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1.
Eur J Neurosci ; 59(12): 3162-3183, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38626924

ABSTRACT

Musical engagement can be conceptualized through various activities, modes of listening and listener states. Recent research has reported that a state of focused engagement can be indexed by the inter-subject correlation (ISC) of audience responses to a shared naturalistic stimulus. While statistically significant ISC has been reported during music listening, we lack insight into the temporal dynamics of engagement over the course of musical works-such as those composed in the Western classical style-which involve the formulation of expectations that are realized or derailed at subsequent points of arrival. Here, we use the ISC of electroencephalographic (EEG) and continuous behavioural (CB) responses to investigate the time-varying dynamics of engagement with functional tonal music. From a sample of adult musicians who listened to a complete cello concerto movement, we found that ISC varied throughout the excerpt for both measures. In particular, significant EEG ISC was observed during periods of musical tension that built to climactic highpoints, while significant CB ISC corresponded more to declarative entrances and points of arrival. Moreover, we found that a control stimulus retaining envelope characteristics of the intact music, but little other temporal structure, also elicited significantly correlated EEG and CB responses, though to lesser extents than the original version. In sum, these findings shed light on the temporal dynamics of engagement during music listening and clarify specific aspects of musical engagement that may be indexed by each measure.


Subject(s)
Auditory Perception , Electroencephalography , Music , Humans , Electroencephalography/methods , Male , Female , Adult , Auditory Perception/physiology , Young Adult , Acoustic Stimulation/methods , Brain/physiology
2.
Transplantation ; 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38557579

ABSTRACT

With the growth of the older adult population, the number of older adults waitlisted for and undergoing kidney and liver transplantation has increased. Transplantation is an important and definitive treatment for this population. We present a contemporary review of the unique preoperative, intraoperative, and postoperative issues that patients older than 65 y face when they undergo kidney or liver transplantation. We focus on geriatric syndromes that are common in older patients listed for kidney or liver transplantation including frailty, sarcopenia, and cognitive dysfunction; discuss important considerations for older transplant recipients, which may impact preoperative risk stratification; and describe unique challenges in intraoperative and postoperative management for older patients. Intraoperative challenges in the older adult include using evidence-based best anesthetic practices, maintaining adequate perfusion pressure, and using minimally invasive surgical techniques. Postoperative concerns include controlling acute postoperative pain; preventing cardiovascular complications and delirium; optimizing immunosuppression; preventing perioperative kidney injury; and avoiding nephrotoxicity and rehabilitation. Future studies are needed throughout the perioperative period to identify interventions that will improve patients' preoperative physiologic status, prevent postoperative medical complications, and improve medical and patient-centered outcomes in this vulnerable patient population.

4.
Cogn Sci ; 47(12): e13390, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38043104

ABSTRACT

Definitions of syncopation share two characteristics: the presence of a meter or analogous hierarchical rhythmic structure and a displacement or contradiction of that structure. These attributes are translated in terms of a Bayesian theory of syncopation, where the syncopation of a rhythm is inferred based on a hierarchical structure that is, in turn, learned from the ongoing musical stimulus. Several experiments tested its simplest possible implementation, with equally weighted priors associated with different meters and independence of auditory events, which can be decomposed into two terms representing note density and deviation from a metric hierarchy. A computational simulation demonstrated that extant measures of syncopation fall into two distinct factors analogous to the terms in the simple Bayesian model. Next, a series of behavioral experiments found that perceived syncopation is significantly related to both terms, offering support for the general Bayesian construction of syncopation. However, we also found that the prior expectations associated with different metric structures are not equal across meters and that there is an interaction between density and hierarchical deviation, implying that auditory events are not independent from each other. Together, these findings provide evidence that syncopation is a manifestation of a form of temporal expectation that can be directly represented in Bayesian terms and offer a complementary, feature-driven approach to recent Bayesian models of temporal prediction.


Subject(s)
Auditory Perception , Music , Humans , Motivation , Bayes Theorem , Learning
5.
J Urol ; 210(6): 853-854, 2023 12.
Article in English | MEDLINE | ID: mdl-37795816
6.
J Endourol ; 37(11): 1174-1178, 2023 11.
Article in English | MEDLINE | ID: mdl-37675902

ABSTRACT

Introduction: The American Urological Association guidelines state that continuing anticoagulant (AC) and antiplatelet (AP) agents during ureteroscopy (URS) is safe. Through a multi-institutional retrospective study, we sought to determine whether pre-stenting in patients on AP or AC was associated with fewer URS bleeding-related complications. Methods: A series of 8614 URS procedures performed across three institutions (April 2010 to September 2017) was electronically reviewed for AC/AP use at time of URS. Records indicating AC or AP use at time of URS were then manually reviewed to characterize intraoperative and 30-day postoperative (intraoperative bleeding, postoperative hematuria, emergency department visits, hospital readmission, unplanned reoperation, phone calls, and other minor 30-day complications). Results: A total of 293 identified URS procedures were completed on patients on AC/AP therapy-112 cases were on AC only (38 were pre-stented), 158 on AP only (51 pre-stented), and 23 on both AP and AC (8 pre-stented). Patient characteristics and comorbidities were similar between the pre-stented and non-pre-stented groups. For AC and AP subjects, pre-stenting did not decrease the composite risk of bleeding complications (10.3% pre-stent vs 12.2% non-prestent, p = 0.6). Pre-stented patients did have a significantly lower likelihood of requiring an unplanned reoperation (1.0% vs 5.6%, p = 0.04). In the subgroup of patients on AP alone, pre-stented patients had significantly fewer episodes of intraoperative bleeding (0% vs 9%, p = 0.04), unplanned reoperations (0% vs 6.5%, p = 0.02), and 30-day complications (14% vs 27%, p = 0.05). In the subgroup of patients on AC alone, there were no significant differences in outcomes based on stent status. Conclusions: In this multi-institutional study, we found that pre-stenting before URS was not associated with fewer bleeding complications. However, pre-stenting appeared to be associated with improved outcomes for those patients on AP therapy. These results suggest a need for prospective studies to clarify the role of pre-stenting for URS.


Subject(s)
Ureteral Calculi , Ureteroscopy , Humans , Ureteroscopy/adverse effects , Ureteroscopy/methods , Platelet Aggregation Inhibitors/adverse effects , Ureteral Calculi/surgery , Retrospective Studies , Prospective Studies , Anticoagulants/adverse effects , Hemorrhage/etiology , Stents/adverse effects , Treatment Outcome , Postoperative Complications/etiology
7.
Article in English | MEDLINE | ID: mdl-37701064

ABSTRACT

In this paper, we propose a method for removing linguistic information from speech for the purpose of isolating paralinguistic indicators of affect. The immediate utility of this method lies in clinical tests of sensitivity to vocal affect that are not confounded by language, which is impaired in a variety of clinical populations. The method is based on simultaneous recordings of speech audio and electroglotto-graphic (EGG) signals. The speech audio signal is used to estimate the average vocal tract filter response and amplitude envelop. The EGG signal supplies a direct correlate of voice source activity that is mostly independent of phonetic articulation. These signals are used to create a third signal designed to capture as much paralinguistic information from the vocal production system as possible-maximizing the retention of bioacoustic cues to affect-while eliminating phonetic cues to verbal meaning. To evaluate the success of this method, we studied the perception of corresponding speech audio and transformed EGG signals in an affect rating experiment with online listeners. The results show a high degree of similarity in the perceived affect of matched signals, indicating that our method is effective.

9.
Can Urol Assoc J ; 17(10): E330-E335, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37494322

ABSTRACT

INTRODUCTION: Despite its minimally invasive nature, percutaneous nephrolithotomy (PCNL ) may be associated with significant pain. Challenges in pain control may prevent timely discharge (and expose patients to adverse effects of opioid use). We sought to evaluate whether our patients who underwent erector spinae plane (ESP) regional blocks experienced improved postoperative pain control and decreased opioid use after PCNL (compared with those who did not receive blocks). METHODS: We retrospectively reviewed consecutive PCNL cases on patients admitted for greater than 24 hours without pre-existing opioid regimens for chronic pain. Cases were completed by a single high-volume surgeon. Patients who accepted an ESP block were compared to those who did not receive a block. Patients received either a single injection or a disposable pump delivering intermittent boluses of ropivacaine 0.2%. Demographic and perioperative data were analyzed. The primary outcomes were opioid use measured in morphine milligram equivalent (MME ) and patient-reported pain scores during the first 24 hours of hospitalization. RESULTS: From March 2019 to August 2021, 44 patients were identified who met criteria - 28 of whom received an ESP block (including 14 continuous blocks). The patients who received blocks had significantly decreased opioid use (18.3 vs. 81.3 MME, p=0.004) and a longer mean time to first non-zero pain score (p=0.004). Continuous blocks had similar opioid use to single shot blocks (21.0 vs. 15.6 MME, p=0.952). CONCLUSIONS: ESP regional blocks appear to offer an effective adjunct method for pain control after PCNL and may reduce post-PCNL opioid use while maintaining adequate patient analgesia.

10.
Front Psychol ; 14: 1187153, 2023.
Article in English | MEDLINE | ID: mdl-37333611

ABSTRACT

Flow is defined as a state of total absorption in an activity, involving focused attention, deep engagement, loss of self-conscious awareness, and self-perceived temporal distortion. Musical flow has been associated with enhanced performance, but the bulk of previous research has investigated flow mechanisms using self-report methodology. Thus, little is known about the precise musical features that may induce or disrupt flow. This work aims to consider the experience of flow from a music performance perspective in order to investigate these features and introduces a method of measuring flow in real time. In Study 1, musicians reviewed a self-selected video of themselves performing, noting first, where in the performance they recalled "losing themselves" in the music, and second, where their focused state was interrupted. Thematic analysis of participant flow experiences suggests temporal, dynamic, pitch and timbral dimensions associated with the induction and disruption of flow. In Study 2, musicians were brought into the lab and recorded while performing a self-selected musical composition. Next, participants were asked to estimate the duration of their performance, and to rewatch their recordings to mark those places in which they recalled "losing themselves in the moment." We found that the proportion of performance time spent in flow significantly correlated with self-reported flow intensity, providing an intrinsic measure of flow and confirming the validity of our method to capture flow states in music performance. We then analyzed the music scores and participants' performed melodies. The results showed that stepwise motion, repeated sequence, and a lack of disjunct motion are common to flow state entry points, whereas disjunct motion and syncopation are common to flow state exit points. Overall, such initial findings suggest directions that warrant future study and, altogether, they have implications regarding utilizing flow in music performance contexts.

11.
J Endourol ; 37(8): 863-867, 2023 08.
Article in English | MEDLINE | ID: mdl-37294208

ABSTRACT

Introduction: Recent retrospective literature suggests that the quick sequential organ failure assessment (qSOFA) scoring tool is a potentially superior tool over use of the systemic inflammatory response syndrome (SIRS) criteria to predict septic shock after percutaneous nephrolithotomy (PCNL) surgery. Here we examine use of qSOFA and SIRS to predict septic shock within data series collected prospectively on PCNL patients as part of a greater study of infectious complications. Materials and Methods: We performed a secondary analysis of two prospective multicenter studies including PCNL patients across nine institutions. Clinical signs informing SIRS and qSOFA scores were collected no later than postoperative day 1. The primary outcome was sensitivity and specificity of SIRS and qSOFA (high-risk score of greater-or-equal to two points) in predicting admission to the intensive care unit (ICU) for vasopressor support. Results: A total of 218 cases at 9 institutions were analyzed. One patient required vasopressor support in the ICU. The sensitivity/specificity was 100%/72.4% (McNemar's test p < 0.001) for SIRS and was 100%/90.8% (McNemar's test p < 0.001) for qSOFA. Conclusion: Although positive predictive value for both qSOFA and SIRS in prediction of post-PCNL septic shock is low, prospectively collected data demonstrate use of qSOFA may offer greater specificity than SIRS criteria when predicting post-PCNL septic shock.


Subject(s)
Nephrolithotomy, Percutaneous , Sepsis , Shock, Septic , Humans , Shock, Septic/diagnosis , Shock, Septic/etiology , Organ Dysfunction Scores , Retrospective Studies , Prospective Studies , Prognosis , Hospital Mortality , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/etiology , ROC Curve
12.
Urolithiasis ; 51(1): 70, 2023 Apr 15.
Article in English | MEDLINE | ID: mdl-37061554

ABSTRACT

In 2018, the Endourology Disease Group for Excellence (EDGE) published a prospective trial comparing dusting versus basketing during ureteroscopy. One hundred fifty-nine patients were included in the original analysis, which found no difference in stone-free rate at 3 months. We report the intermediate and long-term outcomes of patients included in the original trial. Two analyses were performed. At 1-year, a retrospective chart review was performed, and data collected on stone episodes, Emergency Department (ED) visits, hospital admissions and surgical interventions. To obtain long-term outcomes, the four sites with the largest initial accrual were included in a second phase of data collection with updated analyses. The patients from those sites were contacted, re-consented, and data were collected on stone surgical interventions, stone episodes, stone recurrences on imaging, emergency department (ED) visits, and hospital admissions for stone-related care since their original procedure. One-year follow-up data were collected in 111 of the original 159 (69.8%) patients from the nine sites. There were no statistically significant differences in the number of painful episodes, ED visits, hospital admissions, or surgical interventions. 94 patients from four sites were included in the long-term analysis. There were no statistically significant differences in surgical interventions, painful stone episodes, stone recurrence on imaging, ED visits or hospitalizations for stone-related events between the two groups. Long-term outcomes of dusting versus basketing during ureteroscopy indicate that there are no significant differences in clinical outcomes between the two surgical modalities.


Subject(s)
Kidney Calculi , Ureteroscopy , Humans , Follow-Up Studies , Prospective Studies , Ureteroscopy/methods , Male , Female , Kidney Calculi/therapy , Treatment Outcome
13.
J Endourol ; 37(6): 628-633, 2023 06.
Article in English | MEDLINE | ID: mdl-36974366

ABSTRACT

Introduction: To evaluate flexible ureteroscope working channels with a 1.06 mm digital borescope (Clarus Medical, Minneapolis, MN) and identify factors contributing to ureteroscope damage over time. Materials and Methods: We performed a single institutional prospective study of patients undergoing stone surgery using a nondisposable flexible ureteroscope. A 1.06 mm borescope was used to evaluate ureteroscopes before and after surgery. Borescope videos were reviewed by two independent researchers to quantify average pre- and postprocedural damage. Results: Twenty-five procedures were performed with pre- and postprocedural borescope assessment between August 2021 and February 2022. All patients received preoperative CT imaging depicting a mean axial stone size of 14.1 ± 8.4 mm and density of 923.4 ± 458.1 HU. Mean operative time was 63.8 ± 34.0 minutes. The average number an instrument passes through the working channel was 2.1 ± 1.6. Laser was used in 11 cases with mean laser time of 18.8 ± 19.7 minutes and mean total energy of 5.8 ± 4.2 KJ. On preoperative assessment, all ureteroscopes had some form of defect (24% shave, 32% pinhole, 96% dents and scratches, and 28% discolorations). During postoperative assessment, 23/25 (92%) ureteroscopes showed additional damage with an average of 3.7 ± 2.8 imperfections acquired after one use. Significant differences were seen in acquired shavings (p = 0.028) and scratches or dents (p = 0.018). Of the 355 imperfections seen on postoperative evaluation, 0.4% were shave, 3% were pinhole, 85.8% were dents and scratches, and 10.8% were discolorations. Conclusion: The Clarus borescope observed defects after the majority of flexible ureteroscopy procedures for nephrolithiasis. Although such disruptions may not immediately render ureteroscopes nonfunctional, they are more common than previously described and could increase maintenance costs. Further studies are needed to investigate the burden of unit damage per procedure to raise operator awareness and reduce preventable ureteroscope imperfections.


Subject(s)
Kidney Calculi , Ureteroscopes , Humans , Prospective Studies , Ureteroscopy/methods , Kidney Calculi/surgery , Costs and Cost Analysis , Equipment Design
14.
Urolithiasis ; 51(1): 48, 2023 Mar 15.
Article in English | MEDLINE | ID: mdl-36920673

ABSTRACT

It is documented that Hispanic/Latinx kidney stone formers have inferior health-related quality of life (HRQoL) compared to the general population. We hypothesized that socioeconomic factors drive HRQoL disparities. Specifically, we sought to determine if medical insurance type is associated with HRQoL disparities among Hispanic/Latinx stone formers. This was a prospective cohort observational study of patients with kidney stones across the University of San Diego Health Care System. Patients enrolled from June 2018 to August 2020 completed a validated Wisconsin Stone Quality of Life questionnaire (WISQoL). Patient characteristics and self-reported HRQoL were compared between Hispanic/Latinx and non-Hispanic/Latinx stone formers using MANCOVA and ordinal logistic regression. Matched group comparisons were performed based on age, gender, body mass index, stone symptoms, and insurance type using MACOVA. A total of 270 patients were enrolled (Hispanic/Latinx n = 88; non-Hispanic/Latinx n = 182). Hispanic/Latinx stone formers had higher rates of public insurance at baseline (p < 0.001) with significantly lower HRQoL [social impact (p = 0.007)]. However, a matched cohort comparison demonstrated no differences. On multivariate analysis, private insurance increased the likelihood of having higher HRQoL (OR 2.21, p = 0.021), while stone symptoms (OR = 0.06, p < 0.001) and emergency department visits (OR = 0.04, p = 0.008) decreased chances of higher HRQoL. Ethnicity was not a significant factor in HRQoL scores on multivariate analysis. Our analysis suggests that differences in HRQoL among Hispanic/Latinx stone formers may be primarily driven by socioeconomic factors as opposed to clinical or racial differences. Specifically, source of insurance appears to have significant effect on HRQoL in this ethnic group.


Subject(s)
Kidney Calculi , Quality of Life , Humans , Prospective Studies , Kidney Calculi/diagnosis , Hispanic or Latino , Ethnicity
15.
J Endourol ; 37(1): 85-92, 2023 01.
Article in English | MEDLINE | ID: mdl-36106604

ABSTRACT

Purpose: To evaluate whether computer program-estimated urolith stone volume (SV) was a better predictor of spontaneous passage (SP) compared with program-estimated stone diameter (PD) or manually measured stone diameter (MD), and whether utilizing SV and MD together provided additional value in SP prediction compared with MD alone. Materials and Methods: Retrospective analysis of patients with acute renal colic and single renal/ureteral stone on CT from July 2017 to April 2020. Diameter obtained from radiology reports or manually measured when report not available. Semiautomated stone analysis software (qSAS) was used to estimate SV and PD. ROC analysis was performed to compare accuracy of SV vs MD vs PD in predicting SP by 2, 4, and 6 weeks. Subgroup analysis was performed by stone size (

Subject(s)
Kidney Calculi , Ureteral Calculi , Humans , Retrospective Studies , Prospective Studies , Remission, Spontaneous , Ureteral Calculi/diagnostic imaging , Software
16.
J Endourol ; 36(11): 1418-1424, 2022 11.
Article in English | MEDLINE | ID: mdl-35699065

ABSTRACT

Introduction: For treatment of nephrolithiasis, ambulatory percutaneous nephrolithotomy (aPCNL) is growing in popularity for select patients. The aim of this study was to investigate the safety and efficacy of a set of aPCNL selection criteria as well as search for predictors of failed aPCNL resulting in inpatient admission. Materials and Methods: We reviewed all percutaneous nephrolithotomy (PCNL) patients from 2016 to 2020. A total of 175 met selection criteria for aPCNL and were included. Primary outcome was safety and efficacy, and secondary outcome was to identify predictors of inpatient stay. Demographic and perioperative data were analyzed with both descriptive and inferential statistics. Results: In total, between 2016 and 2020, 552 patients underwent PCNL, with 175 of them meeting criteria for aPCNL. One hundred thirty-four of the 175 (76.6%) of these patients were discharged the same day as the surgery and 41 patients were admitted. On univariate analysis, patients who required upper pole access or multiple accesses (p = 0.038) American Society of Anesthesiologists >2 (p = 0.005), or postoperative nephrostomy (PCN) tube (p < 0.001) were more likely to be admitted after surgery. On multivariate analysis, only postoperative PCN was significantly associated with admission (p = 0.015). Regarding reasons for unsuccessful aPCNL, 19.5% of admissions were attributed to intraoperative complications, 7% to social causes, 12.2% to postoperative complications, 14.6% to uncontrolled pain, and 34.1% to unexpected intraoperative procedures. Conclusions: aPCNL using selection criteria is safe and effective, with postoperative PCN predicting the possible necessity for conversion to inpatient admission. Furthermore, our study provides a practical algorithm for those opting to provide aPCNL to patients.


Subject(s)
Kidney Calculi , Nephrolithotomy, Percutaneous , Humans , Hospitalization , Kidney Calculi/surgery , Nephrolithotomy, Percutaneous/adverse effects , Nephrolithotomy, Percutaneous/methods , Retrospective Studies , Treatment Outcome
17.
J Endourol ; 36(10): 1265-1270, 2022 10.
Article in English | MEDLINE | ID: mdl-35545870

ABSTRACT

Introduction: The objective of this process improvement project was to determine the effect of enhanced recovery after surgery (ERAS) protocol for percutaneous nephrolithotomy (PCNL) patients with respect to quality of life (QOL) and pain management in the postoperative recovery period. Methods: An electronic-based medical record ERAS orders protocol for PCNL was instituted at an academic medical center in July 2020. The protocol utilized a pain control regimen designed to minimize opioid medication use postoperatively. We prospectively evaluated PCNL patients' QOL through the Wisconsin Stone Quality of Life (WISQOL) survey and Patient-Reported Outcomes Measurement System (PROMIS) at routine perioperative visits. To assess any opioid reduction benefit of the ERAS protocol, we reviewed an age-matched historical cohort n = 66 (before ERAS implementation) to serve as a comparison cohort with respect to opioid usage. Results: After an inception cohort of 95 patients, 55 ERAS patients remained available for assessment with the WISQOL and PROMIS surveys. In comparison with the non-ERAS cohort, the ERAS cohort represented larger stones, more supine positioning, higher blood loss, shorter hospital stay, and more use of access sheath. ERAS patients received a significantly lower amount of opioids compared with non-ERAS patients upon discharge narcotic usage (116.13 morphine milliequivalent [MME] vs 39.57 MME, p = 0.0001). Compared with their preoperative evaluation, the ERAS cohort had significantly improved QOL scores at 1 week, which sustained through 8 weeks postoperatively. Moreover, pain intensity and pain interference scores were improved at 8 weeks postoperatively for ERAS patients compared with their preoperative time point. Conclusions: We demonstrate that standardizing medications in early efforts toward a PCNL ERAS protocol is feasible and allows for reduced opioid use by patients while achieving early and sustained postprocedure QOL.


Subject(s)
Enhanced Recovery After Surgery , Nephrolithotomy, Percutaneous , Analgesics, Opioid/therapeutic use , Endrin/analogs & derivatives , Humans , Length of Stay , Morphine Derivatives/therapeutic use , Narcotics/therapeutic use , Pain, Postoperative/drug therapy , Pain, Postoperative/etiology , Quality of Life , Retrospective Studies
18.
Ann Vasc Surg ; 87: 245-253, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35413413

ABSTRACT

BACKGROUND: Transplant renal artery stenosis (TRAS) after renal transplantation is a common cause of graft dysfunction and failure. Endovascular intervention in the form of percutaneous transluminal angioplasty (PTA) and stenting has rapidly become the dominant treatment modality for the TRAS. There is a paucity of clinical data on the use of drug-eluting stent (DES) for TRAS. We investigated the outcomes of patients with clinically significant TRAS undergoing DES placement. METHODS: A retrospective review of patients with clinically significant TRAS undergoing PTA with DES placement from June 2014 to April 2021 was conducted. Patients treated for TRAS exhibited uncontrolled hypertension and/or unexplained allograft dysfunction. Patient demographics, procedural details, and follow-up outcomes were collected. Primary endpoints were the in-stent primary patency and graft survival. Secondary endpoints were freedom from reintervention, primary-assisted patency, and access-related complications. RESULTS: Thirteen TRAS in 12 patients with graft function alteration were treated with DES. The median age was 57 years (interquartile range (IQR), 48-63 years), and 9 (70%) patients were male. The median follow-up was 9 months (IQR, 4-52 months). The most common comorbidity was hypertension (100%), coronary artery disease (83%), and diabetes. The median time from deceased donor transplant to intervention was 5.8 months (IQR, 3.5-6.7 months). TRAS was most commonly found at the juxta-ostial segment (77%). The procedure was performed with carbon dioxide angiography with minimal amount of iodinated contrast (median, 3 mL) under local anesthesia in 9 (69%), and general anesthesia in 4 (31%) patients. The median stent diameter was 4.5 mm (IQR, 4-5 mm), and the median stent length was 15 mm (IQR, 15-18 mm). No intraoperative complications occurred. The rates of stenosis-free primary patency of the DES and graft survival were 76% and 100%, respectively. All 3 reinterventions for restenosis resulted from the kinking of the transplant renal artery proximal to the DES, which were treated by extending the stent more proximally 1-2 mm into the external iliac artery. There were no access-related complications. The median time to reintervention was 0.9 months (range, 0.23-2 months). Freedom from reintervention and primary-assisted patency were 76% and 100%, respectively. CONCLUSIONS: Our study demonstrates that DES is a safe and effective treatment modality in patients with TRAS at short to mid-term follow-up. As all reinterventions after DES were performed due to kinking of the transplant renal artery proximal to the stent, bridging of the DES 1-2 mm into the external iliac artery is recommended.


Subject(s)
Angioplasty, Balloon , Drug-Eluting Stents , Hypertension , Renal Artery Obstruction , Humans , Male , Middle Aged , Female , Renal Artery Obstruction/diagnostic imaging , Renal Artery Obstruction/etiology , Renal Artery Obstruction/therapy , Drug-Eluting Stents/adverse effects , Angioplasty, Balloon/adverse effects , Treatment Outcome , Stents/adverse effects , Retrospective Studies , Constriction, Pathologic/etiology , Hypertension/etiology
19.
Front Sociol ; 7: 848098, 2022.
Article in English | MEDLINE | ID: mdl-35399192

ABSTRACT

The COVID-19 pandemic has devastated the economic and social wellbeing of communities worldwide. Certain groups have been disproportionately impacted by the strain of the pandemic, such as classical musicians. The COVID-19 pandemic has greatly harmed the classical music industry, silencing the world's concert halls and theaters. In an industry characterized by instability, a shock as great as COVID-19 may bring negative effects that far outlast the pandemic itself. This study investigates the wellbeing of classical musicians during the COVID-19 pandemic. 68 professional classical musicians completed a questionnaire composed of validated measures of future time horizons, emotional experience, social relationships, and life satisfaction. Findings show that feelings of loneliness had a significant negative association with other measures of wellbeing and were significantly mediated by increased social integration and perceived social support from colleagues, friends, and family. These findings help to characterize the present psychological, emotional, and social wellness of classical musicians in the United States, the first step toward mitigating the hazardous impacts of COVID-19 on this vulnerable group's mental health and wellness.

20.
Front Neurosci ; 15: 702067, 2021.
Article in English | MEDLINE | ID: mdl-34955706

ABSTRACT

Musical minimalism utilizes the temporal manipulation of restricted collections of rhythmic, melodic, and/or harmonic materials. One example, Steve Reich's Piano Phase, offers listeners readily audible formal structure with unpredictable events at the local level. For example, pattern recurrences may generate strong expectations which are violated by small temporal and pitch deviations. A hyper-detailed listening strategy prompted by these minute deviations stands in contrast to the type of listening engagement typically cultivated around functional tonal Western music. Recent research has suggested that the inter-subject correlation (ISC) of electroencephalographic (EEG) responses to natural audio-visual stimuli objectively indexes a state of "engagement," demonstrating the potential of this approach for analyzing music listening. But can ISCs capture engagement with minimalist music, which features less obvious expectation formation and has historically received a wide range of reactions? To approach this question, we collected EEG and continuous behavioral (CB) data while 30 adults listened to an excerpt from Steve Reich's Piano Phase, as well as three controlled manipulations and a popular-music remix of the work. Our analyses reveal that EEG and CB ISC are highest for the remix stimulus and lowest for our most repetitive manipulation, no statistical differences in overall EEG ISC between our most musically meaningful manipulations and Reich's original piece, and evidence that compositional features drove engagement in time-resolved ISC analyses. We also found that aesthetic evaluations corresponded well with overall EEG ISC. Finally we highlight co-occurrences between stimulus events and time-resolved EEG and CB ISC. We offer the CB paradigm as a useful analysis measure and note the value of minimalist compositions as a limit case for the neuroscientific study of music listening. Overall, our participants' neural, continuous behavioral, and question responses showed strong similarities that may help refine our understanding of the type of engagement indexed by ISC for musical stimuli.

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