Stony Brook Research Articles

COMPARISON OF SURGICAL SITE INFECTION IN PATIENTS UNDERGOING SKIN CLOSURE WITH STAPLES VS. SUTURES IN CLEAN ELECTIVE SURGERIES

Thyroidectomy is a common surgical procedure with various techniques for wound closure, including dermal staples and intradermal suturing. Each method has potential advantages and disadvantages, particularly in terms of wound complications, cosmetic outcomes, and postoperative pain. Understanding which technique offers better outcomes in these areas can guide surgeons in selecting the most appropriate method for skin closure after thyroidectomy. Objective: To compare wound complications, cosmetic outcomes, and pain scores between skin closure with dermal staples and intradermal sutures in patients undergoing thyroidectomy. Methods: A prospective study was conducted in the Surgical Department of Sheikh Zayed Hospital, Lahore, from August 2023 to August 2024. The study included 100 adult patients undergoing thyroidectomy for thyroid disease. The patients were randomly divided into two groups: Group A (n=50) received wound closure with dermal staples, and Group B (n=50) received intradermal suturing. Postoperative assessments were conducted at 1, 4, 12, and 24 weeks to evaluate wound complications, cosmetic outcomes, and pain scores. Cosmetic outcomes were measured using the Stony Brook Scar Evaluation Scale and Manchester Scar Scale. Pain was assessed using the Visual Analog Scale (VAS). Results: No surgical site infections were reported in either group. At the 24-week follow-up, cosmetic outcomes measured by the Stony Brook Scar Evaluation Scale were significantly better in Group A (4.12 ± 1.0) compared to Group B (3.32 ± 1.17) (p=0.027). Similarly, the Manchester Scar Scale score was higher in Group A (7.83 ± 1.34) than in Group B (9.20 ± 2.26) (p=0.033), indicating better cosmesis with staples. However, pain scores were significantly higher in Group A than in Group B both immediately after surgery and at the 4- and 12-week follow-ups. Conclusion: The use of dermal staples in thyroidectomy demonstrated better cosmetic outcomes and wound healing compared to intradermal suturing. However, patients who received staples experienced significantly more postoperative pain. While dermal stapling is a safe and effective alternative for skin closure, further studies with larger populations are necessary to corroborate these findings and guide clinical practice.

Adjusting for Glycemic Control in Assessing the Relationship Between Age-Related Macular Degeneration and Diabetic Retinopathy.

Purpose Studies regarding the relationship between age-related macular degeneration (AMD) and diabetic retinopathy (DR) conflict: while some support that AMD is protective against DR, others find the opposite. The mechanism by which AMD may protect against DR is unclear. We sought to assess the association between AMD and DR when controlling for glycemic control in patients with diabetes mellitus (DM) type II. Methods We identified 461 unique patients over 55 years old with a diagnosis of DM type II seen in our academic retina clinic in Stony Brook, New York between 12/31/2019 and 12/31/2020. Data were manually extracted and the population was split based on the presence of AMD diagnosis. Multivariate regression analyses were then performed comparing the prevalence of DR between groups while controlling for A1c. Secondary endpoints included demographic differences and smoking status. Results Among the 461 patients, 118 (25.6%) had a diagnosis of AMD. Compared to patients without AMD, patients with AMD were older (69 vs. 66; OR 1.05; p=0.005) and less likely to have DR (37.3% vs. 59.2%; OR 0.35; p<0.001). There was no difference in average A1c between groups. Conclusion This is the first reported study assessing the relationship between AMD and DR while controlling for A1c. In our population, diagnosis of AMD was associated with significantly reduced odds of having DR. As AMD and DR appear to be related even after holding A1c constant, researchers should use caution when using DR as a surrogate for diabetic control in the context of AMD.

Korean Medicine Subcision Therapies in Scar Treatment: A Retrospective, Multicenter Study at Network Clinics.

This study is a retrospective, multicenter research designed to report the efficacy of Korean medicine subcision therapies in scar treatment. Charts and photographs of 29 patients who received subcision treatment between May 2016 and June 2020 in four scar treatment network clinics were analyzed. The Qualitative Global Acne Scarring Grade System (QGASC) and the Stony Brook Scar Evaluation Scale (SBSES) were used to objectively measure scar scores. Except for 4 patients whose GASGS and SBSES scores remained unchanged, most patients' scars showed improvement from Visit 2 to about Visit 8. Furthermore, the degree of change for both scales was found to be statistically significant. Subcision therapy using acupuncture has been found to be an effective treatment for scar, with statistically significant improvements in patients' SBSES and QGASC scores.

Three-Part Analysis for Designing Nasal Alar Reduction Surgery in Asian Patients.

The external nasal alar reduction can be associated with many complications, such as nostril malformation and significant scarring. The authors proposed a 3-part analysis method for the design of nasal alar reduction surgery with the aim of improving nasal alar morphology more precisely. The 3-part analysis was based on the patient's flared nose, wide nasal base, and drooping ala, respectively. We included 20 patients who underwent this surgery between January 2021 and January 2022. The visual analog scale (VAS) and the Stony Brook Scar Evaluation Scale (SBSES) were used to assess postoperative scar outcomes. The preoperative and postoperative ratios of the interalar distance to intercanthal distance and nostril shape were analyzed. Patient-reported satisfaction with the esthetic outcome was also assessed. All operations were successfully completed. There were no postoperative complications, such as wound infection or skin necrosis. Both VAS and SBSES assessment of postoperative scarring suggested keloid hyperplasia at 3 months postoperatively. At 12 months postoperatively, the scarring was insignificant and improved significantly over 3 months postoperatively. The mean ratio of the interalar distance to intercanthal distance decreased significantly from 1.15 preoperatively to 1.01 postoperatively (P<0.05). The shape of the patient's nostrils was also significantly improved after surgery compared with the preoperative period. Patient-reported satisfaction after surgery was high at long-term follow-up. The 3-part analysis to design an external nasal alar reduction procedure can accurately improve the morphology of nasal flaring, excessively wide nasal alar base, and nasal ptosis in Asian patients. IV.

Dose-Dependent Effects of Botulinum Toxin Type A on Prevention of Postoperative Scars in Various Regions in the Body: A Prospective, Double-Blind Randomized Controlled Trial.

Botulinum toxin type A (BTXA) can improve wound healing and reduce scar formation; however, the exact dose required to prevent postoperative scarring across various anatomical sites remains unclear. This study aimed to investigate the effectiveness and optimal concentrations of BTXA for preventing postoperative scarring across various common surgical sites throughout the body. In this prospective randomized controlled trial, 46 patients with benign skin tumors received injections of 1, 2.5, or 5U/0.1mL of BTXA or 0.9% saline immediately following surgical tumor excision on both sides of the incisions. Follow-ups were conducted at 7days, 15days, and 1, 3, and 6months postoperatively. Patient-reported adverse events and standardized digital photographs were collected. Scar formation was assessed using the modified Stony Brook Scar Evaluation Scale (mSBSES). All 46 patients completed the trial without severe complications. The mSBSES scores were higher in the experimental groups at all follow-ups. The 5U/0.1mL BTXA dose group demonstrated optimal scar prevention at all high-risk sites for scar hyperplasia. No significant difference was observed between the 2.5U/0.1mL and 5U/0.1mL doses for intermediate-risk sites, while 1U/0.1mL dose was sufficient for low-risk sites. Overall, 86.5% of patients were satisfied with their treatments, with 16.3% being very satisfied. Early postoperative BTXA injection can reduce or prevent hypertrophic scarring, with optimal doses ranging from 1 to 5U/0.1mL depending on the surgical site, supporting broader clinical application of BTXA. The effectiveness of different concentrations of botulinum toxin type A (BTXA) in preventing postoperative scarring was compared, expanding the scope of previous research, which focused only on the head, face, and neck regions, to include the trunk and extremity areas. Different optimal injection strategies were determined based on different surgical sites and their risks of developing hypertrophic scars. The study demonstrates that BTXA not only reduces scar formation but also enhances patient satisfaction and reduces postoperative itching and pain, contributing to overall better postoperative outcomes. By establishing the efficacy and optimal dosing of BTXA for various surgical sites, this research supports the potential for broader clinical application of BTXA in aesthetic and reconstructive surgeries. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Elliptical excision and primary closure of nasal defect to achieve best esthetic outcome: A case series of 50 patients.

To evaluate the cosmetic result of nasal of an elliptical excision and primary closure on small nasal defect by using Scar assessment using the Stony Brook Scar Evaluation Scale (SBSES) score. This retrospective interventional study was conducted in a private clinic over a 2-year duration. Patients aged 18-60 years with nasal defects <1.5 cm were enrolled after obtaining informed consent. Exclusion criteria included immunocompromised status, keloidal tendency, local site infection, bleeding disorder, age <18 years, and lack of consent. Scar assessment using the SBSES was performed at the end of 6 months. Statistical analysis included summary statistics, analysis of variance tests, and a significance level of P < 0.05. The study included 50 patients, with 54% males and 46% females. The most common age group was 21-40 years, and melanocytic nevi was the most common cause for excision. Lesions were excised mainly from the lateral wall and dorsum of the nose. The mean SBSES score was 3.79 ± 0.467. The best cosmetic outcome was observed in lesions involving the dorsum followed by the root of the nose. No significant difference was found among the SBSES scores for various subunits. Elliptical excision with primary closure is a simple and effective technique for small nasal defects, providing good cosmetic results. The location of the nasal defect influences the cosmetic outcome, with better results observed in areas with thinner skin and increased skin laxity.

Pyxis Proximity Improves Narcotic Waste Compliance Among Anesthesia Personnel.

Introduction Controlled substance waste processes in perioperative areas can be cumbersome. Streamlining this process is a critical component of improving operating room efficiency. At our institution, unused controlled substances require a two-person waste prior to disposal. We hypothesized that access to a centrally located automated medication dispensing system to conduct medication waste would decrease the amount of time required to perform a two-person waste and dispose of unused medications after the completion of a case. We further hypothesized that a decrease in the time required to waste would improve user satisfaction with the waste process. Methods This was a single-center, retrospective, IRB-approved quality assurance analysis. Research Electronic Data Capture (REDCap, Stony Brook, NY, United States) software was used to design an anonymous survey, which was distributed via email from 06/09/2021 to 09/09/2021. Wilcoxon signed-rank tests were used to compare before and after paired responses for individuals. Analyses were performed using SAS 9.4 © (Cary, NC, United States) software. Results Participants reported a significant decrease in time carrying used narcotics after a surgical case. For the primary outcome, median (IQR) scores demonstrated a significant decrease from 2, representing "10-20 minutes" (IQR 1-3), to 1, indicating "<10 minutes" (IQR 1-2) spent carrying used narcotics (p < 0.0001). Reported satisfaction with the process significantly increased from 2 to 3 points, on a scale of 5, after using the new centrally located Pyxis (p < 0.0001). Participants reported the wasting process as less time-consuming, carried fewer used controlled substances, and were less likely to wait until the end of the shift to waste. Conclusions By improving the ergonomics of the waste process after adding a Pyxis system in a more central location, the time anesthesia clinicians spent carrying used controlled substances decreased. Additionally, provider satisfaction increased, likely related to the ease of finding a partner to witness wasted medications.

Telemedicine at a University Ophthalmology Practice During the Beginning of the COVID-19 Pandemic.

The aim of the research was to evaluate the use of teleophthalmology at a university practice during the COVID-19 pandemic, specifically examining precision, effectiveness, and patient satisfaction. Telemedicine visits were offered to new and established patients requesting appointments with the Stony Brook University Department of Ophthalmology between March 30 and June 2, 2020. Records from these visits were reviewed for chief complaint, past medical and ocular history, diagnoses, treatment/management, and providers' sub-specialty. Precision was determined by comparing agreement between diagnoses of the telemedicine visit with those of the subsequent in-person visit. The decision to follow up in person was made by the physician and patient. Diagnostic precision as well as progression, improvement, or stability of patients' symptoms were determined by the physician's assessment at follow-up visits. Post-telemedicine visit satisfaction surveys were sent to all patients. Telemedicine visits were offered to 783 patients, 520 (66.4%) of whom accepted. Of these 520 patients, 409 (78.7%) were established and 105 (20.2%) had in-person, follow-up visits. Overall, the diagnostic precision of the follow-up visits was 89.5%. Precision differed significantly across ophthalmologic subspecialties. Of the patients who had in-person follow-up visits, 56.8% remained stable, 32.4% improved, and 10.8% worsened. Established patients presented with more extensive ocular histories/procedures and experienced a higher percentage of worsening symptoms/disease stage compared to new patients. Oculoplastics/orbit was the most prevalent diagnostic subspecialty that worsened. Surveys were sent to all patients completing telemedicine visits, 15.0% of whom responded. Overall satisfaction was 91.9%, although only 23.0% of respondents preferred telemedicine to an in-office visit. Telehealth provides high levels of precision and patient satisfaction for a wide range of ophthalmologic visits, although most patients still prefer in-office examinations. Employing teleophthalmology for follow-up and emergency care may provide patients with an effective alternative during pandemic situations and beyond.

Nursing Impact on a Multi-Disciplinary Approach to First Case On-Time Starts at Stony Brook Medicine

Nursing Impact on a Multi-Disciplinary Approach to First Case On-Time Starts at Stony Brook Medicine

Development of a Spectrum-Based Scheme for Simulating Fine-Grained Sediment Transport in Estuaries

Fine-grained cohesive sediments in estuaries play a critical role in sediment transport and biogeochemical cycles in estuaries. Due to the convergence of marine saltwater and freshwater runoff, combined with periodic tidal cycles, fine-grained sediments exhibit intricate flocculation processes that are challenging to simulate. A size-resolved flocculation module using a bin-based scheme aids in modeling these processes but is hindered by high computational costs. In this study, we develop a new spectrum-based scheme based on the spectral shape of floc size distribution from the original bin-based scheme to expedite modeling execution. This new scheme is implemented in the Stony Brook Parallel Ocean Model (sbPOM) and applied to simulate fine-grained sediment transport in the Hudson River estuary. The effectiveness of this spectrum-based scheme is assessed by comparing its simulations with observations and results from the original bin-based scheme. The findings indicate that the new scheme can simulate the evolution of suspended sediment concentration well at a specific point by comparisons with in-situ observations. Specifically, the results of the 50 paired experiments show an average percentage difference of 1.86% and an average speedup ratio of 4.51 times compared to the original bin-based scheme. In summary, the new spectrum-based scheme offers significant acceleration benefits for the size-resolved flocculation module and has the potential for widespread application in simulating fine-grained sediments in estuaries.

A New Alar Base Reduction Technique in Rhinoplasty.

Alar base reduction is one of the most challenging parts of rhinoplasty because the maneuvers that are performed during this procedure are nearly irreversible. Some of the important complications of alar base reduction are notching, scarring and unnatural results. In this study, we present a modified alar base reduction technique in order to prevent these complications. Seventy-five female patients (46 bilateral and 29 unilateral alar base reductions) who needed alar base reduction were operated on consecutively between January 2016 and June 2022 with this new technique. They were compared retrospectively with 67 female patients (41 bilateral and 26 unilateral alar base reductions) who were operated on consecutively with the classical alar base reduction technique between 2010 and 2015. Scar quality was assessed with a modified Stony Brook Scar Evaluation Scale (MSBSES). Three people assessed the overall appearance (resulting in naturalness and symmetry) with a Visual Analog Scale (VAS). Statistically significant differences were found between classical alar base reduction and modified alar base reduction techniques (p<0.05) according to SBSES scores. Also, VAS scores about the result of naturalness were statistically different between the two groups (p<0.05) (Cronbach's alpha value 0.796). There was no significant difference between the VAS scores of the two groups in terms of symmetry (p>0.05) (Cronbach's alpha value 0.828). This new modified alar base reduction technique is found to be useful, easy to apply and has better results than the classical alar base reduction technique. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Role of Triamcinolone Acetonide in the Maturation of Scars.

Surgeons have tried various measures to achieve a minimum and aesthetically appealing scars after wound healing at surgical sites. Various regimens have been recommended to minimize scars both intraoperatively and postoperatively. Our study aims to assess the outcome of the injection of triamcinolone acetonide used intraoperatively on a normal surgical suture line. This is a prospective, observational study of 21 patients (divided into test and control groups with a single scar at the same site) treated with or without injection of triamcinolone acetonide, and outcomes were assessed using Vancouver Scar Scale and Stony Brook Scar Evaluation Scale. We found a significant difference (P > 0.05) between the median of vascularity, pigmentation, and total score on the Vancouver Scar Scale, whereas there was significant difference between height, color, and overall appearance according to the Stony Brook Scar Evaluation Scale between the test and the control group. We could not find a significant difference in outcome with varying, increasing doses of triamcinolone acetonide. A low dose of triamcinolone acetonide is an effective drug that tends to improve the outcome of a scar in terms of vascularity, pigmentation, height, and overall appearance of the postoperative surgical scar and helps in the maturation of a normal scar.

Prospects for Use of Botulinum Toxin Type A for Prevention of Hypertrophic and Keloid Scars after Surgeries (Meta-analysis)

Abstract Objective To evaluate the possibility of improving and preventing the formation of postoperative hypertrophic and keloid scars using botulinum toxin type A (BTA). Materials and Methods Scientific articles published in English have been systematically screened in PubMed/MEDLINE database over the entire period. The following information about the studies was analyzed: first author surname; year of publication; number of patients; average age; scar location; dosage of the drug administered; follow-up duration; scar assessment methods; results, incidence of hypertrophic and keloid scars formation. The odds ratio and 95% confidence interval were calculated for each of the estimated parameters. The statistical heterogeneity of publications assessed using the criteria of chi-square test and I 2. The differences were considered significant at p &lt; 0.05. Results A total of 18 prospective randomized studies were selected for evaluation, containing data on the use of BTA in 363 cases. Patients receiving botulinum toxin had a lower Vancouver scar scale index, higher visual analog scale index, and higher Stony Brook scar evaluation scale score. The use of BTA reduces the risk of perceptible scar formation, the incidence of hypertrophic and keloid scars. Conclusion The use of BTA to obtain imperceptible scar and prevent hypertrophic and keloid postoperative scars demonstrates good prospects. However, there is no consensus regarding the pathophysiological mechanisms underlying the positive effect of BTA on the prevention of hypertrophic and keloid scars.

Educating and empowering health care teams who present to the hospital to recognize and intervene on cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) in patients on bispecific t-cell engager therapy (BiTEs): A quality improvement study.

e23212 Background: Treatment of oncologic disease with Bispecific T-Cell Engager antibodies (BiTEs) are an emerging novel immunotherapy with demonstrated efficacy in multiple hematologic malignancies. Notable side effects of BiTE therapy include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which can be life-threatening and must be rapidly identified. We aim to fill knowledge gaps surrounding CRS and ICANS for medical providers, particularly considering increased use of BiTE therapy. We hope that educating providers will allow faster recognition and treatment and will improve patient outcomes. Methods: Our study focused on the impact of educational presentations on awareness and identification of CRS/ICANS. Our intervention targeted the residents and attendings in the emergency department and the nurses, advanced practice providers, and hospitalists in the bone marrow transplant (BMT) unit at Stony Brook University Hospital. Anonymous surveys consisting of 9 multiple choice questions were conducted to assess baseline foundational knowledge of CRS/ICANS. QI consisted of a 15-minute educational presentation for both groups. The same surveys were repeated following the presentations to assess improvement in overall knowledge of CRS/ICANS. A two tailed independent T test was used to calculate significance. Results: The average pre-survey score for the emergency department (N = 37) was 39%. The average presurvey score for the BMT department (N = 13) was 45%. Significant improvements in scores after intervention were shown in both the emergency department (39% vs 66%, p = 0.0001) and the BMT department (45% vs 68%, p = 0.0006). Conclusions: Education among emergency department and hospitalist providers is essential in improving management of CRS and ICANS in patients treated with BiTEs. This quality improvement initiative confirmed a knowledge gap in CRS and ICANS amongst our healthcare teams. By providing educational resources to both departments, there was a significant improvement in this gap. Future directions for continued improvement in the detection and management of CRS/ICANS include patient medication identification cards, a central repository of treatment protocols, algorithms, and toxicities associated with BiTEs, and expanding our educational curriculum which are all currently under development at Stony Brook University Hospital.

11 Stony brook medicine – respiratory protection in a NY public hospital before, during and post COVID-19

11 Stony brook medicine – respiratory protection in a NY public hospital before, during and post COVID-19

Prognostic factors for survival in NSCLC treated with immunotherapy: An institutional analysis.

e20591 Background: Immune check point inhibitors (ICIs) are the cornerstone of treatment for patients with advanced NSCLC. However, not all patients benefit from ICIs and some develop significant immune-mediated toxicities. There is limited data regarding prognostic factors in NSCLC patients treated with ICIs. Imaging features can complement clinical variables in predicting response to ICIs. This study aims to evaluate CEA, blood leukocyte markers, and novel CT-derived radiomic features as factors predictive of survival in this patient population. Methods: In this retrospective study, clinical data from patients with advanced stage NSCLC treated with ICIs at Stony Brook University Hospital from 2016 to 2021 were collected. Baseline and subsequent CEA (carcinoembryonic antigen), ANC (absolute neutrophil count), ALC (absolute lymphocyte count), NLR (neutrophil to lymphocyte ratio), AEC (absolute eosinophil count), and AMC (absolute monocyte count) were evaluated as independent prognostic factors. 3-D segmentation of ipsilateral lung lobe was obtained using U-Net and radiologist report of tumor location. 600 stable IBSI-standardized features were extracted from the region using PyRadiomics. The discriminative ability of clinical and image-derived variables was assessed using Kaplan-Meier survival and Cox proportional hazards regression analysis. Results: This study included 80 patients. Objective response rate (ORR) was 25.0% with 1-year OS of 58.0%. PD-L1 expression ≥ 50% was significantly associated with survival (p &lt; 0.02). Decrease in CEA (p &lt; 0.01) and 5% increase in AEC (p = 0.027) significantly correlated with survival. Age, sex, clinical stage, ANC, ALC, NLR, AMC did not significantly predict survival. Three image biomarkers that correlated with median enhancement of tissue on chest CT, and degree of tissue heterogeneity were significant predictors of mortality (p &lt; 0.02). A multivariable model with clinical inputs outperformed one with radiomic features only (C-index 0.70 vs. 0.64). Clinical and radiomic inputs together performed well in predicting survival (C-index 0.76). Conclusions: Changes in CEA and AEC were the strongest predictors of survival in advanced NSCLC patients treated with ICIs. This study suggests that combined clinical and radiomic biomarkers (quantifying local lobar heterogeneity) can identify patients most likely to benefit from immunotherapy. [Table: see text]

Octyl-2-cyanoacrylate Tissue Adhesive Closure Versus Subcuticular Suture for Post-Auricular Incisions.

Skin closure techniques in otolaryngology vary based on surgeon preference and wound site. Octyl-2-Cyanoacrylate may be a safe, rapid, and cost-effective option for post-site closure. This randomized controlled trial study aimed to compare Octyl-2-Cyanoacrylate and conventional subcuticular sutures in ear surgeries, assessing wound closure results in both case and control groups. This prospective, randomized, controlled, single-blind study was conducted at Ohud Hospital from May 2021 to May 2022. Ear surgery and cochlear implantation in patients were examined, and each group was randomly assigned to receive Dermabond TM and deep layer subcuticular sutures closure. Incisions were assessed at various time points, including 3 weeks, 6 weeks, 6 months, and 1 year post-surgery. The patient and observer Scar Assessment Scale was used, and two independent ear surgeons used the Stony Brook Scar Evaluation Scale for initial scar assessment. This study involved 126 ear surgery and cochlear implantation patients randomized to use cyanoacrylate tissue adhesive or subcuticular suture for port site closure. The study found that tissue adhesive (OCA) was faster and more efficient than standard sutures, saving an average of 12 min per incision in each ear. Incision cosmesis showed immediate results and significant differences, and patient satisfaction with OCA wound closure was higher than standard sutures. The findings confirmed that cyanoacrylate tissue adhesive significantly reduced the time needed for skin closure during ear surgery and showed immediate cosmetic improvements without any documented instances of bleeding, hematoma, infection, or wound separation. This is a randomized controlled trial, it follows Level 2 of evidence. Randomized trial or observational study with dramatic effects Laryngoscope, 134:4036-4041, 2024.

Inspiratory Neural Network Complexity Quantified by Approximate Entropy (ApEn) Analysis in SN 6-OHDA-induced Rat Model of Parkinson’s Disease

Parkinson’s disease (PD) is a multifaceted chronic and progressive neurodegenerative disease that includes a broad range of motor and non-motor symptoms (NMS). Breathing abnormalities are a common NMS in PD, and despite respiratory dysfunction being a major problem in PD as well as respiratory complications being the most common cause of death in PD patients, this NMS receives little attention. Over the last decade, a number of preclinical experimental rat models of PD generated by nigrostriatal site-targeted administration of the neurotoxin 6-hydroxydopamine (6-OHDA) have been used to evaluate various aspects of ventilatory control in PD. While all of these models have been shown to exhibit basal and chemical control of breathing abnormalities that are consistent with those in clinical reports, no studies have assessed the complex intrinsic dynamics that are associated with the central inspiratory neural network in PD. Since preclinical rat models of PD have also been shown exhibit neuroanatomical changes in brainstem regions involved in ventilatory control, it is likely that changes in inspiratory neural network dynamics, which can be assessed using nonlinear dynamical analysis methods, are also present in PD. To begin to assess this possibility, we quantified the complexity of 20 consecutive inspiratory (diaphragm EMG) bursts recorded during basal breathing in urethane-anesthetized spontaneously breathing adult female rats at 4-weeks after unilateral injection of 6-OHDA (n=18) or vehicle (VEH; n=14) directly into the substantia nigra (SN). For these analyses, we calculated approximate entropy (ApEn), which provides a statistical measure of regularity (orderliness) of a signal in the time domain, with values for the embedding dimension m and the tolerance r set to m=3 and r=0.44 SD. ApEn values were significantly higher in 6-OHDA-injected rats compared to VEH-injected rats (0.6169±0.0069 vs 0.5894±0.0087; P=0.017) albeit TI and Tpeak/TI were similar in both groups (TI: 305.8±9.5 vs 300.0±12.7 ms, P=0.713; Tpeak/TI: 51.0±1.3 vs 51.3±1.1%, P=0.904). Other significant differences in temporal features included higher breathing frequencies (93.4±2.4 vs 82.0±3.2 bpm; P=0.007), reduced TE (in ms: 334.7±12.7 vs 445.5±27.4; P=0.001), and decreased inspiratory duty cycle (in %: 47.2±1.1 vs 40.8±2.0; P=0.006) in 6-OHDA (compared to VEH)-injected rats. These observations suggest that respiratory dysfunction in PD is also accompanied by reorganization of the central inspiratory neural network that is associated with greater irregularity or less system order. Additional experiments are needed to identify the precise neural mechanisms underlying this higher system complexity. NIH NS101737; Thomas Hartman Center for Parkinson's Disease Research at Stony Brook University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

SBFI-26 enhances apoptosis in docetaxel-treated triple-negative breast cancer cells by increasing ROS levels

Introduction: Fatty acid binding protein 5 (FABP5) exhibits heightened expression levels in triple-negative breast cancer. The inhibitor of FABP5, Stony Brook fatty acid‐binding protein inhibitor 26 (SBFI-26), has demonstrated the capacity to suppress cell proliferation, migration, and invasion. This study delves into the functional mechanism and impact of combining SBFI-26 with docetaxel in treating MDA-MB-231 cells of triple-negative breast cancer. Methods: Various concentrations of docetaxel and SBFI-26 were chosen for individual or combined treatments. The effects of SBFI-26, docetaxel, or their combination on cell cycle arrest and apoptosis were assessed using flow cytometry. Western blotting was utilised to detect the expression of apoptosis-related proteins, namely cysteinyl aspartate-specific proteases 3 (Caspase3), B cell leukemia/lymphoma 2 (Bcl-2), and Bcl-2 associated X (Bax), while intracellular reactive oxygen species (ROS) levels were determined using a fluorescence spectrophotometer. Results: The IC50 values for SBFI-26 and docetaxel in inhibiting MDA-MB-231 cells were determined to be 106.1 μM and 86.14 nM, respectively. Significantly, the combination treatment augmented the proportion of G1 phase (apoptotic) cells by 3.67-fold compared to the control group (P &lt; 0.0001). Furthermore, the apoptosis rate in the combination group was 2.59-fold higher than that in the docetaxel group (P &lt; 0.0001) and demonstrated a significant increase of 1.82-fold compared with the SBFI-26 group (P &lt; 0.001). Analyses revealed a decrease in the protein expression of Bcl-2, while Bax and Caspase3 exhibited an increase in the combination group for MDA-MB-231 cells. Moreover, the combined treatment group demonstrated a 2.97-fold increase (P &lt; 0.0001) in ROS fluorescence intensity compared to the control group, a noteworthy 1.39-fold increase (P &lt; 0.01) compared to the SBFI-26 treatment group, and a substantial 1.70-fold increase (P &lt; 0.0001) compared to the docetaxel treatment group. Conclusion: These findings suggest that the co-administration of SBFI-26 with docetaxel effectively enhances apoptosis in triple-negative breast cancer MDA-MB-231 cells by elevating intracellular ROS levels.

Scar Outcome in Unilateral Complete Cleft Lip Repair: A Comparative Analysis of Vertical Lip Lengthening Strategies Using the Rotation-Advancement Concept.

To assess the differences in scar outcomes between modified rotation-advancement techniques proposed by Drs. Mohler and Noordhoff, designed to address issues such as inadequate vertical lip length and scarring on the upper third of the lip in the original rotation-advancement technique. Retrospective single-surgeon (RD) study. Consecutive non-syndromic children (n = 68) with unilateral complete cleft lip and palate. Modified Mohler (columellar backcut reconstructed with C flap; n = 34) and modified Noordhoff (lower, medially-created backcut reconstructed with laterally-based triangular skin flap; n = 34) repairs. Using 12-month postoperative frontal photographs, scar evaluations (overall and superior, middle, and inferior portions of the lip) were appraised by an assessment panel composed by independent professional and nonprofessional raters employing four validated qualitative scar assessment scales: Manchester Scar Scale, modified Scar-Rating Scale, Stony Brook Scar Evaluation Scale, and Visual Analog Scale. Quantitative computerized photogrammetric scar widths of the superior, middle, and inferior portions of the upper lip were also measured. The modified Noordhoff method showed significantly (all P < .001) better scar quality for the overall scar and superior portion of the scar in all four scales compared to the modified Mohler method, with no significant (all P > .05) difference for the middle and lower portions. No significant difference (all P > .05) was observed for photogrammetric scar width measurements. The modified Noordhoff technique provided better qualitative results for unilateral complete cleft lip-related scars compared to the modified Mohler technique.