Obesity Is Associated With Increased Mortality in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation.

Objectives: To determine the relationship between all-cause hospital mortality and morbidity in patients treated with venoarterial extracorporeal membrane oxygenation (ECMO) and to assess whether this relationship is mediated via body mass index (BMI).

Design: Using the Extracorporeal Life Support Organization (ELSO) registry, venoarterial ECMO runs from 2015 to 2021 were retrospectively analyzed. Patient demographics, ECMO indications, and complications for survivors and decedents were univariately compared.

Temporal Immune Profiling in the CSF and Blood of Patients with Aneurysmal Subarachnoid Hemorrhage.

Background: Delayed cerebral ischemia (DCI) is a significant complication of aneurysmal subarachnoid hemorrhage (aSAH). This study profiled immune responses after aSAH and evaluated their association with DCI onset.

Methods: Twelve aSAH patients were enrolled.

Occupational Factors Associated With Burnout Among a Sample of 9-1-1 Public Safety Telecommunicators in Washington State.

Introduction: This study aimed to investigate occupational factors associated with burnout among a sample of 9-1-1 public safety telecommunicators (PSTs).

Methods: An online survey measuring organizational factors (ie, perceived visibility and inclusion in the agency, respectful culture, leadership support, perceived gratitude, and coworker conflict); job characteristic s (ie, work-life integration, overtime, salary satisfaction, and job meaningfulness); and burnout, demographic, and call center characteristics was emailed to a sample of PSTs.

Analysis: Descriptive, bivariate, and multiple linear regression analyses were used to characterize the sample and investigate relationships among variables.

A dose-ranging study of the physiological and self-reported effects of repeated, rapid infusion of remifentanil in people with opioid use disorder and physical dependence on fentanyl.

Rationale: Understanding mechanisms of drug use decisions will inform the development of treatments for opioid use disorder (OUD). Decision-making experiments using neurobehavioral approaches require many trials or events of interest for statistical analysis, but the pharmacokinetics of most opioids limit dosing in humans.

Objectives: This experiment characterized the effects of repeated infusions of the ultra-short acting opioid remifentanil in people with OUD and physical opioid dependence.

Use of drug purchase tasks in medications development research: orexin system regulation of cocaine and drug demand.

Commodity purchase tasks provide a useful method for evaluating behavioral economic demand in the human laboratory. Recent research has shown how responding to purchase tasks for blinded drug administration can be used to study abuse liability. This analysis uses data from a human laboratory study to highlight how similar procedures may be particularly useful for understanding momentary changes in drug valuation when screening novel interventions.

Suvorexant maintenance enhances the reinforcing but not subjective and physiological effects of intravenous cocaine in humans.

Preclinical research has sought to understand the role of the orexin system in cocaine addiction given the connection between orexin producing cells in the lateral hypothalamus and brain limbic areas. Exogenous administration of orexin peptides increased cocaine self-administration whereas selective orexin-1 receptor antagonists reduced cocaine self-administration in non-human animals. The first clinically available orexin antagonist, suvorexant (a dual orexin-1 and orexin-2 receptor antagonist), attenuated motivation for cocaine and cocaine conditioned place preference, as well as cocaine-associated impulsive responding, in rodents.

Coupled influence of tectonics, climate, and surface processes on landscape evolution in southwestern North America.

The Cenozoic landscape evolution in southwestern North America is ascribed to crustal isostasy, dynamic topography, or lithosphere tectonics, but their relative contributions remain controversial. Here we reconstruct landscape history since the late Eocene by investigating the interplay between mantle convection, lithosphere dynamics, climate, and surface processes using fully coupled four-dimensional numerical models. Our quantified depth-dependent strain rate and stress history within the lithosphere, under the influence of gravitational collapse and sub-lithospheric mantle flow, show that high gravitational potential energy of a mountain chain relative to a lower Colorado Plateau can explain extension directions and stress magnitudes in the belt of metamorphic core complexes during topographic collapse.

Vestibular Migraine Confounds Management of Superior Canal Dehiscence Syndrome.

Objective: To investigate the prevalence of vestibular migraine (VM) in a cohort of patients with radiologic confirmation of superior canal dehiscence (SCD) and to compare management of superior canal dehiscence syndrome (SCDS) in patients with and without comorbid VM.

Study Design: Retrospective review of a SCD database.

Setting: University-based tertiary medical center.

Spontaneous eye blink rate mediates the relationship between sleepiness and impulsivity to negative stimuli.

Previous studies have demonstrated that sleep deprivation results in a negativity bias, especially in the context of impaired response inhibition. In the present study we investigated spontaneous eye blink rate (EBR), a correlate of dopamine function, as a mediator of the relationship between subjective sleepiness and impulsivity toward negative stimuli on a Go/NoGo task. Participants rated their sleepiness on a number of measures including the Epworth Sleepiness Scale (ESS), the Karolinska Sleepiness Scale (KSS) and subscales of the Chronic Sleep Reduction Questionnaire (CSRQ).

MicroRNAs as Biomarkers for Predicting Complications following Aneurysmal Subarachnoid Hemorrhage.

Aneurysmal subarachnoid hemorrhage (aSAH) is a high mortality hemorrhagic stroke that affects nearly 30,000 patients annually in the United States. Approximately 30% of aSAH patients die during initial hospitalization and those who survive often carry poor prognosis with one in five having permanent physical and/or cognitive disabilities. The poor outcome of aSAH can be the result of the initial catastrophic event or due to the many acute or delayed neurological complications, such as cerebral ischemia, hydrocephalus, and re-bleeding.

CN-105 in Participants with Acute Supratentorial Intracerebral Hemorrhage (CATCH) Trial.

Background: Endogenous apolipoprotein (apo) E mediates neuroinflammatory responses and recovery after brain injury. Exogenously administered apoE-mimetic peptides effectively penetrate the central nervous system compartment and downregulate acute inflammation. CN-105 is a novel apoE-mimetic pentapeptide with excellent evidence of functional and histological improvement in preclinical models of intracerebral hemorrhage (ICH).

Effects of Lifestyle Modification on Vestibular Migraine.

Objective: To evaluate effects of lifestyle modification on symptoms of dizziness and headache in patients diagnosed with definite vestibular migraine.

Study Design: Prospective within-participants repeated-measures study.

Setting: Otolaryngology tertiary care.

Operative management of symptomatic, metachronous carotid body tumors involving the skull base and its neurological sequelae.

A 44-year-old morbidly obese woman with a history of right carotid body tumor (CBT) resection presented with a symptomatic, nonfunctional, left Shamblin-III CBT. Abutment of the skull base precluded distal internal carotid artery control for arterial reconstruction, favoring parent vessel sacrifice after an asymptomatic provocative test. She underwent CBT resection with anticipated sacrifice of cranial nerves X and XII and the common carotid artery and its branches, developing baroreceptor failure syndrome and sequelae of cranial nerve sacrifice.

Relative potency of intravenous oxymorphone compared to other µ opioid agonists in humans - pilot study outcomes.

Aims: Intravenous (IV) misuse of the µ opioid analgesic oxymorphone has caused significant public health harms; however, no controlled data on its IV abuse potential are available. The primary aims of this pilot study were to directly compare IV oxymorphone to IV oxycodone, morphine, and hydromorphone on a subjective measure of drug liking and to assess relative potency.

Methods: Participants (n = 6) with opioid use disorder, physical dependence, and current IV use completed this two-site, within-subject, double-blind, placebo-controlled, inpatient pilot study.

A Highly Predictive MicroRNA Panel for Determining Delayed Cerebral Vasospasm Risk Following Aneurysmal Subarachnoid Hemorrhage.

Approximately one-third of aneurysmal subarachnoid hemorrhage (aSAH) patients develop delayed cerebral vasospasm (DCV) 3-10 days after aneurysm rupture resulting in additional, permanent neurologic disability. Currently, no validated biomarker is available to determine the risk of DCV in aSAH patients. MicroRNAs (miRNAs) have been implicated in virtually all human diseases, including aSAH, and are found in extracellular biofluids including plasma and cerebrospinal fluid (CSF).

Barriers and facilitators to pharmacists integrating into the ward-based multidisciplinary team: A systematic review and meta-synthesis.

Background: Pharmacists who are integrated into the ward team are involved in initial decision making, therefore pre-empting pharmaceutical problems and optimising therapy from the outset. Identifying the barriers and facilitators (determinants) to successful pharmacist integration within a multidisciplinary ward team will facilitate design of strategies to support integration.

Objective: The study aimed to identify the modifiable barriers and facilitators to pharmacist integration into the ward-based multidisciplinary team.

Tricuspid Valve Excision Complicated by Postoperative Gerbode Defect Following Recurrent Infective Endocarditis: A Case Report.

Tricuspid valve infective endocarditis is an increasingly common sequela of the opioid epidemic. While often managed medically, certain subsets of patients will require surgical intervention, including repair, replacement, and possibly even excision. Historically, simple valvectomy was performed in instances of recidivism and reinfection; however, reoperation and replacement has become the preferred treatment in the current era.

Test-Retest Reliability of the Dizziness Symptom Profile.

Objectives: This investigation was conducted to measure the test-retest reliability of the Dizziness Symptom Profile (DSP). The DSP was developed to assist primary care providers, general otolaryngologists, and other health care providers in the development of a differential diagnosis for patients who present with dizziness, vertigo, or unsteadiness. The DSP yields a score ranging from 0 to 100% for each of 7 subscales.

Multiple Co-Occurring Vestibular Disorders Identified Using the Dizziness Symptom Profile.

Purpose The purpose of the current investigation was to determine the interrelations among vestibular disorders from a data set generated from the patient perspective as compared to previous data generated from the physician's perspective. Method The data for the current investigation originated from a previously published study describing the development of the Dizziness Symptom Profile (DSP; Jacobson et al., 2019).

A factor analytic assessment of the English translation of the neuropsychological vertigo inventory (NVI).

Purpose: Vestibular impairments have been associated with a variety of cognitive deficits, most notably deficits in visuo-spatial memory. The Neuropsychological Vertigo Inventory (NVI) was developed to measure self-reported cognitive deficits in patients with dizziness and/or vertigo. The original French language version of the NVI includes 28 items and 7 subscales.

Potentially Harmful Ionizing Radiation Exposure from Diagnostic Tests and Medical Procedures in Patients with Aneurysmal Subarachnoid Hemorrhage.

Background: Patients with aneurysmal subarachnoid hemorrhage (aSAH) may have significant potentially harmful ionizing radiation exposure (PHIRE) from diagnostic tests and medical procedures (DTMP) during their initial hospitalization.

Methods: In this single-center, retrospective, observational study, we evaluated the incidence of PHIRE using all patients with radiographically proven aSAH who survived hospitalization over a 6-year period. Patient data were then used to fit a full logistic regression model, a reduced-variable logistic regression model with least absolute shrinkage and selection operator penalty, and a nonparametric tree-based model.

Short Communication: The Belly-Tendon Derivation Yields Superior Ocular Vestibular Evoked Myogenic Potential Amplitudes in a Normal Pediatric Sample.

Purpose The purpose of the investigation was to determine whether the "belly-tendon" electrode derivation produced ocular vestibular evoked myogenic potentials (oVEMPs) in children that were superior to those recorded with the infraorbital-chin electrode derivation. Method This was a prospective observational study using a sample of convenience at a tertiary care medical center. Subjects were 13 children between the ages of 5 and 12 years.