache and visual complaints. Many current theories regarding the etiology of IIH focus on increased secretion or decreased absorption of cerebrospinal fluid (CSF) and on cerebral venous outflow obstruction due to venous sinus stenosis. In addition, it has been postulated that obesity plays a role, given its prevalence in this population of patients. Several treatments, including optic nerve sheath fenestration, CSF diversion with ventriculoperitoneal or lumboperitoneal shunts, and more recently venous sinus stenting, have been described for medically refractory IIH. Despite the availability of these treatments, no guidelines or standard management algorithms exist for the treatment of this disorder. In this paper, the authors provide a review of the literature on IIH, its clinical presentation, pathophysiology, and evidence supporting treatment strategies, with a specific focus on the role of venous sinus stenting.
- Published
- 2018
46. Distance formula and shortest paths for the (n,k)-star graphs
- Author
-
Jerrold W. Grossman, László Lipták, Eddie Cheng, Ke Qiu, and Zhizhang Shen
- Subjects
Discrete mathematics ,Information Systems and Management ,Astrophysics::Cosmology and Extragalactic Astrophysics ,Star (graph theory) ,Longest path problem ,Computer Science Applications ,Theoretical Computer Science ,Combinatorics ,Modular decomposition ,Indifference graph ,Pathwidth ,Shortest Path Faster Algorithm ,Artificial Intelligence ,Control and Systems Engineering ,Chordal graph ,Astrophysics::Solar and Stellar Astrophysics ,Astrophysics::Earth and Planetary Astrophysics ,Astrophysics::Galaxy Astrophysics ,Software ,Distance ,MathematicsofComputing_DISCRETEMATHEMATICS ,Mathematics - Abstract
The class of (n,k)-star graphs is a generalization of the class of star graphs. Thus a distance formula for the first class implies one for the second. In this paper, we show that the converse is also true. Another important concept is the number of shortest paths between two vertices. This problem has been solved for the star graphs. We will solve the corresponding problem for the (n,k)-star graphs.
- Published
- 2010
47. The IBEX Flight Segment
- Author
-
J. Crock, E. Fowler, E. Walter, C. Loeffler, T. Gaio, W. Holemans, M. Epperly, J. Gerhardus, M. Phillips, B. Ungar, G. Rahal, S. Pope, B. Hautamaki, Jennifer Hanley, Mark B. Tapley, S. Wesley, T. Wiegand, T. Perry, W. Cross, D. Hawes, A. Dunn, M. Peterson, John Scherrer, R. Tyler, A. DeLosSantos, S. Kinaman, A. Osovets, David J. McComas, B. Fields, S. Kirn, G. Dunn, W. Grossman, and John Carrico
- Subjects
Attitude control ,Spacecraft ,Space and Planetary Science ,business.industry ,Launched ,Astronomy and Astrophysics ,Adapter (rocketry) ,Solid-fuel rocket ,Propulsion ,Aerospace engineering ,business ,Heliosphere ,Mission assurance - Abstract
IBEX provides the observations needed for detailed modeling and in-depth understanding of the interstellar interaction (McComas et al. in Physics of the Outer Heliosphere, Third Annual IGPP Conference, pp. 162–181, 2004; Space Sci. Rev., 2009a, this issue). From mission design to launch and acquisition, this goal drove all flight system development. This paper describes the management, design, testing and integration of IBEX’s flight system, which successfully launched from Kwajalein Atoll on October 19, 2008. The payload is supported by a simple, Sun-pointing, spin-stabilized spacecraft with no deployables. The spacecraft bus consists of the following subsystems: attitude control, command and data handling, electrical power, hydrazine propulsion, RF, thermal, and structures. A novel 3-step orbit approach was employed to put IBEX in its highly elliptical, 8-day final orbit using a Solid Rocket Motor, which provided large delta-V after IBEX separated from the Pegasus launch vehicle; an adapter cone, which interfaced between the SRM and Pegasus; Motorized Lightbands, which performed separation from the Pegasus, ejection of the adapter cone, and separation of the spent SRM from the spacecraft; a ShockRing isolation system to lower expected launch loads; and the onboard Hydrazine Propulsion System. After orbit raising, IBEX transitioned from commissioning to nominal operations and science acquisition. At every phase of development, the Systems Engineering and Mission Assurance teams supervised the design, testing and integration of all IBEX flight elements.
- Published
- 2009
48. Social approach in genetically engineered mouse lines relevant to autism
- Author
-
Jean M. Lauder, Randal J. Nonneman, Jacqueline N. Crawley, Terry Magnuson, A. J. D'Ercole, A. W. Grossman, Sheryl S. Moy, Jessica J. Nadler, Dennis L. Murphy, and Nancy B. Young
- Subjects
Male ,Genetically modified mouse ,Oxidoreductases Acting on CH-CH Group Donors ,Nerve Tissue Proteins ,Anxiety ,Motor Activity ,Social identity approach ,Article ,Fragile X Mental Retardation Protein ,Mice ,Behavioral Neuroscience ,Neurodevelopmental disorder ,Pregnancy ,Genetics ,medicine ,Animals ,Autistic Disorder ,Insulin-Like Growth Factor I ,Social Behavior ,Postural Balance ,Serotonin transporter ,Homeodomain Proteins ,Mice, Knockout ,Serotonin Plasma Membrane Transport Proteins ,Sex Characteristics ,Behavior, Animal ,biology ,medicine.disease ,FMR1 ,Social relation ,Mice, Inbred C57BL ,Smell ,Neurology ,Endophenotype ,Exploratory Behavior ,biology.protein ,Autism ,Female ,Food Deprivation ,Genetic Engineering ,Psychology - Abstract
Profound impairment in social interaction is a core symptom of autism, a severe neurodevelopmental disorder. Deficits can include a lack of interest in social contact and low levels of approach and proximity to other children. In this study, a three-chambered choice task was used to evaluate sociability and social novelty preference in five lines of mice with mutations in genes implicated in autism spectrum disorders. Fmr1tm1Cgr/Y (Fmr1−/y) mice represent a model for fragile X, a mental retardation syndrome that is partially co-morbid with autism. We tested Fmr1−/y mice on two genetic backgrounds, C57BL/6J and FVB/N-129/OlaHsd (FVB/129). Targeted disruption of Fmr1 resulted in low sociability on one measure, but only when the mutation was expressed on FVB/129. Autism has been associated with altered serotonin levels and polymorphisms in SLC6A4 (SERT), the serotonin-transporter gene. Male mice with targeted disruption of Slc6a4 displayed significantly less sociability than wildtype controls. Mice with conditional overexpression of Igf-1 (Insulin-like growth factor-1) offered a model for brain overgrowth associated with autism. Igf-1 transgenic mice engaged in levels of social approach similar to wildtype controls. Targeted disruption in other genes of interest, En2 (Engrailed 2) and Dhcr7, was carried on genetic backgrounds that demonstrated low levels of exploration in the choice task, precluding meaningful interpretations of social behavior scores. Overall, results show that loss of Fmr1 or Slc6a4 gene function can lead to deficits in sociability. Findings from the fragile X-model suggest that the FVB/129 background confers enhanced susceptibility to consequences of Fmr1 mutation on social approach.
- Published
- 2009
49. Structures for Facilitating Student Reflection
- Author
-
Robert W. Grossman
- Subjects
Transformative learning ,Higher education ,business.industry ,ComputingMilieux_COMPUTERSANDEDUCATION ,Mathematics education ,Cognitive development ,Metacognition ,Scientific thinking ,business ,Psychology ,Education - Abstract
The goal of this article is to describe a continuum of levels of reflection. It briefly focuses on Deanna Kuhn's research into the development of scientific thinking and Robert Kegan's Object-Subject Theory of Development applied to the problems of inspiring students to be able to reflect. Assignments for improving students' ability to reflect are presented. Examples of student reflections are provided. These may be especially helpful for faculty in a wide range of courses.
- Published
- 2009
50. Severe autologous GVHD after hematopoietic progenitor cell transplantation for multiple myeloma
- Author
-
William R. Drobyski, Richard A. Komorowski, W Grossman, Parameswaran Hari, and Carolyn A. Keever-Taylor
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Graft vs Host Disease ,Hematopoietic stem cell transplantation ,Fatal Outcome ,Internal medicine ,medicine ,Humans ,Combined Modality Therapy ,Multiple myeloma ,Transplantation ,Hematology ,business.industry ,Hematopoietic Stem Cell Transplantation ,Cancer ,Middle Aged ,medicine.disease ,Graft-versus-host disease ,Immunology ,Stem cell ,Multiple Myeloma ,Complication ,business - Abstract
GVHD is a recognized complication of autologous hematopoietic progenitor cell transplantation (HPCT), but has typically been reported to respond well to primary therapy with corticosteroids. In this study, we report the development of severe autologous GVHD in five patients who underwent HPCT for multiple myeloma. In all cases, response to corticosteroids was unsatisfactory and three of these patients ultimately died from complications that ensued from prolonged immunosuppressive therapy. Severe autologous GVHD occurred only in patients transplanted for multiple myeloma and was observed at a much higher frequency in patients undergoing their second HPCT. The severity of this syndrome primarily in patients undergoing second HPCTs suggests that repetitive exposure to high-dose therapy may compromise endogenous peripheral regulatory mechanisms and predispose these patients to autoimmunity. Given the evolving role of second autologous transplantations in the therapeutic armamentarium for multiple myeloma, consideration of this potential toxicity may be appropriate when considering treatment options for these patients.
- Published
- 2008
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.