Publications

PURPOSE: To evaluate the impact of socioeconomic factors on survival in patients with HCC undergoing interventional LRT at a tertiary center.

MATERIALS AND METHODS: A retrospective cohort of 1,091 HCC patients treated with interventional LRT (2000-2022). Clinical and socioeconomic data (gender, insurance, race, education, language, marital status) were collected. Survival analysis utilized Kaplan-Meier and multivariable Cox regression to assess the impact of socioeconomic factors . Among identified patients (median age: 63 [IQR=12.14], 81% male), the majority had Medicare (43%) or private insurance (33%), were White (63%), had a college (42%) or high school (45%) education, and were married (51%). Median AFP was 11 (IQR=76); most were Child-Pugh B (72%), BCLC Stage A (66%) and ECOG 0 (75%). Overall mortality was 62%, and 23% underwent liver transplant.

RESULTS: Female gender (HR 1.26, 95% CI 1.03-1.55, p = 0.028), lower education (high school vs. college; HR 1.24, 95% CI 1.04-1.50, p = 0.015), and being divorced (HR 1.43, 95% CI 1.08-1.90, p = 0.012) were independently associated with increased mortality. Asian race predicted improved survival (HR 0.44, 95% CI 0.29-0.67, p < 0.05).

CONCLUSION: Asian race, male gender, marriage, and higher education independently predicted better survival in HCC patients receiving interventional LRT.

Color centers hosted in hexagonal boron nitride (hBN) have emerged as a highly promising platform for single-photon emission and spin-photon technologies relevant to quantum communication and quantum networking. As a wide bandgap van der Waals material, hBN can host optically active quantum defects across a broad spectral range. Here, we demonstrate a simple and scalable oxygen-plasma process that reproducibly creates single quantum emitters in hBN with blinking-free zero-phonon lines (ZPLs) spanning near-infrared (NIR) from 700 up to 971 nm. These emitters combine MHz-level brightness, single-photon purity up to 99.9%, and ultranarrow cryogenic line widths down to 2.7 GHz under quasi-resonant excitation, placing them in a particularly attractive regime for quantum photonics. Photostability measurements further reveal resistance to photobleaching, subnanometer spectral stability over long time scales, and near-shot-noise-limited intensity fluctuations. Analysis of the phonon sidebands shows weak vibronic coupling and ZPL-dominated emission, with Debye-Waller factors approaching 50%. Control experiments together with elemental mapping support oxygen incorporation as a necessary ingredient in activating the NIR emitter population, while first-principles calculations identify ONVN and ONVNH as the leading defect candidates. These results establish a high-performance NIR quantum-emitter platform in hBN for free-space quantum networking and future integrated quantum-photonic architectures.

Prussian Blue is not only the oldest synthetic pigment, but also an electrochemically active material with modern technological relevance for its electrochromic properties and applications in energy storage. In this work, we study the fundamental mechanism of electron transport processes in this material, and how it varies as the material is progressively oxidized from Prussian White to Prussian Blue. Recently developed methods in spectroelectrochemical ultrafast 2D infrared spectroscopy allow us to measure the electron transfer rate within a film of Prussian Blue deposited onto the working electrode in an electrochemical cell as a function of applied bias potential. The intrinsic CN stretching modes serve as a local probe of the Fe oxidation state and as a measure for the solvation dynamics induced by water molecules incorporated into the subcells of the zeolitic lattice. We observe a fast, ps-scale electron transfer process with a rate that varies with the state of the material, revealing the intrinsic mobility of electrons decoupled from the slow diffusion of K+ ions. By correlating these observations to changes in the local structural distributions of FeIII sites, K+ ions and water molecules with the aid of a lattice model, we obtain insight into the mechanism of electron transport in this material. These results demonstrate a method for observing fast electron transfer and correlating them with nuclear motions, and provide a way to study chemical transformations at the electrochemical interface.

OBJECTIVE: To compare computed tomography (CT) scan-based morphometric measures associated with atlanto-occipital joint (AOJ) instability between Chiari malformation type I (CMI) patients and controls and to examine associations between these measures, clinical symptoms, and established craniocervical/posterior fossa morphometrics in CMI.

MATERIALS AND METHODS: Four AOJ-related morphometric measures were evaluated on CT: condyle-C1 interval (CCI), C1 socket depth-to-length ratio (DL ratio), condyle depth-to-depth ratio (CD ratio), and atlas tilt angle. Measurements were compared between CMI (n = 45) and controls (n = 55). Within CMI, associations were tested between AOJ measures and symptom variables, as well as 13 established craniocervical/posterior fossa morphometrics.

RESULTS: Mean CCI was slightly larger in CMI than in controls (1.00 vs. 0.91 mm, P < 0.05). DL ratio, CD ratio, and atlas tilt angle did not differ significantly between groups. Within CMI, CCI showed a modest association with hypermobility (r = 0.34, P < 0.05). Moderate correlations were observed between AOJ measures and selected morphometrics, suggesting relationships between AOJ geometry and posterior fossa/craniocervical anatomy.

CONCLUSION: Among the AOJ measures examined, only CCI demonstrated a small but statistically significant group difference and a modest association with hypermobility in CMI. The shape of the AOJ curvature was not different between CMI and control. However, further investigation of AOJ-related morphometrics as potential contributors to symptom heterogeneity among CMI patients is necessary.

PURPOSE: To evaluate the impact of reducing protective equipment requirements on post-procedural infection rates in ultrasound-guided paracenteses, comparing outcomes between full protective equipment protocol (sterile gloves, gown, surgical mask, and hat) vs. limited protective equipment protocol (sterile gloves only).

MATERIALS AND METHODS: A single-center retrospective study analyzed 1,177 consecutive ultrasound-guided paracenteses performed between June 1st, 2021 and May 31st, 2022. The study compared infection rates across two six-month periods: before (619 procedures) and after (558 procedures) the 12/1/2021 policy change reducing protective equipment requirements. Primary outcome measures included post-procedural infection rates, specifically spontaneous bacterial peritonitis (SBP), soft tissue infection, or other intra-abdominal infections, evaluated at 7 and 14 days post-procedure. Analysis was conducted at both the individual paracentesis and patient level.

RESULTS: No statistically significant differences were observed in post-procedural infection rates between the full and limited protective equipment groups. The 7-day infection rates were 1.1% vs. 0.9% (p=0.41), and 14-day infection rates were 1.5% vs. 1.8% (p=0.65) for full versus limited protective equipment groups, respectively. Patient-level analysis showed similar results, with 14-day infection rates of 3.3% vs. 4.1% (p=0.69). The median volume of fluid removed remained consistent between groups (3.2L vs. 3.0L, p=0.50).

CONCLUSION: Sterile gloves alone provide adequate protection for ultrasound-guided paracentesis while reducing the use of protective equipment, enabling simplified protocols without compromising patient safety.

OBJECTIVE: In patients with acute ischemic stroke, CT perfusion (CTP)-derived infarct core is valuable for prognostication, triage and transfer decision-making, and for informing studies of emerging therapeutic targets. In this study, we compare the accuracy and variability of the infarct core predicted by 2 FDA-cleared CTP programs, using diffusion-weighted MRI (DWI) as the reference standard.

METHODS: We analyzed 61 stroke patients who underwent admission CTP and DWI within 90 minutes. Infarct core was estimated using relative cerebral blood flow thresholds and compared with DWI-derived ground truth. After coregistration of CTP and DWI, Dice similarity coefficients were calculated to quantify the topographic concordance of the infarct core.

RESULTS: The CTP-determined infarct core volumes were significantly correlated with DWI but demonstrated substantial variability and bias. Our results showed limited topographic overlap, with median dice scores of 0.367 (CTP-A) and 0.289 (CTP-B). However, in patients with larger infarcts (volumes ≥50 mL), CTP provides more reliable estimates of spatial agreement, reaching median Dice scores of 0.61 (CTP-A) and 0.47 (CTP-B).

CONCLUSIONS: Although these findings show a generally low accuracy of CTP estimation, they suggest that CTP may offer clinically meaningful insights for decision-making in the large-core setting and inform the design of future trials.

AIM: To explore the prevalence and outcomes of dysphagia in paediatric acquired brain injury, associated with aetiology, unilateral and bilateral injury, and brain regions involved, while considering age, sex, and length of stay.

METHOD: This was a retrospective observational cohort study of 85 children with acquired brain injury (50 males, 35 females; age range 6 months to 16 years, mean 8 years 2 months, SD 5 years 3 months). Aetiologies included traumatic brain injury (TBI) (n = 24), stroke/vascular injury (n = 23), hypoxic/ischaemic injury (n = 8), infection (n = 15), autoimmune conditions (n = 8), and other causes (n = 7). Dysphagia at admission and discharge was recorded; magnetic resonance imaging review identified lesion laterality and regions involved. One-year follow-up evaluated recovery in children with dysphagia at discharge.

RESULTS: Dysphagia prevalence at admission varied (TBI 83%, stroke/vascular 52%, hypoxic 100%, infection 87%, autoimmune 63%, other 43%), decreasing at discharge (TBI 33%, stroke/vascular 8%, hypoxic 87%, infection 13%, autoimmune 25%, other 0%). At admission, 97.6% of children with bilateral injury presented with dysphagia, compared to 47.7% with unilateral injury. All children with unilateral injury had resolved dysphagia at discharge, compared to 47.5% with bilateral injury. Children with both cortical and subcortical injury showed low resolution of dysphagia at discharge (33%).

INTERPRETATION: Dysphagia is prevalent in paediatric acquired brain injury. Bilateral injuries, particularly involving cortical and subcortical regions, are associated with persistent dysphagia.