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Reconstructing Covert Consciousness: Neural Decoding as a Novel Consciousness Assessment.
Neurology
February 2025
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Determining the level of consciousness in patients with brain injury-and more fundamentally, establishing what they can experience-is ethically and clinically impactful. Patient behaviors may unreliably reflect their level of consciousness: a subset of unresponsive patients demonstrate covert consciousness by willfully modulating their brain activity to commands through fMRI or EEG. However, current paradigms for assessing covert consciousness remain fundamentally limited because they are insensitive, rely on imperfect assumptions of functional neuroanatomy, and do not reflect the spectrum of conscious experience.
View Article and Find Full Text PDFResults From First-in-Human Phase I Study of a Novel CD19-1XX Chimeric Antigen Receptor With Calibrated Signaling in Large B-Cell Lymphoma.
J Clin Oncol
January 2025
Center for Cell Engineering, Sloan Kettering Institute, New York, NY.
Purpose: We designed a CD19-targeted chimeric antigen receptor (CAR) comprising a calibrated signaling module, termed 1XX, that differs from that of conventional CD28/CD3ζ and 4-1BB/CD3ζ CARs. Preclinical data demonstrated that 1XX CARs generated potent effector function without undermining T-cell persistence. We hypothesized that 1XX CAR T cells may be effective at low doses and elicit minimal toxicities.
View Article and Find Full Text PDFIntraprocedural Three-Dimensional Imaging Registration Optimizes Magnetic Resonance Imaging-Guided Focused Ultrasound and Facilitates Novel Applications.
Oper Neurosurg (Hagerstown)
November 2024
Department of Neurosurgery, University of Pennsylvania Health System, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Background And Objective: Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) has revolutionized ablative treatment of essential tremor in recent years. However, limitations in precision targeting may account for suboptimal efficacy and significant side effects. We describe a simple intraprocedural three-dimensional image-guided lesion shaping technique that can improve overall outcomes of MRgFUS for essential tremor and facilitate expansion to novel indications.
View Article and Find Full Text PDFReview of Endosaccular Flow Disrupters for Wide-Neck Aneurysm Treatment.
Cardiol Rev
January 2025
From the Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Endosaccular flow disruption has emerged as a transformative approach for treating wide-neck intracranial aneurysms, which are characterized by neck diameters exceeding 4 millimeters or dome-to-neck ratios below 2. This review examines the technical specifications and clinical outcomes of major endosaccular devices, including the Woven EndoBridge (WEB) device, the Artisse embolization device, the Medina embolization device, the neck bridging device for bifurcation aneurysms, the polycarbonate urethane membrane-assisted device, the Galaxy saccular endovascular aneurysm lattice, and the Contour Neurovascular System. Analysis of pivotal trials reveals varying degrees of efficacy and safety across platforms.
View Article and Find Full Text PDFClosed Reduction and Intrafocal Pinning for Complex Dorsal Fracture Dislocation of the Distal Interphalangeal Joint: A Case Report and Novel Technique.
JBJS Case Connect
January 2025
Olympia Hospital & Research Centre, Trichy, Tamilnadu, India.
Case: Dorsal dislocations of the distal interphalangeal joint with associated volar base fractures of the distal phalanx are complex injuries that pose challenges for achieving stable reduction and restoring optimal joint function. This case report describes the successful management of a 40-year-old male cardiologist who sustained such an injury after a cricket ball trauma. The treatment involved a combined approach of closed reduction, dorsal extension block pinning, and intrafocal pinning of the volar base fracture.
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