Publications by authors named "Shaver C"

The importance of mental toughness on lung transplant outcomes is unknown. We performed a pilot study to assess whether pretransplant grit and resilience are associated with short-term posttransplant outcomes. We enrolled 31 lung transplant candidates, of whom 7 (26%) had greater mental toughness, defined as the upper tertile for both grit and resilience within our cohort.

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  • The study investigates the link between long-term blood glucose levels (measured by hemoglobin A1c, HbA1c) and the development of Acute Respiratory Distress Syndrome (ARDS) among critically ill adults who are at risk for ARDS.
  • It analyzes data from two cohorts, finding that patients with diabetes did not have a significantly higher risk of ARDS compared to nondiabetics; however, those with poorly controlled diabetes (high HbA1c) had an increased risk.
  • While the findings were not consistent across both cohorts, the combined analysis suggests that high HbA1c levels could indicate an elevated risk for ARDS, particularly in patients with diabetes.
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  • - The alveolar epithelium has a protective layer called the glycocalyx, which gets damaged during conditions like acute respiratory distress syndrome (ARDS) and influenza A infection, leading to increased lung injury by making the alveolar-capillary barrier more permeable.
  • - In the study, researchers tested the impact of a matrix metalloproteinase (MMP) inhibitor called Ilomastat (ILO) on glycocalyx shedding and lung injury in mouse models infected with influenza A, measuring various indicators over several days.
  • - Results showed that IAV infection caused significant glycocalyx shedding, but treatment with ILO reduced the shedding by 36% and lung injury by 40%, while also lowering the viral load
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The contemporary health care resource utilization after an acute myocardial infarction (MI) is not well-known. All patients admitted because of MI between January 2015 and December 2021 across 28 hospitals in the Baylor Scott & White Health system were studied. Patient characteristics and outcomes, including all-cause and cardiovascular (CV) rehospitalizations, emergency department (ED) visits, and outpatient visits were evaluated.

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Lung endothelium resides at the interface between the circulation and the underlying tissue, where it senses biochemical and mechanical properties of both the blood as it flows through the vascular circuit and the vessel wall. The endothelium performs the bidirectional signaling between the blood and tissue compartments that is necessary to maintain homeostasis while physically separating both, facilitating a tightly regulated exchange of water, solutes, cells, and signals. Disruption in endothelial function contributes to vascular disease, which can manifest in discrete vascular locations along the artery-to-capillary-to-vein axis.

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Background: This study's purpose is to investigate emergent blood (EB) usage, massive transfusion protocols (MTP), and the use of pharmacologic adjuncts to resuscitation across trauma centers in the Southwestern Surgical Congress (SWSC).

Methods: Anonymous, voluntary 26-question survey conducted by the SWSC multicenter trials group. Descriptive statistical analysis was performed.

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The pathophysiology of silicosis is poorly understood, limiting development of therapies for those who have been exposed to the respirable particle. We explored mechanisms of silica-induced pulmonary fibrosis in human lung samples collected from patients with occupational exposure to silica and in a longitudinal mouse model of silicosis using multiple modalities including whole-lung single-cell RNA sequencing and histological, biochemical, and physiologic assessments. In addition to pulmonary inflammation and fibrosis, intratracheal silica challenge induced osteoclast-like differentiation of alveolar macrophages and recruited monocytes, driven by induction of the osteoclastogenic cytokine, receptor activator of nuclear factor κΒ ligand (RANKL) in pulmonary lymphocytes, and alveolar type II cells.

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Background: The primary aim of this study was to identify and stratify candidate metrics used by anesthesiology residency program directors (PDs) to develop their residency rank lists through the National Resident Matching Program.

Methods: Sixteen PDs comprised the participants, selected for diversity in geography and program size. We used a 3-round iterative survey to identify and stratify candidate metrics.

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Exertional dyspnea has been documented in US military personnel after deployment to Iraq and Afghanistan. We studied whether continued exertional dyspnea in this patient population is associated with pulmonary vascular disease (PVD). We performed detailed histomorphometry of pulmonary vasculature in 52 Veterans with biopsy-proven post-deployment respiratory syndrome (PDRS) and then recruited five of these same Veterans with continued exertional dyspnea to undergo a follow-up clinical evaluation, including symptom questionnaire, pulmonary function testing, surface echocardiography, and right heart catheterization (RHC).

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Common genetic variants confer substantial risk for chronic lung diseases, including pulmonary fibrosis. Defining the genetic control of gene expression in a cell-type-specific and context-dependent manner is critical for understanding the mechanisms through which genetic variation influences complex traits and disease pathobiology. To this end, we performed single-cell RNA sequencing of lung tissue from 66 individuals with pulmonary fibrosis and 48 unaffected donors.

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Background: Social ABCs is a caregiver-mediated Naturalistic Developmental Behavioral Intervention for toddlers with confirmed/suspected Autism Spectrum Disorder (ASD), with evidence in controlled research settings. Information is lacking on implementation in community settings. We reported on the treatment effectiveness of this program within a community setting, and the current paper describes the implementation phase of this work.

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Purpose: Hypoxemia during a failed airway scenario is life threatening. A dual-lumen pharyngeal oxygen delivery device (PODD) was developed to fit inside a traditional oropharyngeal airway for undisrupted supraglottic oxygenation and gas analysis during laryngoscopy and intubation. We hypothesized that the PODD would provide oxygen as effectively as high-flow nasal cannula (HFNC) while using lower oxygen flow rates.

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The human lung is structurally complex, with a diversity of specialized epithelial, stromal and immune cells playing specific functional roles in anatomically distinct locations, and large-scale changes in the structure and cellular makeup of this distal lung is a hallmark of pulmonary fibrosis (PF) and other progressive chronic lung diseases. Single-cell transcriptomic studies have revealed numerous disease-emergent/enriched cell types/states in PF lungs, but the spatial contexts wherein these cells contribute to disease pathogenesis has remained uncertain. Using sub-cellular resolution image-based spatial transcriptomics, we analyzed the gene expression of more than 1 million cells from 19 unique lungs.

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Article Synopsis
  • Cell-free hemoglobin (CFH) in the lungs of patients with acute respiratory distress syndrome (ARDS) causes inflammation and lung injury, but the mechanisms are not fully understood.
  • Researchers hypothesized that Toll-like receptor 4 (TLR4) plays a role in mediating the inflammatory response to CFH.
  • Their findings showed that mice lacking TLR4 had less inflammation and lung permeability, indicating that TLR4 signaling activates key inflammatory pathways after CFH exposure.
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Acute lung injury (ALI) carries a high risk of mortality but has no established pharmacologic therapy. We previously found that experimental ALI occurs through natural killer (NK) cell NKG2D receptor activation and that the cognate human ligand, MICB, was associated with ALI after transplantation. To investigate the association of a common missense variant, , with ALI.

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Background: We hypothesized that patients who received an adductor canal block (ACB) in the operating room following unilateral total knee arthroplasty would have a lower oral morphine milligram equivalent (MME) consumption during the postanesthesia care unit (PACU) phase 1 recovery period compared to patients who received an ACB in the PACU.

Methods: This was a retrospective cohort study of patients who underwent robotic-assisted unilateral total knee arthroplasty under general anesthesia between March 1, 2020, and February 28, 2021, and received postoperative ACB either in the operating room or the PACU.

Results: A total of 36 and 178 patients received postoperative ACB in the operating room and PACU, respectively, and had median and interquartile range MME consumption in the PACU of 22.

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Unlabelled: Donor-derived cell-free DNA (dd-cfDNA%) is a biomarker of early acute lung allograft dysfunction (ALAD), with a value of ≥1.0% indicating injury. Whether dd-cfDNA% is a useful biomarker in patients >2 y posttransplant is unknown.

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  • There is a pressing need for better methods to expand the donor lung pool for people with severe lung disease, as current options are limited.
  • Previous studies have shown that cross-circulation (XC) involving connecting swine blood with human lungs can help recover lungs that were initially deemed unfit for transplantation.
  • New research indicates that while porcine immune cells invade the human lungs in this XC setup, the process still maintains lung viability and functionality for up to 24 hours, highlighting potential areas for improving immunosuppressive strategies in organ support technology.
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Common genetic variants confer substantial risk for chronic lung diseases, including pulmonary fibrosis (PF). Defining the genetic control of gene expression in a cell-type-specific and context-dependent manner is critical for understanding the mechanisms through which genetic variation influences complex traits and disease pathobiology. To this end, we performed single-cell RNA-sequencing of lung tissue from 67 PF and 49 unaffected donors.

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The pathophysiology of silicosis is poorly understood, limiting development of therapies for those who have been exposed to the respirable particle. We explored the mechanisms of silica-induced pulmonary fibrosis in a mouse model using multiple modalities including whole-lung single-nucleus RNA sequencing. These analyses revealed that in addition to pulmonary inflammation and fibrosis, intratracheal silica challenge induced osteoclast-like differentiation of alveolar macrophages and recruited monocytes, driven by induction of the osteoclastogenic cytokine, receptor activator of nuclear factor-κB ligand (RANKL) in pulmonary lymphocytes and alveolar type II cells.

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