Vessel Wall Imaging, Flow, and Hemorrhage in the Draining Veins of Cerebral Arteriovenous Malformations

Aim Cerebral arteriovenous malformations (AVMs) demonstrate significant risk for hemorrhage, yet intervention also involves significant risk. The aim of this proof-of-concept study is to determine if Vessel Wall Imaging (VWI) technology may capture the draining veins of AVMs and, secondarily, if this technology may capture inflammatory processes in the walls of draining veins that correlate with rupture status. Methods Patients with a diagnosed cerebral arteriovenous malformation underwent T1-weighted fluid-attenuated inversion recovery imaging, with and without gadolinium contrast, to assess wall enhancement. Patients also underwent standard-of-care imaging, including digital subtraction angiography and magnetic resonance angiography. The presence of any (Y/N) and of circumferential (Y/N) draining vein, hemorrhage, AVM architecture, and clinical/demographic data was obtained for each patient. AVM flows were quantified using Non-invasive Optimized Vessel Analysis. Results VWI successfully captured venous wall contours in 8 of 9 cases studied; 1 case had a substantial hematoma that completely eclipsed venous anatomy. Post-gadolinium contrast enhancement in draining vein walls had a nearly-significant association with hemorrhagic presentation in the nidus. Post-gadolinium contrast enhancement was more prevalent in the draining veins of patients with a history of hypertension. There was a nearly-significant association of gadolinium wall enhancement in high-flow veins. Conclusion This proof-of-concept experiment successfully demonstrates that VWI technology is capable of capturing the tortuous anatomy of AVM draining veins. It also suggests that gadolinium-enhanced VWI is capable of capturing inflammatory processes exacerbated by factors such as hypertension and high-volume venous flow. Notably, this pilot study suggests that this technology may also be used to predict AVMs at highest risk of hemorrhage

Drone-Based Wireless Communications for Disaster Recovery

This project aims to establish a drone system that can deploy a wireless mesh network over a disaster area, which would aid in the process of finding survivors by using wireless communications to identify where victims are and allow authorities to send out alerts to people in the area. We also seek to add a device detection feature that would allow the drones to passively look for devices through WiFi and Bluetooth Low Energy, giving disaster responders the ability to actively identify specific devices, locate zones where victims lie, and discern a rough population estimate of that area. Those that find themselves in the middle of the disaster situation are able to use their own devices to establish a connection with the outside world. Under a mesh topology, the drones will act as network nodes that will dynamically connect to each other which enables a more resilient configuration. The drones will be flying above an area to enable wireless connectivity for first responders as well as those in distress, ensuring reliable detection and a critical communications pipeline when it is needed the most

Crusted scabies infection in the setting of chronic steroid and omalizumab use

Scabies infection is a very common skin disease that occurs due to infestation with the Sarcoptes scabei mite. Typically, it results in intensely pruritic papules and excoriations in the webs of the hand, groin, or axilla, and remains limited in its spread. In rare cases, the disease can become diffuse and progress to crusted or nodular subtypes. Here, we report the case of crusted scabies infestation in a 69-year-old male who presented with a diffuse pruritic, erythematous, and petechial rash. His medical history was significant for severe idiopathic urticaria treated with omalizumab. Before starting omalizumab, the patient was self-medicating for several months with corticosteroids obtained through his veterinary practice to alleviate symptoms. His presentation was complicated by immune thrombocytopenic purpura and muscle weakness, likely secondary to omalizumab and corticosteroid use, respectively. The patient underwent an extensive rheumatologic workup until skin biopsy confirmed the underlying etiology as crusted scabies infestation. He was treated with ivermectin and weekly 5% permethrin skin cream with great improvement of his rash; however, unfortunately, he succumbed to bacterial sepsis. Scabies infestation can masquerade as a manifestation of other systemic diseases and is often misdiagnosed. As this case illustrates, initial misdiagnosis and subsequent treatment with immunosuppressive drug regimens can cause preventable, but potentially fatal, concomitant superinfections

The Oncopig Cancer Model: An Innovative Large Animal Translational Oncology Platform.

Despite an improved understanding of cancer molecular biology, immune landscapes, and advancements in cytotoxic, biologic, and immunologic anti-cancer therapeutics, cancer remains a leading cause of death worldwide. More than 8.2 million deaths were attributed to cancer in 2012, and it is anticipated that cancer incidence will continue to rise, with 19.3 million cases expected by 2025. The development and investigation of new diagnostic modalities and innovative therapeutic tools is critical for reducing the global cancer burden. Toward this end, transitional animal models serve a crucial role in bridging the gap between fundamental diagnostic and therapeutic discoveries and human clinical trials. Such animal models offer insights into all aspects of the basic science-clinical translational cancer research continuum (screening, detection, oncogenesis, tumor biology, immunogenicity, therapeutics, and outcomes). To date, however, cancer research progress has been markedly hampered by lack of a genotypically, anatomically, and physiologically relevant large animal model. Without progressive cancer models, discoveries are hindered and cures are improbable. Herein, we describe a transgenic porcine model-the Oncopig Cancer Model (OCM)-as a next-generation large animal platform for the study of hematologic and solid tumor oncology. With mutations in key tumor suppressor and oncogenes, TP53R167H and KRASG12D , the OCM recapitulates transcriptional hallmarks of human disease while also exhibiting clinically relevant histologic and genotypic tumor phenotypes. Moreover, as obesity rates increase across the global population, cancer patients commonly present clinically with multiple comorbid conditions. Due to the effects of these comorbidities on patient management, therapeutic strategies, and clinical outcomes, an ideal animal model should develop cancer on the background of representative comorbid conditions (tumor macro- and microenvironments). As observed in clinical practice, liver cirrhosis frequently precedes development of primary liver cancer or hepatocellular carcinoma. The OCM has the capacity to develop tumors in combination with such relevant comorbidities. Furthermore, studies on the tumor microenvironment demonstrate similarities between OCM and human cancer genomic landscapes. This review highlights the potential of this and other large animal platforms as transitional models to bridge the gap between basic research and clinical practice

The Oncopig Cancer Model: An Innovative Large Animal Translational Oncology Platform

Despite an improved understanding of cancer molecular biology, immune landscapes, and advancements in cytotoxic, biologic, and immunologic anti-cancer therapeutics, cancer remains a leading cause of death worldwide. More than 8.2 million deaths were attributed to cancer in 2012, and it is anticipated that cancer incidence will continue to rise, with 19.3 million cases expected by 2025. The development and investigation of new diagnostic modalities and innovative therapeutic tools is critical for reducing the global cancer burden. Toward this end, transitional animal models serve a crucial role in bridging the gap between fundamental diagnostic and therapeutic discoveries and human clinical trials. Such animal models offer insights into all aspects of the basic science-clinical translational cancer research continuum (screening, detection, oncogenesis, tumor biology, immunogenicity, therapeutics, and outcomes). To date, however, cancer research progress has been markedly hampered by lack of a genotypically, anatomically, and physiologically relevant large animal model. Without progressive cancer models, discoveries are hindered and cures are improbable. Herein, we describe a transgenic porcine model—the Oncopig Cancer Model (OCM)—as a next-generation large animal platform for the study of hematologic and solid tumor oncology. With mutations in key tumor suppressor and oncogenes, TP53R167H and KRASG12D, the OCM recapitulates transcriptional hallmarks of human disease while also exhibiting clinically relevant histologic and genotypic tumor phenotypes. Moreover, as obesity rates increase across the global population, cancer patients commonly present clinically with multiple comorbid conditions. Due to the effects of these comorbidities on patient management, therapeutic strategies, and clinical outcomes, an ideal animal model should develop cancer on the background of representative comorbid conditions (tumor macro- and microenvironments). As observed in clinical practice, liver cirrhosis frequently precedes development of primary liver cancer or hepatocellular carcinoma. The OCM has the capacity to develop tumors in combination with such relevant comorbidities. Furthermore, studies on the tumor microenvironment demonstrate similarities between OCM and human cancer genomic landscapes. This review highlights the potential of this and other large animal platforms as transitional models to bridge the gap between basic research and clinical practice