Andrew Tang

Interests

Teaching

Trauma CareGeneral surgerySurgical Critical Care

Research

Quality Improvement in Trauma CareContaminated Wound ManagementTraumatic Brain InjuryMedical Devices

Courses

Scholarly Contributions

Chapters

• Tang, A., & Stewart, C. (2022). Esophagus, Stomach, and Duodenum. In Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers. Wiley.
• Tang, A. (2018). Esophagus, Stomach and Duodenum. In Surgical Critical Care and Acute Care Surgery: Clinical Questions and Answers 2nd Edition(pp 359-370). Wiley-Blackwell. doi:2018
• Tang, A. (2018). Gallbladder and pancreas. In Surgical Critical Care and Acute Care Surgery: Clinical Questions and Answers 2nd Edition(pp 385-392). Wiley-Blackwell.
• Tang, A., Joseph, B. A., Cox, C., & Rhee, P. (2013). Pregnancy in Trauma. In Maternal Critical Care: A mutlidisciplinary Approach(pp 356-366). Cambridge University Press.
• Tang, A. (2012). Esophagus, stomach and doudenum. In Surgical Critical Care and Acute Care Surgery: Clinical Questions and Answers(pp 328-337). Wiley-Blackwell.
• Tang, A. (2012). Gallbladder and Pancreas. In Surgical Critical Care and Acute Care Surgery: Clinical Questions and Answers(pp 348-356).
• Tang, A., Tarmey, n., Dubose, j., & Rhee, P. (2012). Abnormal surgical and post operative bleeding. In Surgery: Evidence Based Practice(pp 909-916).
• Tang, A., Joseph, B., Cox, C., & Rhee, P. (2011). Trauma. In Maternal Critical Care: A multidisciplinary approach(pp 356-366). Cambridge University Press.
• Tang, A., Wip, C., & Demetriades, D. (2011). Burns. In Color Atlas of Emergency Trauma(pp 253-270). Cambridge University Press.

Journals/Publications

• Hosseinpour, H., Magnotti, L. J., Huang, D. D., Weinberg, J. A., Tang, A., Hejazi, O., Stewart, C., Bhogadi, S. K., Anand, T., & Joseph, B. (2024). The role of number of affected vessels on radiologic and clinical outcomes of patients with blunt cerebrovascular injury. Journal of vascular surgery, 80(3), 685-692.
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  There is a lack of data on the role of characteristics of injured vessels on the outcomes of patients with blunt cerebrovascular injuries (BCVIs). The aim of this study was to assess the effect of the number (single vs multiple) of injured vessels on outcomes.
• Mamaril-Davis, J. C., Riordan, K., Sumdani, H., Bowlby, P., Emami Neyestanak, M., Simpson, L., Avellino, A. M., Tang, A., & Weinand, M. E. (2024). Subdural hematoma, retinal hemorrhage, and fracture triad as a clinical predictor for the diagnosis of child abuse. Journal of neurosurgery. Pediatrics, 33(2), 142-148.
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  Nonaccidental trauma (NAT) is a major cause of traumatic death during infancy and early childhood. Several findings are known to raise the index of clinical suspicion: subdural hematoma (SDH), retinal hemorrhage (RH), fracture, and external trauma. Combinations of certain injury types, determined via statistical frequency associations, may assist clinical diagnostic tools when child abuse is suspected. The present study sought to assess the statistical validity of the clinical triad (SDH + RH + fracture) in the diagnosis of child abuse and by extension pediatric NAT.
• Tang, A. (2023). "Subdural hematoma, retinal hemorrhage, and fracture triad as a clinical predictor for the diagnosis of child abuse". Journal of Neurosurgery, 1 - 7. doi:https://doi.org/10.3171/2023.11.PEDS23212
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  Nonaccidental trauma (NAT) is a major cause of traumatic death during infancy and early childhood. Several findings are known to raise the index of clinical suspicion: subdural hematoma (SDH), retinal hemorrhage (RH), fracture, and external trauma. Combinations of certain injury types, determined via statistical frequency associations, may assist clinical diagnostic tools when child abuse is suspected. The present study sought to assess the statistical validity of the clinical triad (SDH + RH + fracture) in the diagnosis of child abuse and by extension pediatric NAT.
• Asmar, S., Nelson, A., Anand, T., Hammad, A., Obaid, O., Ditillo, M., Saljuqi, T., Tang, A., & Joseph, B. (2022). Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation!. American journal of surgery, 223(4), 798-803.
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  Tetrahydrocannabinol (THC) can alter the coagulation cascade resulting in hypercoagulability. The aim of our study is to evaluate the impact of THC use on thromboembolic complications (TEC) in geriatric trauma patients (GTP).
• Erstad, B. L., Kopp, B. J., & Tang, A. L. (2022). Antibiotic prophylaxis for traumatic facial fractures. Journal of clinical pharmacy and therapeutics, 47(3), 386-395.
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  The purpose of this paper is to discuss the limitations of the evidence supporting the SIS recommendations for antibiotic prescribing in patients with traumatic facial fractures and to provide suggestions for clinical decision-making and further research in this area given the wide variation in prescribing practices.
• Perlmutter, B. C., Ali, J., Cengiz, T. B., Said, S. A., Tang, A., Augustin, T., Joyce, D., Simon, R., & Walsh, R. M. (2022). Correlation between physical status measures and frailty score in patients undergoing pancreatic resection. Surgery, 171(3), 711-717.
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  This study aimed to assess the correlation between validated measures of physical status in a prehabilitation regimen with an established frailty score and analyze changes in these measures after completion of a directed prehabilitation program among patients undergoing elective pancreatic resection.
• Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2022). Authors' response to "The diameter of the gelatin sponge affects the outcome of pelvic internal iliac artery embolization". The journal of trauma and acute care surgery, 92(5), e111.
• Tang, A. (2022). Antibiotic Prophlyaxis for Traumatic Facial Fractures. The Journal of Clinical Pharmacy and Therapeutics.
• Asmar, S., Bible, L., Obaid, O., Tang, A., Khurrum, M., Castanon, L., Ditillo, M., & Joseph, B. (2021). Open vs Endovascular Treatment of Traumatic Peripheral Arterial Injury: Propensity Matched Analysis. Journal of the American College of Surgeons, 233(1), 131-138.e4.
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  Arterial injuries occur in the setting of blunt and penetrating trauma. Despite increasing use, there remains a paucity of data comparing long-term outcomes of endovascular vs open repair management of these injuries. The aim of our study was to compare outcomes and readmission rates of open vs endovascular repair of traumatic arterial injuries.
• Asmar, S., Bible, L., Vartanyan, P., Castanon, L., Masjedi, A., Richards, J., Ditillo, M., Tang, A., & Joseph, B. (2021). Firearm-Related Injuries: A Single Center Experience. The Journal of surgical research, 265, 289-296.
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  Firearm-related injuries (FRI) are an important public health crisis in the US. There is relatively less city level data examining the injury-related trends in Tucson, Arizona. Our study aims to examine FRI, in Southern Arizona's only Level I trauma center.
• Bauman, Z. M., Kulvatunyou, N., Joseph, B., Gries, L., O'Keeffe, T., Tang, A. L., & Rhee, P. (2021). Randomized Clinical Trial of 14-French (14F) Pigtail Catheters versus 28-32F Chest Tubes in the Management of Patients with Traumatic Hemothorax and Hemopneumothorax. World journal of surgery, 45(3), 880-886.
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  Traditional management of traumatic hemothorax/hemopneumothorax (HTX/HPTX) has been insertion of large-bore 32-40 French (Fr) chest tubes (CTs). Retrospective studies have shown 14Fr percutaneous pigtail catheters (PCs) are equally effective as CTs. Our aim was to compare effectiveness between PCs and CTs by performing the first randomized controlled trial (RCT). We hypothesize PCs work equally as well as CTs in management of traumatic HTX/HPTX.
• Calabrese, E. C., Asmar, S., Bible, L., Khurrum, M., Chehab, M., Tang, A., Castanon, L., Ditillo, M., & Joseph, B. (2021). Prospective Evaluation of Health Literacy and Its Impact on Outcomes in Emergency General Surgery. The Journal of surgical research, 261, 343-350.
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  Health literacy (HL) is an important component of national health policy. The aim of our study was to assess the prevalence of low HL (LHL) and determine its impact on outcomes after emergency general surgery (EGS).
• Dharia, N. V., Kugener, G., Guenther, L. M., Malone, C. F., Durbin, A. D., Hong, A. L., Howard, T. P., Bandopadhayay, P., Wechsler, C. S., Fung, I., Warren, A. C., Dempster, J. M., Krill-Burger, J. M., Paolella, B. R., Moh, P., Jha, N., Tang, A., Montgomery, P., Boehm, J. S., , Hahn, W. C., et al. (2021). A first-generation pediatric cancer dependency map. Nature genetics, 53(4), 529-538.
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  Exciting therapeutic targets are emerging from CRISPR-based screens of high mutational-burden adult cancers. A key question, however, is whether functional genomic approaches will yield new targets in pediatric cancers, known for remarkably few mutations, which often encode proteins considered challenging drug targets. To address this, we created a first-generation pediatric cancer dependency map representing 13 pediatric solid and brain tumor types. Eighty-two pediatric cancer cell lines were subjected to genome-scale CRISPR-Cas9 loss-of-function screening to identify genes required for cell survival. In contrast to the finding that pediatric cancers harbor fewer somatic mutations, we found a similar complexity of genetic dependencies in pediatric cancer cell lines compared to that in adult models. Findings from the pediatric cancer dependency map provide preclinical support for ongoing precision medicine clinical trials. The vulnerabilities observed in pediatric cancers were often distinct from those in adult cancer, indicating that repurposing adult oncology drugs will be insufficient to address childhood cancers.
• Kulvatunyou, N., Bauman, Z. M., Zein Edine, S. B., de Moya, M., Krause, C., Mukherjee, K., Gries, L., Tang, A. L., Joseph, B., & Rhee, P. (2021). The small (14 Fr) percutaneous catheter (P-CAT) versus large (28-32 Fr) open chest tube for traumatic hemothorax: A multicenter randomized clinical trial. The journal of trauma and acute care surgery, 91(5), 809-813.
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  The traditional treatment of traumatic hemothorax (HTX) has been an insertion of a large-bore 36- to 40-Fr chest tube. Our previous single-center randomized controlled trial (RCT) had shown that 14-Fr percutaneous catheters (PCs) (pigtail) were equally as effective as chest tube. We performed a multicenter RCT, hypothesizing that PCs are as equally effective as chest tubes in the management of patients with traumatic HTX (NCT03546764).
• Kulvatunyou, N., Zimmerman, S. A., Adhikhari, S., Joseph, B., Gries, L., Tang, A. L., & Rhee, P. (2021). The Impact of FASTPASS: A Collaboration With Emergency Department to Improve Management of Patients With Gallbladder Disease and Acute Appendicitis. The Journal of surgical research, 260, 293-299.
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  Efficient Emergency Department (ED) throughput depends on several factors, including collaboration and consultation with surgical services. The acute care surgery service (ACS) collaborated with ED to implement a new process termed "FASTPASS" (FP), which might improve patient-care for those with acute appendicitis and gallbladder disease. The aim of this study was to evaluate the 1-year outcome of FP.
• Sherman, N. C., Williams, K. N., Hennemeyer, C. T., Devis, P., Chehab, M., Joseph, B., & Tang, A. L. (2021). Effects of nonselective internal iliac artery angioembolization on pelvic venous flow in the swine model. The journal of trauma and acute care surgery, 91(2), 318-324.
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  Pelvic angioembolization (AE) is a mainstay in the treatment algorithm for pelvic hemorrhage from pelvic fractures. Nonselective AE refers to embolization of the bilateral internal iliac arteries (IIAs) proximally rather than embolization of their tributaries distally. The aim of this study was to quantify the effect of nonselective pelvic AE on pelvic venous flow in a swine model. We hypothesized that internal iliac vein (IIV) flow following IIA AE is reduced by half.
• Tang, A., & Raja, S. (2021). Commentary: Does Toll Play the Sole Role?. Seminars in thoracic and cardiovascular surgery.
• Tang, A., Ahmad, U., Raja, S., Rappaport, J., Raymond, D. P., Sudarshan, M., Bribriesco, A. C., Blackstone, E. H., & Murthy, S. C. (2021). Looking beyond the eyeball test: A novel vitality index to predict recovery after esophagectomy. The Journal of thoracic and cardiovascular surgery, 161(3), 822-832.e6.
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  To (1) measure 4 physiologic metrics before esophagectomy, (2) use these in an index to predict composite postoperative outcome after esophagectomy, and (3) compare predictive accuracy of this index to that of the Fried Frailty Index and Modified Frailty Index.
• Tang, A., Ahmad, U., Raja, S., Siddiqui, H. U., Sinopoli, J. N., O'Dell, A., Pande, A., Blackstone, E. H., & Murthy, S. C. (2021). Repair, Reconstruct, or Divert: Fate of the Perforated Esophagus. Annals of surgery, 274(5), e417-e424.
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  The aim of this study was to determine differences in esophageal perforation populations undergoing different advanced interventions for perforated esophagus and identify predictors of treatment outcomes.
• Anand, T., Hanna, K., Kulvatunyou, N., Zeeshan, M., Ditillo, M., Castanon, L., Tang, A., Gries, L., & Joseph, B. (2020). Time to tracheostomy impacts overall outcomes in patients with cervical spinal cord injury. The journal of trauma and acute care surgery, 89(2), 358-364.
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  The morbidity associated with cervical spine injury increases in the setting of concomitant cervical spinal cord injury (CSCI). A significant proportion of these patients require placement of a tracheostomy. However, it remains unclear if timing to tracheostomy following traumatic CSCI can impact outcomes. The aim of our study was to characterize outcomes associated with tracheostomy timing following traumatic CSCI.
• Asmar, S., Bible, L., Chehab, M., Tang, A., Khurrum, M., Douglas, M., Castanon, L., Kulvatunyou, N., & Joseph, B. (2020). Resuscitative Endovascular Balloon Occlusion of the Aorta vs Pre-Peritoneal Packing in Patients with Pelvic Fracture. Journal of the American College of Surgeons.
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  Pelvic hemorrhage is potentially lethal despite homeostatic interventions such as pre-peritoneal packing (PP), resuscitative endovascular balloon occlusion of the aorta (REBOA), surgery, and/or angioembolization. REBOA may be used as an alternative/adjunct to PP for temporizing bleeding in patients with pelvic fractures. Our study aims to compare the outcomes of REBOA and/or PP, as temporizing measures, in blunt pelvic fracture patients. We hypothesize that REBOA is associated with worsened outcomes.
• Augustin, T., Moslim, M. A., Cengiz, T. B., El-Hayek, K., Simon, R., Bhatt, A., Tang, A., Burke, C. A., & Matthew Walsh, R. (2020). Survival outcomes after surgical management of sporadic or familial adenomatous polyposis associated duodenal cancer. Journal of surgical oncology, 122(6), 1132-1144.
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  Duodenal cancer is the second most common cause of cancer death in familial adenomatous polyposis (FAP) patients. In this study, we compare oncologic outcomes between sporadic and FAP-associated duodenal cancer.
• Branco, B. C., Tang, A. L., Rhee, P., Fraga, G. P., Nascimento, B., Rizoli, S., & O'Keeffe, T. (2020). Selective nonoperative management of high grade splenic trauma. Revista do Colegio Brasileiro de Cirurgioes, 40(3), 246-50.
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  The "Evidence-based Telemedicine - Trauma & Acute Care Surgery" (EBT-TACS) Journal Club performed a critical review of the literature and selected three up-to-date articles on the management of splenic trauma. Our focus was on high-grade splenic injuries, defined as AAST injury grade III-V. The first paper was an update of the 2003 Eastern Association for the Surgery of Trauma (EAST) practice management guidelines for nonoperative management of injury to the spleen. The second paper was an American Association for the Surgery of Trauma (AAST) 2012 plenary paper evaluating the predictive role of contrast blush on CT scan in AAST grade IV and V splenic injuries. Our last article was from Europe and investigates the effects of angioembolization of splenic artery on splenic function after high-grade splenic trauma (AAST grade III-V). The EBT-TACS Journal Club elaborated conclusions and recommendations for the management of high-grade splenic trauma.
• Campbell, J., Tirapelle, L., Yates, K., Clark, R., Inaba, K., Green, D., Plurad, D., Lam, L., Tang, A., Cestero, R., & Sullivan, M. (2020). The effectiveness of a cognitive task analysis informed curriculum to increase self-efficacy and improve performance for an open cricothyrotomy. Journal of surgical education, 68(5), 403-7.
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  This study explored the effects of a cognitive task analysis (CTA)-informed curriculum to increase surgical skills performance and self-efficacy beliefs for medical students and postgraduate surgical residents learning how to perform an open cricothyrotomy.
• Ditillo, M., Hanna, K., Castanon, L., Zeeshan, M., Kulvatunyou, N., Tang, A., Sakran, J., Gries, L., & Joseph, B. (2020). The role of cryoprecipitate in massively transfused patients: Results from the Trauma Quality Improvement Program database may change your mind. The journal of trauma and acute care surgery, 89(2), 336-343.
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  Cryoprecipitate was developed for the treatment of inherited and acquired coagulopathies. The role of cryoprecipitate in hemorrhaging trauma patients is still speculative. The aim of our study was to assess the role of cryoprecipitate as an adjunct to transfusion in trauma patients.
• Driesen, A. M., Romero Arenas, M. A., Arora, T. K., Tang, A., Nfonsam, V. N., O'Grady, C. L., Riall, T. S., & Morris-Wiseman, L. F. (2020). Do General Surgery Residency Program Websites Feature Diversity?. Journal of surgical education.
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  This study assesses ways in which General Surgery residency program websites demonstrate diversity.
• Elofson, K. A., Rhoads, S. F., Tang, A., Gaither, J. B., & Patanwala, A. E. (2020). Long-acting neuromuscular blocker use during prehospital transport of trauma patients. Air medical journal, 32(4), 203-7.
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  The purpose of this study was to determine the rate of long-acting neuromuscular blocker (LA-NMB) use and evaluate the concurrent use of sedatives during prehospital care.
• Hanna, K., Bible, L., Chehab, M., Asmar, S., Douglas, M., Ditillo, M., Castanon, L., Tang, A., & Joseph, B. (2020). Nationwide analysis of whole blood hemostatic resuscitation in civilian trauma. The journal of trauma and acute care surgery, 89(2), 329-335.
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  Renewed interest in whole blood (WB) resuscitation in civilians has emerged following its military use. There is a paucity of data on its role in civilians where balanced component therapy (CT) resuscitation is the standard of care. The aim of this study was to assess nationwide outcomes of using WB as an adjunct to CT versus CT alone in resuscitating civilian trauma patients.
• Hanna, K., Chehab, M., Bible, L., Asmar, S., Ditillo, M., Castanon, L., Tang, A., & Joseph, B. (2020). Failure to Rescue in Emergency General Surgery: Impact of Fragmentation of Care. Annals of surgery.
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  Compare emergency general surgery (EGS) patient outcomes following index and non-index hospital readmissions, and explore predictive factors for non-index readmission.
• Hanna, K., Chehab, M., Bible, L., Castanon, L., Douglas, M., Asmar, S., Ditillo, M., Tang, A., & Joseph, B. (2020). Nationwide analysis of cryopreserved packed red blood cell transfusion in civilian trauma. The journal of trauma and acute care surgery, 89(5), 861-866.
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  Liquid packed red blood cells (LPRBCs) have a limited shelf life and worsening quality with age. Cryopreserved packed red blood cells (CPRBCs) can be stored up to 10 years with no quality deterioration. The effect of CPRBCs on outcomes in civilian trauma is less explored. This study aims to evaluate the safety and efficacy of CPRBCs in civilian trauma patients.
• Hanna, K., Haddadin, Z., Sakran, J., Zeeshan, M., Asmar, S., Kulvatunyou, N., Tang, A., Northcutt, A., & Joseph, B. (2020). Barriers to improving health care value in emergency general surgery: A nationwide analysis. The journal of trauma and acute care surgery, 89(2), 289-300.
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  There is a growing need to improve the quality of care while decreasing health care costs in emergency general surgery (EGS). Health care value includes costs and quality and is a targeted metric by improvement programs. The aim of our study was to evaluate the trend of health care value in EGS over time and to identify barriers to high-value surgical care.
• Hanna, K., Hamidi, M., Vartanyan, P., Henry, M., Castanon, L., Tang, A., Zeeshan, M., Kulvatunyou, N., & Joseph, B. (2020). Non-neurologic organ dysfunction plays a major role in predicting outcomes in pediatric traumatic brain injury. Journal of pediatric surgery, 55(8), 1590-1595.
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  Nonneurological organ dysfunction (NNOD) occurs after traumatic brain injury (TBI) and is associated with mortality. The aim of our study was to evaluate the prevalence of NNOD and its association with outcomes in pediatric patients with TBI. We hypothesized that NNOD is associated with worse outcomes in pediatric patients with severe TBI.
• Hanna, K., Khan, M., Ditillo, M., Hamidi, M., Tang, A., Zeeshan, M., Saljuqi, A. T., & Joseph, B. (2020). Prospective evaluation of preoperative cognitive impairment and postoperative morbidity in geriatric patients undergoing emergency general surgery. American journal of surgery, 220(4), 1064-1070.
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  Cognitive impairment (CI) is common in geriatric patients. We aimed to evaluate the prevalence and impact of CI on outcomes in geriatric patients undergoing emergency general surgery (EGS).
• Hodges, K., Tang, A., Rivas, C. G., Umana-Pizano, J., Chemtob, R., Desai, M. Y., Gillinov, A. M., Smedira, N., & Wierup, P. (2020). Surgical ablation of atrial fibrillation in hypertrophic obstructive cardiomyopathy: Outcomes of a tailored surgical approach. Journal of cardiac surgery, 35(11), 2957-2964.
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  To assess outcomes of concomitant ablation for atrial fibrillation (AF) in patients with preoperative AF undergoing septal myectomy for hypertrophic obstructive cardiomyopathy.
• Jehan, F., Zeeshan, M., Con, J., Hanna, K., Tang, A., Hamidi, M., Latifi, R., & Joseph, B. (2020). Metabolic Syndrome Exponentially Increases the Risk of Adverse Outcomes in Operative Diverticulitis. The Journal of surgical research, 245, 544-551.
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  Metabolic syndrome (MS) is defined as the cluster: hypertension, obesity, and diabetes. Operative diverticulitis in the setting of MS can be challenging to manage. The aim of our study was to evaluate the impact of MS on outcomes in operative acute diverticulitis patients.
• Joseph, B., Joseph, B., Joseph, B., Hadeed, S., Hadeed, S., Hadeed, S., Haider, A. A., Haider, A. A., Haider, A. A., Ditillo, M., Ditillo, M., Ditillo, M., Joseph, A., Joseph, A., Joseph, A., Pandit, V., Pandit, V., Pandit, V., Kulvatunyou, N., , Kulvatunyou, N., et al. (2020). Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes. Obesity research & clinical practice, 11(1), 72-78.
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  Protective effects of safety devices in obese motorists in motor vehicle collisions (MVC) remain unclear. Aim of our study is to assess the association between morbid obesity and mortality in MVC, and to determine the efficacy of protective devices. We hypothesised that patients with morbid obesity will be at greater risk of death after MVC.
• Khurrum, M., Asmar, S., Henry, M., Ditillo, M., Chehab, M., Tang, A., Bible, L., Gries, L., & Joseph, B. (2020). The survival benefit of low molecular weight heparin over unfractionated heparin in pediatric trauma patients. Journal of pediatric surgery.
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  Venous thromboembolism (VTE) prophylaxis in pediatric patients is controversial and is mainly dependent on protocols derived from adult practices. Our study aimed to compare outcomes among pediatric trauma patients who received low molecular weight heparin (LMWH) compared to those who received unfractionated heparin (UFH).
• Kline, G. A., Boyd, J., Leung, A. A., Tang, A., & Sadrzadeh, H. M. (2020). Moderate renal impairment does not preclude the accuracy of 24-hour urine normetanephrine measurements for suspected pheochromoctyoma. Clinical endocrinology, 92(6), 518-524.
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  A 24-hour urine nor/metanephrine (urine NM-MN) measurements are a recommended first step in pheochromocytoma diagnosis. We hypothesized the presence of renal impairment (CKD) significantly confounds the results obtained in a urine NM-MN collection, giving artificially lower measurements.
• Lal, P., Tang, A., Sarvepalli, S., Raja, S., Thota, P., Lopez, R., Murthy, S., Ray, M., & Gabbard, S. (2020). Manometric Esophageal Length to Height (MELH) Ratio Predicts Hiatal Hernia Recurrence. Journal of clinical gastroenterology, 54(6), e56-e62.
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  The shortened esophagus is poorly defined and is determined intraoperatively, as there exists no objective test to identify a shortened esophagus before surgical hiatal hernia repair. We devised a unique manometric esophageal length to height (MELH) ratio to define the presence of a shortened esophagus and examined the role of esophageal length in hiatal hernia recurrence.
• Lokhandwala, A., Hanna, K., Gries, L., Zeeshan, M., Ditillo, M., Tang, A., Hamidi, M., & Joseph, B. (2020). Preinjury Statins Are Associated With Improved Survival in Patients With Traumatic Brain Injury. The Journal of surgical research, 245, 367-372.
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  Statins have been shown to improve outcomes in traumatic brain injury (TBI) in animal models. The aim of our study was to determine the effect of preinjury statins on outcomes in TBI patients.
• McGregor, H., Woodhead, G., Patel, M., Khan, A., Hannallah, J., Ruiz, D., Conrad, M., Tang, A., & Hennemeyer, C. (2020). Gallbladder Cryoablation for Chronic Cholecystitis in High-Risk Surgical Patients: 1-Year Clinical Experience with Imaging Follow-up. Journal of vascular and interventional radiology : JVIR, 31(5), 801-807.
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  To assess the short-term safety and efficacy of gallbladder cryoablation in high-risk patients.
• Roman, J., Roman, J., Shank, W., Shank, W., Demirjian, J., Demirjian, J., Tang, A., Tang, A., Vercruysse, G. A., & Vercruysse, G. A. (2020). Overutilization of Helicopter Transport in the Minimally Burned-A Healthcare System Problem That Should Be Corrected. Journal of burn care & research : official publication of the American Burn Association, 41(1), 15-22.
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  Eighty-eight percent of all patients burned in North America suffer burns of less than 20% TBSA. These patients may need care at a burn center, but barring any inhalation injury or polytrauma, these patients do not require helicopter transport (HEMS). We sought to identify a cohort of patients suffering smaller burns who do not benefit from HEMS to establish significant health care system savings. A 5-year retrospective analysis of data collected from our trauma registry was performed. Patients were separated into two groups: HEMS and ground transport (EMS). A subanalysis was performed between those with smaller burns (
• Roussas, A., Masjedi, A., Hanna, K., Zeeshan, M., Kulvatunyou, N., Gries, L., Tang, A., & Joseph, B. (2020). Number and Type of Complications Associated With Failure to Rescue in Trauma Patients. The Journal of surgical research, 254, 41-48.
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  Failure to rescue (FTR) is becoming a ubiquitous metric of quality care. The aim of our study is to determine the type and number of complications associated with FTR after trauma.
• Saljuqi, A. T., Hanna, K., Asmar, S., Tang, A., Zeeshan, M., Gries, L., Ditillo, M., Kulvatunyou, N., Castanon, L., & Joseph, B. (2020). Prospective Evaluation of Delirium in Geriatric Patients Undergoing Emergency General Surgery. Journal of the American College of Surgeons, 230(5), 758-765.
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  The prevalence of delirium and its impact on outcomes after emergency general surgery (EGS) remain unexplored. The aims of our study were to assess the impact of frailty on delirium and the impact of delirium on outcomes in geriatric EGS patients.
• Sanaka, M. R., Chadalavada, P., Alomari, M., Tang, A., Parikh, M., Garg, R., Gupta, N., Thota, P., Gabbard, S., Murthy, S., & Raja, S. (2020). Peroral endoscopic myotomy is a safe and effective treatment modality for geriatric patients with achalasia. Esophagus : official journal of the Japan Esophageal Society, 17(4), 484-491.
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  Peroral endoscopic myotomy (POEM) is an appealing treatment for older patients, as it is minimally invasive but highly efficacious similar to surgical myotomy. However, there is a lack of systematic studies analyzing POEM outcomes in young (
• Tang, A., & Raja, S. (2020). Commentary: Signet ring cell: One bad apple spoils the bunch!. The Journal of thoracic and cardiovascular surgery.
• Tang, A., Ahmad, U., Toth, A. J., Bourdakos, N., Raja, S., Raymond, D. P., Blackstone, E. H., & Murthy, S. C. (2020). Non-small cell lung cancer in never- and ever-smokers: Is it the same disease?. The Journal of thoracic and cardiovascular surgery.
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  To investigate differences in presentation, pathology, and outcomes after resection of non-small cell lung cancer (NSCLC) in never-smokers versus ever-smokers.
• Tang, A., Chehab, M., Ditillo, M., Asmar, S., Khurrum, M., Douglas, M., Bible, L., Kulvatunyou, N., & Joseph, B. (2020). Regionalization of Trauma Care by Operative Experience: Does the Volume of Emergent Laparotomy Matter?. The journal of trauma and acute care surgery.
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  The volume-outcome relationship led to the regionalization of trauma care. The relationship between trauma centers' injury-specific laparotomy volume and outcomes has not been explored. The aim of our study was to examine the relationship between a trauma center's injury-specific laparotomy volume and outcomes in blunt and penetrating trauma patients.
• Tang, A., Raja, S., Bribriesco, A. C., Raymond, D. P., Sudarshan, M., Murthy, S. C., & Ahmad, U. (2020). Robotic Approach Offers Similar Nodal Upstaging to Open Lobectomy for Clinical Stage I Non-small Cell Lung Cancer. The Annals of thoracic surgery, 110(2), 424-433.
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  Appropriate nodal dissection during pulmonary resection improves pathologic staging accuracy. Detection of unexpected nodal metastases can be a surrogate for nodal dissection adequacy and reflect oncologic resection quality. The goal of this study was to determine whether robotic lobectomy carries worse, same, or better incidence of nodal upstaging as open lobectomy for clinical stage I non-small cell lung cancer (NSCLC).
• Tang, A., Rappaport, J., Raja, S., Bribriesco, A. C., Sudarshan, M., Siddiqui, H. U., Raymond, D., Murthy, S. C., & Ahmad, U. (2020). Signet Ring Cell Histology Confers Worse Overall Survival in Treated Esophageal Adenocarcinoma. The Annals of thoracic surgery.
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  Signet ring cell (SRC) histology is regarded as a poor prognostic indicator for esophageal cancer. The objectives of this study were to understand the clinical presentation and stage-specific survival outcomes of patients with SRC and nonsignet adenocarcinoma (AC).
• Tang, A., Siddiqui, H. U., Thuita, L., Rappaport, J., Bribriesco, A. C., McCurry, K. R., Yun, J., Unai, S., Budev, M., Murthy, S. C., Blackstone, E. H., & Ahmad, U. (2020). Natural History of Pleural Complications after Lung Transplantation. The Annals of thoracic surgery.
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  Despite advances in lung transplantation, 5-year survival remains at 56%. Although focus has been on chronic lung allograft dysfunction and infection, pleural complications in some may contribute to adverse outcomes. Therefore, we determined 1) prevalence of, and risk factors for, pleural complications after lung transplant and 2) their association with allograft function and mortality.
• Tang, A., Sohal, D., McNamara, M., Murthy, S. C., & Raja, S. (2020). Siewert III Adenocarcinoma: Still Searching for the Right Treatment Combination. Surgical oncology clinics of North America, 29(4), 647-653.
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  It remains uncertain whether Siewert III tumors should be treated as esophageal or gastric cancers. Neoadjuvant therapy has been shown to improve survival in both esophageal and gastric trials. Randomized control trials comparing neoadjuvant chemotherapy versus chemoradiation should help define the most optimal treatment regimen. Surgical treatment follows general oncology principals: resect to negative margins with complete lymph node dissection, and, the extent of resection often extends more proximal onto the esophagus in addition to the total/subtotal gastrectomy.
• Tang, A., Thuita, L., Siddiqui, H. U., Rappaport, J., Blackstone, E. H., McCurry, K. R., Ahmad, U., & , L. T. (2020). Urgently listed lung transplant patients have outcomes similar to those of electively listed patients. The Journal of thoracic and cardiovascular surgery.
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  To (1) determine outcomes after urgent listing compared with elective listing for lung transplant and (2) compare in-hospital morbidity and mortality, survival, and allograft function in these 2 groups.
• Zhang, X., Potty, A. S., Jackson, G. W., Stepanov, V., Tang, A., Liu, Y., Kourentzi, K., Strych, U., Fox, G. E., & Willson, R. C. (2020). Engineered 5S ribosomal RNAs displaying aptamers recognizing vascular endothelial growth factor and malachite green. Journal of molecular recognition : JMR, 22(2), 154-61.
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  In previous work, Vibrio proteolyticus 5S rRNA was shown to stabilize 13-50 nucleotide "guest" RNA sequences for expression in Escherichia coli. The expressed chimeric RNAs accumulated to high levels in E. coli without being incorporated into ribosomes and without obvious effects on the host cells. In this work, we inserted sequences encoding known aptamers recognizing a protein and an organic dye into the 5S rRNA carrier and showed that aptamer function is preserved in the chimeras. A surface plasmon resonance competitive binding assay demonstrated that a vascular endothelial growth factor (VEGF) aptamer/5S rRNA chimera produced in vitro by transcriptional runoff could compete with a DNA aptamer for VEGF, implying binding of the growth factor by the VEGF "ribosomal RNA aptamer." Separately, a 5S rRNA chimera displaying an aptamer known to increase the fluorescence of malachite green (MG) also enhanced MG fluorescence. Closely related control rRNA molecules showed neither activity. The MG aptamer/5S rRNA chimera, like the original MG aptamer, also increased the fluorescence of other triphenyl methane (TPM) dyes such as crystal violet, methyl violet, and brilliant green, although less effectively than with MG. These results indicate that the molecular recognition properties of aptamers are not lost when they are expressed in the context of a stable 5S rRNA carrier. Inclusion of the aptamer in a carrier may facilitate production of large quantities of RNA aptamers, and may open an approach to screening aptamer libraries in vivo.
• Ahmad, U., Hakim, A. H., Tang, A., Tong, M. Z., Bribriesco, A., Budev, M., Mehta, A., Akindipe, O., Lane, C., McCurry, K. R., Pennell, N. A., Farver, C., & Murthy, S. C. (2019). Patterns of Recurrence and Overall Survival in Incidental Lung Cancer in Explanted Lungs. The Annals of thoracic surgery, 107(3), 891-896.
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  Recurrence and overall survival for incidental lung cancer in explanted lungs vary between different series. Recurrence patterns are also not well described. The primary objective of this study is to study the recurrence patterns and time to recurrence for various stages of lung cancer in lung transplant recipients.
• Choi, S., Tang, A., Murthy, S., & Raja, S. (2019). Preoperative Evaluation and Clinical Decision Making for Giant Paraesophageal Hernias: Who Gets an Operation?. Thoracic surgery clinics, 29(4), 415-419.
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  Giant paraesophageal hernias can present as an asymptomatic incidentally detected paraesophageal hernia to an emergent gastric volvulus with concern for ischemia. In the acute setting, the preoperative evaluation aims to determine the extent of complications from gastric volvulus. In the elective setting, preoperative testing defines the gastroesophageal anatomy and function to select the optimal operation. Through thoughtful preoperative evaluation, the best operative approach can be tailored to each patient.
• Downing, A. D., Eid, H. M., Tang, A., Ahmed, F., Harris, C. S., Haddad, P. S., Johns, T., Arnason, J. T., Bennett, S. A., & Cuerrier, A. (2019). Growth environment and organ specific variation in in-vitro cytoprotective activities of Picea mariana in PC12 cells exposed to glucose toxicity: a plant used for treatment of diabetes symptoms by the Cree of Eeyou Istchee (Quebec, Canada). BMC complementary and alternative medicine, 19(1), 137.
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  The Cree of Eeyou Istchee (James Bay area of northern Quebec) suffer from a high rate of diabetes and its complications partly due to the introduction of the western lifestyle within their culture. As part of a search for alternative medicine based on traditional practice, this project evaluates the biological activity of Picea mariana (Mill.) Britton, Sterns & Poggenb. needle, bark, and cone, in preventing glucose toxicity to PC12-AC cells in vitro (a diabetic neurophathy model) and whether habitat and growth environment influence this activity.
• Hamidi, M., Haddadin, Z., Zeeshan, M., Saljuqi, A. T., Hanna, K., Tang, A., Northcutt, A., Kulvatunyou, N., Gries, L., & Joseph, B. (2019). Prospective evaluation and comparison of the predictive ability of different frailty scores to predict outcomes in geriatric trauma patients. The journal of trauma and acute care surgery, 87(5), 1172-1180.
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  Different frailty scores have been proposed to measure frailty. No study has compared their predictive ability to predict outcomes in trauma patients. The aim of our study was to compare the predictive ability of different frailty scores to predict complications, mortality, discharge disposition, and 30-day readmission in trauma patients.
• Hamidi, M., Zeeshan, M., Kulvatunyou, N., Mitra, H. S., Hanna, K., Tang, A., Northcutt, A., O'Keeffe, T., & Joseph, B. (2019). Operative spinal trauma: Thromboprophylaxis with low molecular weight heparin or a direct oral anticoagulant. Journal of thrombosis and haemostasis : JTH, 17(6), 925-933.
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  Essentials Operative spine trauma patients are at increased risk of venous thromboembolism (VTE). Direct oral anticoagulants (DOACs) may have a favorable efficacy and safety in spine trauma. Patients on DOACs had lower rates of VTE in comparison to low molecular weight heparin. DOACs did not augment the risk of surgical bleeding (transfusion, decompressive procedures).
• Hamidi, M., Zeeshan, M., Sakran, J. V., Kulvatunyou, N., O'Keeffe, T., Northcutt, A., Zakaria, E. R., Tang, A., & Joseph, B. (2019). Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin for Thromboprophylaxis in Nonoperative Pelvic Fractures. Journal of the American College of Surgeons, 228(1), 89-97.
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  Patients with pelvic fractures are prone to venous thromboembolic (VTE) complications. Recent literature shows superiority of direct oral anticoagulants (DOACs) over low-molecular-weight heparin (LMWH) for thromboprophylaxis in patients undergoing orthopaedic operations. The aim of our study was to compare in-hospital outcomes for DOACs vs LMWH in patients with nonoperative pelvic fractures.
• Hanna, K., Hamidi, M., Anderson, K. T., Ditillo, M., Zeeshan, M., Tang, A., Henry, M., Kulvatunyou, N., & Joseph, B. (2019). Pediatric resuscitation: Weight-based packed red blood cell volume is a reliable predictor of mortality. The journal of trauma and acute care surgery, 87(2), 356-363.
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  The definition of massive transfusion (MT) in civilian pediatric trauma patients is not established. In combat-injured pediatric patients, the definition of MT is based on the volume of total blood products transfused. The aim of this study is to define MT in civilian pediatric trauma patients based on a packed red blood cell (PRBC) volume threshold and compare its predictive power to a total blood products volume threshold.
• Jehan, F., Zeeshan, M., Kulvatunyou, N., Khan, M., O'Keeffe, T., Tang, A., Gries, L., & Joseph, B. (2019). Is There a Need for Platelet Transfusion After Traumatic Brain Injury in Patients on P2Y12 Inhibitors?. The Journal of surgical research, 236, 224-229.
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  A significant portion of patients sustaining traumatic brain injury (TBI) are on antiplatelet medications. The reversal of P2Y12 agents after intracranial hemorrhage (ICH) remains unclear. The aim of our study is to evaluate outcomes after TBI in patients who are on preinjury P2Y12 inhibitors and received a platelet transfusion.
• Keshava, H. B., Keshava, H. B., Keshava, H. B., Keshava, H. B., Tang, A., Tang, A., Tang, A., Tang, A., Siddiqui, H. U., Siddiqui, H. U., Siddiqui, H. U., Siddiqui, H. U., Raja, S., Raja, S., Raja, S., Raja, S., Raymond, D. P., Raymond, D. P., Raymond, D. P., , Raymond, D. P., et al. (2019). Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA. World journal of surgery, 43(12), 3239-3247.
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  Projections based on regulations curtailing asbestos use in the USA suggest that peak incidence of pleural mesothelioma would occur between 2000 and 2005 and then decline. We analyzed the National Cancer Database (NCDB) to assess current trends in disease incidence, patient demographics, cancer treatment, and survival.
• Kulvatunyou, N., Zimmerman, S. A., Joseph, B., Friese, R. S., Gries, L., O'Keeffe, T., Stroster, J. A., & Tang, A. L. (2019). Risk Factors for Perforated Appendicitis in the Acute Care Surgery Era-Minimizing the Patient's Delayed Presentation Factor. The Journal of surgical research, 238, 113-118.
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  Numerous factors contribute to advanced disease or increased complications in patients with acute appendicitis (AA). This study aimed to identify risk factors associated with AA perforation, including the effect of system time (ST) delay, after controlling for patient time (PT) delay. In this study, PT was controlled (to less than or equal to 24 h) to better understand the effect of ST delay on AA perforation.
• McGregor, H., Woodhead, G., Conrad, M., Tang, A., Ruiz, D., Khan, A., & Hennemeyer, C. (2019). First in-Human Gallbladder Cryoablation in a Patient with Acute Calculous Cholecystitis Initially Treated with a Cholecystostomy Tube. Journal of vascular and interventional radiology : JVIR, 30(8), 1229-1232.
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  A 71-year-old poor surgical candidate with acute calculous cholecystitis was initially managed with cholecystostomy tube drainage for 28 days. He subsequently underwent gallbladder cryoablation under moderate sedation with 3 cryoprobes and 2 separate 10-8-10 freeze-thaw cycles targeting the gallbladder neck/body and fundus followed by cholecystostomy tube removal. He was discharged 1 day after ablation. Magnetic resonance and hepatobiliary iminodiacetic acid scan 1 month postablation demonstrated a thick-walled, distended gallbladder and no filling of the cystic duct. Magnetic resonance 3 months postablation demonstrated retraction of the gallbladder wall with luminal collapse. The patient denied any pain after discharge and is asymptomatic 3 months after ablation.
• Raja, S., Murthy, S. C., Tang, A., Siddiqui, H. U., Parikh, M. P., Ahmad, U., Gabbard, S., Thota, P., Ray, M. N., Wadhwa, N., & Sanaka, M. R. (2019). Per oral endoscopic myotomy: Another tool in the toolbox. The Journal of thoracic and cardiovascular surgery, 158(3), 945-951.
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  Use of per oral endoscopic myotomy is increasing for the treatment of achalasia, with potential for rapid recovery and less invasiveness. We report our experience with per oral endoscopic myotomy to better understand how it fits into a modern paradigm of achalasia management.
• Siddiqui, H. U., Tang, A., & Raymond, D. P. (2019). Transformation of Recurrent Respiratory Papillomatosis: Squamous Cell Carcinoma in a Pregnant Teen. The Annals of thoracic surgery, 107(6), e403-e404.
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  Recurrent respiratory papillomatosis is a rare intractable benign disease with a bimodal age distribution. We present a rare case of malignant transformation of juvenile-onset recurrent respiratory papillomatosis in a 19-year-old pregnant woman, who was found to have a right upper lobe mass and cavitary nodules bilaterally that were biopsy proven to be node-negative, multifocal squamous cell carcinoma. In her second trimester, she underwent video-assisted thoracoscopic right upper lobectomy and middle lobe lateral segmentectomy, followed by left lower lobe segmentectomy 0 months later. Recovery was uneventful, and she remains disease-free 1 year following both resections.
• Tang, A. (2019). Association of Racial, Ethnic Disparities, and Frailty in Geriatric Trauma Patients. Journal of the American College of Surgeons, 229(4, supplement 1), 1. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.265
• Tang, A. (2019). Delta Shock Index Predicts Outcomes in Pediatric Trauma Patients Regardless of Age.. Journal of the American College of Surgeons, 229(4), 2. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.441
• Tang, A. (2019). Impact of Non-Neurologic Organ Dysfunction on Outcomes in Severe Isolated Traumatic Brain Injury. Journal of the American College of Surgeons, 229(Issue 4, Supplement 1), 1. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.655
• Tang, A. (2019). Is There a Need for Platelet Transfusion After Traumatic Brain Injury in Patients on P2Y12 Inhibitors?. Journal of Surgical Research., 236, 5. doi:https://doi.org/10.1016/j.jss.2018.11.050
• Tang, A. (2019). Operative spinal trauma: Thromboprophylaxis with low molecular weight heparin or a direct oral anticoagulant.. Journal of Thrombosis and Haemostasis, 17(6), 9. doi:https://doi.org/10.1111/jth.14439
• Tang, A. (2019). Pediatric Liver Injury: Physical Examination, Fast and Serum Transaminases Can Serve as a Guide. Journal of Surgical Research, 242, 6. doi:https://doi.org/10.1016/j.jss.2019.04.021
• Tang, A. (2019). Penetrating Neck Trauma: a Review. Current Trauma Reports, 5(1), 7. doi:https://doi.org/10.1007/s40719-019-0154-6
• Tang, A. (2019). Prospective Evaluation of Factors Contributing to Racial Disparities in Outcomes after Trauma. Journal of the American College of Surgeons. 2019;229(4):e239., 229(4, supplement 2), 1. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.1389
• Tang, A. (2019). Prospective evaluation and comparison of the predictive ability of different frailty scores to predict outcomes in geriatric trauma patients. Journal of Trauma and Acute Care Surgery, 87(5), 8. doi:https://doi.org/10.1097/TA.0000000000002458
• Tang, A. (2019). Rib Plating the Non-Flail Chest May Not Be as Good as You Think.. Journal of the American College of Surgeons., 229(4, supplement 2), 2. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.1396
• Tang, A. (2019). Rib Plating the Non-Flail Chest May Not Be as Good as You Think.. Journal of the American College of Surgeons, 229(4), 2. doi:https://doi.org/10.1016/j.jamcollsurg.2019.08.1396
• Tang, A. R., Tang, A. R., Tang, A. R., Hinz, L. E., Hinz, L. E., Hinz, L. E., Khan, A., Khan, A., Khan, A., Kline, G. A., Kline, G. A., Kline, G. A., Tang, A. R., Hinz, L. E., Khan, A., & Kline, G. A. (2019). Phosphate matters when investigating hypercalcemia: a mutation in SLC34A3 causing HHRH. Endocrinology, diabetes & metabolism case reports, 2019(1), 1-6.
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  Hereditary hypophosphatemic rickets with hypercalciuria (HHRH) is a rare, autosomal recessive disorder caused by mutations in the SLC34A3 gene that encodes the renal sodium-dependent phosphate cotransporter 2c (NaPi-IIc). It may present as intermittent mild hypercalcemia which may attract initial diagnostic attention but appreciation of concomitant hypophosphatemia is critical for consideration of the necessary diagnostic approach. A 21-year-old woman was assessed by adult endocrinology for low bone mass. She initially presented age two with short stature, nephrocalcinosis and mild intermittent hypercalcemia with hypercalciuria. She had no evidence of medullary sponge kidney or Fanconi syndrome and no bone deformities, pain or fractures. She had recurrent episodes of nephrolithiasis. In childhood, she was treated with hydrochlorothiazide to reduce urinary calcium. Upon review of prior investigations, she had persistent hypophosphatemia with phosphaturia, low PTH and a high-normal calcitriol. A diagnosis of HHRH was suspected and genetic testing confirmed a homozygous c.1483G>A (p.G495R) missense mutation of the SLC34A3 gene. She was started on oral phosphate replacement which normalized her serum phosphate, serum calcium and urine calcium levels over the subsequent 5 years. HHRH is an autosomal recessive condition that causes decreased renal reabsorption of phosphate, leading to hyperphosphaturia, hypophosphatemia and PTH-independent hypercalcemia due to the physiologic increase in calcitriol which also promotes hypercalciuria. Classically, patients present in childhood with bone pain, vitamin D-independent rickets and growth delay. This case of a SLC34A3 mutation illustrates the importance of investigating chronic hypophosphatemia even in the presence of other more common electrolyte abnormalities.
• Zeeshan, M., Hamidi, M., O'Keeffe, T., Hanna, K., Kulvatunyou, N., Tang, A., & Joseph, B. (2019). Pediatric Liver Injury: Physical Examination, Fast and Serum Transaminases Can Serve as a Guide. The Journal of surgical research, 242, 151-156.
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  The aim of our study was to determine if the combination of physical examination (PE), serum transaminases along with Focused Assessment with Sonography in Trauma (FAST) would effectively rule out major hepatic injuries (HIs) after blunt abdominal trauma (BAT) in hemodynamically stable pediatric patients.
• Zeeshan, M., Hamidi, M., OʼKeeffe, T., Bae, E. H., Hanna, K., Friese, R. S., Kulvatunyou, N., Zakaria, E. R., Gries, L., Tang, A., & Joseph, B. (2019). Propranolol attenuates cognitive, learning, and memory deficits in a murine model of traumatic brain injury. The journal of trauma and acute care surgery, 87(5), 1140-1147.
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  β-blockers have been shown to improve survival after traumatic brain injury (TBI); however, the impact of continuous dosage of β-blockers on cognitive function has not been elucidated. We hypothesized that a daily dose of propranolol can improve memory, learning, and cognitive function following TBI.
• Augustin, T., Moslim, M. A., Tang, A., & Walsh, R. M. (2018). Tailored surgical treatment of duodenal polyposis in familial adenomatous polyposis syndrome. Surgery, 163(3), 594-599.
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  To review our experience in patients undergoing operative treatment for duodenal polypoisis associated with familial adenomatous polyposis with an emphasis on operative approach and long-term outcomes.
• Bussmann, B. M., Hulme, W., Tang, A., & Harris, T. (2018). Investigating the ability of non-invasive measures of cardiac output to detect a reduction in blood volume resulting from venesection in spontaneously breathing subjects. Scandinavian journal of trauma, resuscitation and emergency medicine, 26(1), 104.
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  Monitoring cardiac output (CO) in shocked patients provides key etiological information and can be used to guide fluid resuscitation to improve patient outcomes. Previously this relied on invasive monitoring, restricting its use in the Emergency Department (ED) setting. The development of non-invasive devices (such as LiDCOrapid with CNAP™ and USCOM 1A), and ultrasound based measurements (Transthoracic echocardiography, inferior vena cava collapsibility index (IVCCI), carotid artery blood flow (CABF) and carotid artery corrected flow time (FTc)) enables stroke volume (SV) and CO to be measured non-invasively in the ED. We investigated the ability of these techniques to detect a change in CO resulting from a 500 ml reduction in circulating blood volume (CBV) following venesection in spontaneously breathing subjects. Additionally, we investigated if using incentive spirometry to standardise inspiratory effort improved the accuracy of IVC based measurements in spontaneously breathing subjects.
• Ibraheem, K., Khan, M., Rhee, P., Azim, A., O'Keeffe, T., Tang, A., Kulvatunyou, N., & Joseph, B. (2018). "No zone" approach in penetrating neck trauma reduces unnecessary computed tomography angiography and negative explorations. The Journal of surgical research, 221, 113-120.
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  The most recent management guidelines advocate computed tomography angiography (CTA) for any suspected vascular or aero-digestive injuries in all zones and give zone II injuries special consideration. We hypothesized that physical examination can safely guide CTA use in a "no zone" approach.
• Jehan, F., Pandit, V., O'Keeffe, T., Azim, A., Jain, A., A Tai, S., Tang, A., Khan, M., Kulvatunyou, N., Gries, L., & Joseph, B. (2018). The burden of firearm violence in the United States: stricter laws result in safer states. Journal of injury & violence research, 10(1), 11-16.
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  Increasing firearm violence has resulted in a strong drive for stricter firearm legislations. Aim of this study was to determine the relationship between firearm legislations and firearm-related injuries across states in the United States.
• Joseph, B., Khan, M., Truitt, M., Jehan, F., Kulvatunyou, N., Azim, A., Jain, A., Zeeshan, M., Tang, A., & O'Keeffe, T. (2018). Massive Transfusion: The Revised Assessment of Bleeding and Transfusion (RABT) Score. World journal of surgery.
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  Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures.
• Khan, M., Azim, A., O'Keeffe, T., Jehan, F., Kulvatunyou, N., Santino, C., Tang, A., Vercruysse, G., Gries, L., & Joseph, B. (2018). Geriatric rescue after surgery (GRAS) score to predict failure-to-rescue in geriatric emergency general surgery patients. American journal of surgery, 215(1), 53-57.
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  Geriatric-patients(GP) undergoing emergency-general-surgery(EGS) are vulnerable to develop adverse-outcomes. Impact of patient-level-factors on Failure-to-Rescue(FTR) in EGS-GP remains unclear. Aim of our study was to determine factors associated with FTR(death from major-complication) and devise simple-bedside-score that predicts FTR in EGS-GP.
• Khan, M., Jehan, F., O'Keeffe, T., Hamidi, M., Kulvatunyou, N., Tang, A., Gries, L., & Joseph, B. (2018). Oral Xa Inhibitors Versus Low Molecular Weight Heparin for Thromboprophylaxis After Nonoperative Spine Trauma. The Journal of surgical research, 232, 82-87.
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  Thromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively.
• Khan, M., Jehan, F., O'Keeffe, T., Hamidi, M., Truitt, M., Zeeshan, M., Gries, L., Tang, A., & Joseph, B. (2018). Optimal Timing of Initiation of Thromboprophylaxis after Nonoperative Blunt Spinal Trauma: A Propensity-Matched Analysis. Journal of the American College of Surgeons, 226(5), 760-768.
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  Patients with spinal trauma have the highest risk of a venous thromboembolism. Although anticoagulation is recommended, its optimal timing is not well-defined. We aimed to assess the impact of early initiation of thromboprophylaxis in spinal trauma patients who were managed nonoperatively.
• Kulvatunyou, N., Kulvatunyou, N., Zimmerman, S. A., Zimmerman, S. A., Sadoun, M., Sadoun, M., Joseph, B. A., Joseph, B. A., Friese, R. S., Friese, R. S., Gries, L. M., Gries, L. M., O'Keeffe, T., O'Keeffe, T., Tang, A. L., & Tang, A. L. (2018). Comparing Outcomes Between "Pull" Versus "Push" Percutaneous Endoscopic Gastrostomy in Acute Care Surgery: Under-Reported Pull Percutaneous Endoscopic Gastrostomy Incidence of Tube Dislodgement. The Journal of surgical research, 232, 56-62.
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  Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared outcomes between "push" and "pull" PEGs. We hypothesized that push PEGs, because of its T-fasteners and balloon tip, would have a lower incidence of TD and complications compared with pull PEGs.
• Lane, K., Ito, K., Johnson, S., Gibson, E. A., Tang, A., & Matte, T. (2018). Burden and Risk Factors for Cold-Related Illness and Death in New York City. International journal of environmental research and public health, 15(4).
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  Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during the cold season from 2005 to 2014 in New York City (NYC), the largest city in the United States. On average each year, there were 180 treat-and-release emergency department visits (average annual rate of 21.6 per million) and 240 hospital admissions (29.6 per million) for cold-related illness, and 15 cold-related deaths (1.8 per million). Seventy-five percent of decedents were exposed outdoors. About half of those exposed outdoors were homeless or suspected to be homeless. Of the 25% of decedents exposed indoors, none had home heat and nearly all were living in single-family or row homes. The majority of deaths and illnesses occurred outside of periods of extreme cold. Unsheltered homeless individuals, people who use substances and become incapacitated outdoors, and older adults with medical and psychiatric conditions without home heat are most at risk. This information can inform public health prevention strategies and interventions.
• Mathew, P. J., Jehan, F., Kulvatunyou, N., Khan, M., O'Keeffe, T., Tang, A., Gries, L., Hamidi, M., Zakaria, E. R., & Joseph, B. (2018). The burden of excess length of stay in trauma patients. American journal of surgery, 216(5), 881-885.
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  Disposition of trauma patients frequently results in excessive hospital-stay. The aim of this study was to assess the risk of developing complications due to excessive stay in the hospital.
• Mccusker, A., Khan, M., Kulvatunyou, N., Zeeshan, M., Sakran, J. V., Hayek, H., O'Keeffe, T., Hamidi, M., Tang, A., & Joseph, B. (2018). Sarcopenia defined by a computed tomography estimate of the psoas muscle area does not predict frailty in geriatric trauma patients. American journal of surgery.
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  The aim of our study was to assess the correlation between frailty & sarcopenia and impact of each condition on outcomes in geriatric trauma patients.
• Swartz, T., Jehan, F., Tang, A., Gries, L., Zeeshan, M., Kulvatunyou, N., Hamidi, M., O'Keeffe, T., & Joseph, B. (2018). PROSPECTIVE EVALUATION OF LOW-HEALTH LITERACY AND ITS IMPACT ON OUTCOMES IN TRAUMA PATIENTS. The journal of trauma and acute care surgery.
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  Health-literacy is emerging focus of interest in public health and is evolving as an important component of national health policy. Low-health-literacy (LHL) is associated with poor outcomes. We aimed to identify factors associated with LHL and its relationship with health outcomes in trauma patients.
• Tang, A. (2018). A prospective study of 7-year experience using percutaneous 14-french pigtail catheters for traumatic hemothorax/ hemopneumothorax at a level-1 trauma center: size still does not matter. World of Journal Surgery, 107-113.
• Tang, A., & Ahmad, U. (2018). Preoperative versus intraoperative localization of pulmonary nodules. The Journal of thoracic and cardiovascular surgery, 156(5), 1970-1971.
• Tang, A., Bribriesco, A., & Ahmad, U. (2018). Needle in a Haystack: Post-thymectomy New-onset Myasthenia Gravis. Seminars in thoracic and cardiovascular surgery.
• Zeeshan, M., Hamidi, M., Kulvatunyou, N., Jehan, F., O'Keeffe, T., Khan, M., Rashdan, L., Tang, A., Zakaria, E. R., & Joseph, B. (2018). 3-Factor Vs. 4-Factor PCC in Coagulopathy of Trauma: Four is Better Than Three. Shock (Augusta, Ga.).
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  Coagulopathy of trauma(COT) is common and highly lethal. Prothrombin complex concentrate(PCC) has been advocated for correction of COT. However, the difference in efficacy between 3-factor PCC(3-PCC) vs. 4-factor PCC(4-PCC) remains unclear. The aim of our study was to compare efficacy of 3-PCC vs. 4-PCC in COT.
• Azim, A., Jehan, F. S., Rhee, P., O'Keeffe, T., Tang, A., Vercruysse, G., Kulvatunyou, N., Latifi, R., & Joseph, B. (2017). Big for small: Validating brain injury guidelines in pediatric traumatic brain injury. The journal of trauma and acute care surgery, 83(6), 1200-1204.
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  Brain injury guidelines (BIG) were developed to reduce overutilization of neurosurgical consultation (NC) as well as computed tomography (CT) imaging. Currently, BIG have been successfully applied to adult populations, but the value of implementing these guidelines among pediatric patients remains unassessed. Therefore, the aim of this study was to evaluate the established BIG (BIG-1 category) for managing pediatric traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH) without NC (no-NC).
• Boerema, D. J., An, B., Gandhi, R. P., Papineau, R., Regnier, E., Wilder, A., Molitor, A., Tang, A. P., & Kee, S. M. (2017). Biochemical comparison of four commercially available human α-proteinase inhibitors for treatment of α-antitrypsin deficiency. Biologicals : journal of the International Association of Biological Standardization, 50, 63-72.
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  Intravenous therapy with purified plasma-derived alpha-proteinase inhibitor (α-PI) concentrates is the only specific treatment for α-PI deficiency. For the therapy to be safe and efficacious, α-PI concentrates should be highly pure and contain high amounts of functional protein. This study compared the four plasma-derived α-PI products commercially available in Europe (Respreeza, Prolastin, Alfalastin, Trypsone) by biochemical methods with respect to function, purity, structure, and chemical modifications. Respreeza had the highest level of functional protein (48.8 mg/mL) and the highest specific activity (0.862 mg active α-PI per mg total protein). By size exclusion chromatography, Respreeza was 97.4% pure, followed by Alfalastin 88.1%, Prolastin 76.9%, and Trypsone 70.8%. By reversed phase chromatography, Respreeza had an α-PI purity of 97.7%, followed by Trypsone 88.0%, Prolastin 78.0%, and Alfalastin 69.5%. The main protein band by sodium dodecyl sulphate-polyacrylamide gel electrophoresis was found for all products at approximately 50 kDa. Additional protein bands were found for Prolastin, Alfalastin, and Trypsone. The α-PI products differed in cysteine oxidation state and C-terminal lysine status. α-PI products tested differ in purity, concentration, and chemical variation. Respreeza has the highest level of purity. The impact of the non-therapeutic proteins identified has not been evaluated.
• Jehan, F., Azim, A., Rhee, P., Khan, M., Gries, L., OʼKeeffe, T., Kulvatunyou, N., Tang, A., & Joseph, B. (2017). Decompressive craniectomy versus craniotomy only for intracranial hemorrhage evacuation: A propensity matched study. The journal of trauma and acute care surgery, 83(6), 1148-1153.
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  Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established; however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing DC versus craniotomy only (CO) for the evacuation of ICH.
• Jehan, F., O'Keeffe, T., Khan, M., Chi, A., Tang, A., Kulvatunyou, N., Gries, L., & Joseph, B. (2017). Early thromboprophylaxis with low-molecular-weight heparin is safe in patients with pelvic fracture managed nonoperatively. The Journal of surgical research, 219, 360-365.
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  Early initiation of thromboprophylaxis is highly desired in pelvic fracture patients, but it is often delayed due to the fear of hemorrhage. Aim of our study was to assess the safety of early initiation of venous thromboprophylaxis in patients with pelvic trauma managed nonoperatively.
• Joseph, B., Azim, A., O'Keeffe, T., Ibraheem, K., Kulvatunyou, N., Tang, A., Vercruysse, G., Friese, R., Latifi, R., & Rhee, P. (2017). American College of Surgeons Level I trauma centers outcomes do not correlate with patients' perception of hospital experience. The journal of trauma and acute care surgery, 82(4), 722-727.
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  The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a data collection methodology for measuring a patient's perception of his/her hospital experience, and it has been selected by the Centers of Medicare and Medicaid Services as the validated and transparent national survey tool with publicly available results. Since 2012, hospital reimbursements rates have been linked to HCAHPS data based on patient satisfaction scores. The aim of this study was, therefore, to assess whether HCAHPS scores of Level I trauma centers correlate with actual hospital performance.
• Joseph, B., Azim, A., Zangbar, B., Bauman, Z., OʼKeeffe, T., Ibraheem, K., Kulvatunyou, N., Tang, A., Latifi, R., & Rhee, P. (2017). Improving mortality in trauma laparotomy through the evolution of damage control resuscitation: Analysis of 1,030 consecutive trauma laparotomies. The journal of trauma and acute care surgery, 82(2), 328-333.
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  The aim of this study was to evaluate the related change in outcomes (mortality, complications) in patients undergoing trauma laparotomy (TL) with the implementation of damage control resuscitation (DCR). We hypothesized that the implementation of DCR in patients undergoing TL is associated with better outcomes.
• Joseph, B., Khalil, M., Hashmi, A., Hecker, L., Kulvatunyou, N., Tang, A., Friese, R. S., & Rhee, P. (2017). Survival benefits of remote ischemic conditioning in sepsis. The Journal of surgical research, 213, 131-137.
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  Sepsis remains the leading cause of death in the surgical intensive care unit. Prior studies have demonstrated a survival benefit of remote ischemic conditioning (RIC) in many disease states. The aim of this study was to determine the effects of RIC on survival in sepsis in an animal model and to assess alterations in inflammatory biochemical profiles. We hypothesized that RIC alters inflammatory biochemical profiles resulting in decreased mortality in a septic mouse model.
• Khan, M., Jehan, F., O'Keeffe, T., Pandit, V., Kulvatunyou, N., Tang, A., Gries, L., & Joseph, B. (2017). Primary repair for pediatric colonic injury: Are there differences among adult and pediatric trauma centers?. The Journal of surgical research, 220, 176-181.
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  Management of colonic injuries (colostomy [CO] versus primary anastomosis [PA]) among pediatric patients remains controversial. The aim of this study was to assess outcomes in pediatric trauma patient with colonic injury undergoing operative intervention.
• Khan, M., O'Keeffe, T., Jehan, F., Kulvatunyou, N., Kattaa, A., Gries, L., Tang, A., & Joseph, B. (2017). The impact of Glasgow Coma Scale-age prognosis score on geriatric traumatic brain injury outcomes. The Journal of surgical research, 216, 109-114.
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  As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients.
• Moslim, M. A., Tang, A., & Morris-Stiff, G. (2017). Management of high-grade dysplasia of the cystic duct after cholecystectomy. BMJ case reports, 2017.
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  High-grade dysplasia (HGD) of the cystic duct margin without evidence of concurrent malignancy is a rare occurrence. We present a case of a 36-year-old woman who developed gallstone pancreatitis and subsequently underwent a laparoscopic cholecystectomy. On histopathology, she was found to have HGD at the cystic duct margin. Following evaluation, she underwent excision of the cystic duct remnant with no malignancy being present on final pathology. We present this case to discuss the management of cystic duct dysplasia in the absence of gallbladder malignancy.
• Petronio, L., Tang, A., Sweet, D., Saxe, J., Chari, S., & Nguyen, A. (2017). Lineage Tracing: Papers and Progress. Cell stem cell, 21(1), 150.
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  This i3 is a data visualization based on the Cell Stem Cell tenth anniversary theme of lineage tracing. Using Scopus citations of Cell Stem Cell research papers, it illustrates both the evolution of the stem cell field and the way new research builds on work that came before. Users can navigate the graphic and the represented papers by stem cell type, organism, and author online at cell.com/i3/cell-stem-cell/lineage. To view this SnapShot, open or download the PDF.
• Singer, M., Azim, A., O'Keeffe, T., Khan, M., Jain, A., Kulvatunyou, N., Gries, L., Jehan, F., Tang, A., & Joseph, B. (2017). How does marijuana affect outcomes after trauma in ICU patients? A propensity-matched analysis. The journal of trauma and acute care surgery, 83(5), 846-849.
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  In the United States, marijuana abuse and dependence are becoming more prevalent among adult and adolescent trauma patients. Unlike several studies that focus on the effects of marijuana on the outcomes of diseases, our aim was to assess the relationship between a positive toxicology screen for marijuana and mortality in such patients.
• Haider, A. A., Azim, A., Rhee, P., Kulvatunyou, N., Ibraheem, K., Tang, A., O'Keeffe, T., Iftikhar, H., Vercruysse, G., & Joseph, B. (2016). Substituting systolic blood pressure with shock index in the National Trauma Triage Protocol. The journal of trauma and acute care surgery, 81(6), 1136-1141.
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  The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance.
• Jokar, T. O., Jokar, T. O., Jokar, T. O., Jokar, T. O., Khalil, M., Khalil, M., Khalil, M., Khalil, M., Rhee, P., Rhee, P., Rhee, P., Rhee, P., Kulvatunyou, N., Kulvatunyou, N., Kulvatunyou, N., Kulvatunyou, N., Pandit, V., Pandit, V., Pandit, V., , Pandit, V., et al. (2016). Ratio-based Resuscitation in Trauma Patients with Traumatic Brain Injury: Is There a Similar Effect?. The American surgeon, 82(3), 271-7.
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  The use of 1:1:1 (packed red blood cells: fresh frozen plasma: platelets) transfusion ratio has been shown to improve survival in severely injured trauma patients. The aim of this study was to assess the outcomes in patients with traumatic brain injury (TBI) receiving 1:1:1 ratio-based blood product transfusion (RBT). We hypothesized that RBT improves survival in patients with TBI as only major injury. We performed a 3-year retrospective analysis of all patients with TBI as only major injury presenting to our Level I trauma center. Patients receiving blood transfusion were included. Patients were stratified into two groups: those who received RBT and those who did not receive RBT (No-RBT). The outcome measure was inhospital mortality. Multivariate logistic regression analysis was performed. A total of 189 patients were included of which 29 per cent (n = 55) received RBT. The mean age was 48 ± 24 years, median (range) Glasgow Coma Scale score was 12 (3-15), and median head abbreviated injury severity scale was 3 (3-5). The overall mortality rate was 28.5 per cent. Patients in the RBT group had a higher survival rate compared with the patients in the No-RBT group (83.6% vs 66.5%, P = 0.02). In conclusion, the survival benefit of RBT exists even in patients with TBI as major injury. Guidelines for the initial management of TBI patients should focus on the use of RBT. The beneficial effect of platelets in RBT among TBI patients requires further evaluation.
• Jokar, t., Khalil, M., Rhee, P., Kulvatunyou, N., Pandit, v., Okeeffe, T. S., Tang, A., & Joseph, B. A. (2016). Ratio-based resuscitation in trauma patients with traumatic brain injury: Is there a similiar effect. American Surgeon, 82(3), 271-277.
• Joseph, B., Haider, A. A., Azim, A., Kulvatunyou, N., Tang, A., OʼKeeffe, T., Latifi, R., Green, D. J., Friese, R. S., & Rhee, P. (2016). The impact of patient protection and Affordable Care Act on trauma care: A step in the right direction. The journal of trauma and acute care surgery, 81(3), 427-434.
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  The Patient Protection and Affordable Care Act (ACA) was implemented to guarantee financial coverage for health care for all Americans. The implementation of ACA is likely to influence the insurance status of Americans and reimbursement rates of trauma centers. The aim of this study was to assess the impact of ACA on the patient insurance status, hospital reimbursements, and clinical outcomes at a Level I trauma center. We hypothesized that there would be a significant decrease in the proportion of uninsured trauma patients visiting our Level I trauma center following the ACA, and this is associated with improved reimbursement.
• Joseph, B., Haider, A., Hassan, A., Kulvatunyou, N., Bains, S., Tang, A., Zangbar, B., OʼKeeffe, T., Vercruysse, G., Gries, L., & Rhee, P. (2016). Injury prevention programs against distracted driving among students. The journal of trauma and acute care surgery, 81(1), 144-8.
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  Motor vehicle crashes are the leading cause of death and nonfatal injury among young adults. The aims of this study were to assess the magnitude of distracted driving (DD) among students and to examine the effectiveness of awareness campaign against DD. We hypothesized that DD is prevalent among students and educational efforts such as DD awareness campaign can effectively reduce it.
• Joseph, B., Haider, A., Ibraheem, K., Kulvatunyou, N., Tang, A., Azim, A., O'Keeffe, T., Gries, L., Vercruysse, G., & Rhee, P. (2016). Revitalizing Vital Signs: The Role of Delta Shock Index. Shock (Augusta, Ga.), 46(3 Suppl 1), 50-4.
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  Although variability in vital parameters has been shown to predict outcomes, the role of change in shock index (delta SI) as a predictive tool remains unknown.
• Joseph, B., Ibraheem, K., Haider, A. A., Kulvatunyou, N., Tang, A., O'Keeffe, T., Bauman, Z. M., Green, D. J., Latifi, R., & Rhee, P. (2016). Identifying potential utility of resuscitative endovascular balloon occlusion of the aorta: An autopsy study. The journal of trauma and acute care surgery, 81(5 Suppl 2 Proceedings of the 2015 Military Health System Research Symposium), S128-S132.
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  Resuscitative thoracotomy (RT) has been the standard therapy in patients with acute arrest due to hemorrhagic shock. However, with the development of resuscitative endovascular balloon occlusion of the aorta (REBOA), its role as a potential adjunct to a highly morbid intervention such as RT is being discussed. The aim of this study was to identify patients who most likely would have potentially benefited from REBOA use based on autopsy findings.
• Joseph, B., Jokar, T. O., Khalil, M., Haider, A. A., Kulvatunyou, N., Zangbar, B., Tang, A., Zeeshan, M., O'Keeffe, T., Abbas, D., Latifi, R., & Rhee, P. (2016). Identifying the broken heart: predictors of mortality and morbidity in suspected blunt cardiac injury. American journal of surgery, 211(6), 982-8.
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  Blunt cardiac injury (BCI) is an infrequent but potentially fatal finding in thoracic trauma. Its clinical presentation is highly variable and patient characteristics and injury pattern have never been described in trauma patients. The aim of this study was to identify predictors of mortality in BCI patients.
• Joseph, B., Parvaneh, S., Swartz, T., Haider, A., Hassan, A., Kulavatunyou, N., Tang, A., Latifi, R., Najafi, B., & Rhee, P. (2016). Stress among surgical attendings and trainees: A quantitative assessment during trauma activation and emergency surgeries. The journal of trauma and acute care surgery.
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  The adverse effects of stress on the wellness of trauma team members is well established, however, the level of stress has never been quantitatively assessed. The aim of our study was to assess the level of stress using subjective data and objective heart rate variability (HRV) among attending surgeons (AS), junior (JR) (PGY2/PGY3), and senior (SR) (PGY5/PGY6) residents during trauma activation and emergency surgery.
• Khalil, M., Rhee, P., Jokar, T. O., Kulvatunyou, N., O'Keeffe, T., Tang, A., Hassan, A., Gries, L., Latifi, R., & Joseph, B. (2016). Antibiotics for appendicitis! Not so fast. The journal of trauma and acute care surgery, 80(6), 923-32.
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  Emerging literature in acute appendicitis favors the nonoperative management of acute appendicitis. However, the actual use of this practice on a national level is not assessed. The aim of this study was to assess the changing trends in nonoperative management of acute appendicitis and its effects on patient outcomes.
• Peachey, T., Tang, A., Baker, E. C., Pott, J., Freund, Y., & Harris, T. (2016). The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study. Scandinavian journal of trauma, resuscitation and emergency medicine, 24(1), 108.
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  Assessment of circulating volume and the requirement for fluid replacement are fundamental to resuscitation but remain largely empirical. Passive leg raise (PLR) may determine fluid responders while avoiding potential fluid overload. We hypothesised that inferior vena cava collapse index (IVCCI) and carotid artery blood flow would change predictably in response to PLR, potentially providing a non-invasive tool to assess circulating volume and identifying fluid responsive patients.
• Rhee, P. M., Moore, E. E., Joseph, B., Tang, A., Pandit, V., & Vercruysse, G. (2016). Gunshot wounds: A review of ballistics, bullets, weapons, and myths. The journal of trauma and acute care surgery, 80(6), 853-67.
• Rhee, P., Vercruysse, G., Tang, A., Okeeffe, T. S., Green, D., Friese, R. S., Gries, L. M., Joseph, B. A., Kulvatunyou, N., & Michailidou, M. (2016). Blunt Bilateral diaphragmatic rupture- a right side can be easily missed. Trauma Case Reports.
• Safavi, A., Safavi, A., Skarsgard, E., Skarsgard, E., Rhee, P., Rhee, P., Zangbar, B., Zangbar, B., Kulvatunyou, N., Kulvatunyou, N., Tang, A., Tang, A., Friese, R. S., Friese, R. S., Okeeffe, T. S., Okeeffe, T. S., Joseph, B. A., & Joseph, B. A. (2016). Trauma Center Variation in the Management of Pediatric Patients with Blunt Abdominal Solid Organ Injury: A National Trauma Data Bank Analysis. Journal of Pediatric surgery.
• Safavi, A., Skarsgard, E. D., Rhee, P., Zangbar, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Friese, R. S., & Joseph, B. (2016). Trauma center variation in the management of pediatric patients with blunt abdominal solid organ injury: a national trauma data bank analysis. Journal of pediatric surgery, 51(3), 499-502.
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  Nonoperative management of hemodynamically stable children with Solid Organ Injury (SOI) has become standard of care. The aim of this study is to identify differences in management of children with SOI treated at Adult Trauma Centers (ATC) versus Pediatric Trauma Centers (PTC). We hypothesized that patients treated at ATC would undergo more procedures than PTC.
• Tang, A., Jokar, T., Khalil, M., Rhee, P., Kulvatunyou, N., Pandit, V., O'Keeffe, T., & Joseph, B. (2016). Ratio-based Resuscitation in Trauma Patients with Traumatic Brain Injury: Is There a Similar Effect?. The American Surgeon.
• Tang, A., Joseph, B., Hadeed, S., Haider, A., Ditillo, M., Joseph, A., Pandit, V., Kulvatunyou, N., Latifi, R., & Rhee, P. (2016). Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes. Obesity Research Clinical Practice.
• Tang, A., Joseph, B., Ibraheem, K., Haider, A., Kulvatunyou, N., O'Keeffe, T., Bauman, Z., Green, D., Latifi, R., & Rhee, P. (2016). Identifying potential utility of REBOA: An autopsy study. Journal of Trauma Acute Care Surgery.
• Tang, A., Serack, B., Zangbar, B., Pandit, V., Kulvatunyou, N., Joseph, B., Hashmi, A., Green, D., O'Keeffe, T., Friese, R., & Rhee, P. (2016). Outcomes in trauma patients with isolated epidural hemorrhage: A single institution retrospective cohort study.. The American Surgeon.
• Zangbar, B., Khalil, M., Rhee, P., Joseph, B., Kulvatunyou, N., Tang, A., Friese, R. S., & O'Keeffe, T. (2016). Metoprolol improves survival in severe traumatic brain injury independent of heart rate control. The Journal of surgical research, 200(2), 586-92.
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  Multiple prior studies have suggested an association between survival and beta-blocker administration in patients with severe traumatic brain injury (TBI). However, it is unknown whether this benefit of beta-blockers is dependent on heart rate control. The aim of this study was to assess whether rate control affects survival in patients receiving metoprolol with severe TBI. Our hypothesis was that improved survival from beta-blockade would be associated with a reduction in heart rate.
• Zangbar, B., Serack, B., Rhee, P., Joseph, B., Pandit, V., Friese, R. S., Haider, A. A., & Tang, A. L. (2016). Outcomes in Trauma Patients with Isolated Epidural Hemorrhage: A Single-Institution Retrospective Cohort Study. The American surgeon, 82(12), 1209-1214.
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  The type, location, and size of intracranial hemorrhage are known to be associated with variable outcomes in patients with traumatic brain injury (TBI). The aim of our study was to assess the outcomes in patients with isolated epidural hemorrhage (EDH) based on the location of EDH. We performed a 3-year (2010-2012) retrospective chart review of the patients with TBI in our level 1 trauma center. Patients with an isolated EDH on initial head CT scan were included. Patients were divided into four groups based on the location of EDH: frontal, parietal, temporal, and occipital. Differences in demographics and outcomes between the four groups were assessed. Outcome measures were progression on repeat head CT and neurosurgical intervention (NI). A total of 76 patients were included in this study. The mean age was 20.6 ± 15.2 years, 68.4 per cent were male, median Glasgow Coma Scale (GCS) score 15 (13-15), and median head Abbreviated Injury Scale score was 3 (2-4). About 32.9 per cent patients (n = 25) had frontal EDH, 26.3 per cent (n = 20) had temporal EDH, 10.5 per cent (n = 8) had occipital EDH, while the remaining 30.3 per cent (n = 23) had parietal EDH. The overall progression rate was 21.1 per cent (n = 12) and NI rate was 29 per cent (n = 22). There was no difference in the outcome of patients based on location of EDH. Patients with NI had a longer hospital length of stay (P = 0.02) and longer intensive care unit length of stay (P = 0.05). The incidence of isolated EDH is low in patients with blunt TBI. Patients with isolated EDH undergoing NI have longer hospital stays compared to patients without NI. Further investigation is warranted to identify factors associated with need for NI and adverse outcomes in the cohort of patients with isolated EDH.
• Asmar, S., Bible, L., Chehab, M., Tang, A., Khurrum, M., Castanon, L., Ditillo, M., Douglas, M., & Joseph, B. (2021). Traumatic brain injury induced temperature dysregulation: What is the role of β blockers?. The journal of trauma and acute care surgery, 90(1), 177-184.
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  Traumatic brain injury (TBI) is associated with sympathetic discharge that leads to posttraumatic hyperthermia (PTH). Beta blockers (ββ) are known to counteract overactive sympathetic discharge. The aim of our study was to evaluate the effect of ββ on PTH in critically-ill TBI patients.
• Aziz, H., Rhee, P., Pandit, V., Tang, A., Gries, L., & Joseph, B. (2015). The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. The journal of trauma and acute care surgery, 78(3), 641-8.
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  Animal and human bite wounds represent a significant global health issue. In the United States, animal and human bites are a very common health issue, causing significant morbidity and even, in rare scenarios, mortality. Most animal bite wounds in the United States are caused by dogs, with cat bites being a distant second. Human bite wounds constitute a dominant subset of all bite wounds. Several studies of bite wounds have reported improved outcomes with early diagnosis and immediate treatment. However, the available literature on the initial treatment provides a plethora of conflicting opinions and results. In this review, our aim was to identify and assess the current evidence on the management of animal (dog, cat, insects, scorpions, and snakes) and human bite wounds.
• Branco, B., Branco, B., De Vitis, J., De Vitis, J., Joseph, B. A., Joseph, B. A., Kulvatunyou, N., Kulvatunyou, N., Tang, A., Tang, A., Friese, R. S., Friese, R. S., Rhee, P., Rhee, P., Okeeffe, T. S., & Okeeffe, T. S. (2015). Financial implications of early tracheostomy in the healthcare cost containment era. Panamerican Journal of Trauma, Critical Care and Emergency Surgery, 4(3), 1-8.
• Branco, B., Branco, B., De Vitis, J., De Vitis, J., Joseph, B. A., Joseph, B. A., Kulvatunyou, N., Kulvatunyou, N., Tang, A., Tang, A., Friese, R. S., Friese, R. S., Rhee, P., Rhee, P., Okeeffe, T. S., Okeeffe, T. S., Branco, B., De Vitis, J., Joseph, B. A., , Kulvatunyou, N., et al. (2015). Financial implications of early tracheostomy in the healthcare cost containment era. Panamerican Journal of Trauma, Critical Care and Emergency Surgery, 4(3), 1-8.
• Elzinga, K. E., Khan, O. F., Tang, A. R., Fernandez, C. V., Elzinga, C. L., Heng, D. Y., Vickers, M. M., Truong, T. H., & Tang, P. A. (2016). Adult patient perspectives on clinical trial result reporting: A survey of cancer patients. Clinical trials (London, England).
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  The provision of study results to research participants is supported by pediatric and adult literature. This study assessed adult cancer patient preferences surrounding aggregate result disclosure to study participants.
• Evonuk, K. S., Baker, B. J., Doyle, R. E., Moseley, C. E., Sestero, C. M., Johnston, B. P., De Sarno, P., Tang, A., Gembitsky, I., Hewett, S. J., Weaver, C. T., Raman, C., & DeSilva, T. M. (2015). Inhibition of System Xc(-) Transporter Attenuates Autoimmune Inflammatory Demyelination. Journal of immunology (Baltimore, Md. : 1950), 195(2), 450-63.
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  T cell infiltration into the CNS is a significant underlying pathogenesis in autoimmune inflammatory demyelinating diseases. Several lines of evidence suggest that glutamate dysregulation in the CNS is an important consequence of immune cell infiltration in neuroinflammatory demyelinating diseases; yet, the causal link between inflammation and glutamate dysregulation is not well understood. A major source of glutamate release during oxidative stress is the system Xc(-) transporter; however, this mechanism has not been tested in animal models of autoimmune inflammatory demyelination. We find that pharmacological and genetic inhibition of system Xc(-) attenuates chronic and relapsing-remitting experimental autoimmune encephalomyelitis (EAE). Remarkably, pharmacological blockade of system Xc(-) 7 d after induction of EAE attenuated T cell infiltration into the CNS, but not T cell activation in the periphery. Mice harboring a Slc7a11 (xCT) mutation that inactivated system Xc(-) were resistant to EAE, corroborating a central role for system Xc(-) in mediating immune cell infiltration. We next examined the role of the system Xc(-) transporter in the CNS after immune cell infiltration. Pharmacological inhibitors of the system Xc(-) transporter administered during the first relapse in a SJL animal model of relapsing-remitting EAE abrogated clinical disease, inflammation, and myelin loss. Primary coculture studies demonstrate that myelin-specific CD4(+) Th1 cells provoke microglia to release glutamate via the system Xc(-) transporter, causing excitotoxic death to mature myelin-producing oligodendrocytes. Taken together, these studies support a novel role for the system Xc(-) transporter in mediating T cell infiltration into the CNS as well as promoting myelin destruction after immune cell infiltration in EAE.
• Haider, A. A., Rhee, P., Orouji, T., Kulvatunyou, N., Hassanzadeh, T., Tang, A., Farman, A., O'Keeffe, T., Latifi, R., & Joseph, B. (2015). A second look at the utility of serial routine repeat computed tomographic scans in patients with traumatic brain injury. American journal of surgery, 210(6), 1088-93; discussion 1093-4.
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  The practice of a routine repeat head computed tomographic scans in patients with traumatic brain injury (TBI) is under question. The aim of our study was to evaluate the utility of a more than 1 repeat head computed tomography (M1CT) scans in patients with TBI.
• Joseph, B., Haider, A. A., Pandit, V., Kulvatunyou, N., Orouji, T., Khreiss, M., Tang, A., O'Keeffe, T., Friese, R., & Rhee, P. (2015). Impact of Hemorrhagic Shock on Pituitary Function. Journal of the American College of Surgeons, 221(2), 502-8.
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  Hypopituitarism after hypovolemic shock is well established in certain patient cohorts. However; the effects of hemorrhagic shock on pituitary function in trauma patients remains unknown. The aim of this study was to assess pituitary hormone variations in trauma patients with hemorrhagic shock.
• Joseph, B., Haider, A. A., Pandit, V., Kulvatunyou, N., Orouji, T., Khreiss, M., Tang, A., O'Keeffe, T., Friese, R., & Rhee, P. (2015). Impact of Hemorrhagic Shock on Pituitary Function. Journal of the American College of Surgeons, 221, 502-508.
• Joseph, B., Haider, A. A., Pandit, V., Tang, A., Kulvatunyou, N., OʼKeeffe, T., & Rhee, P. (2015). Changing paradigms in the management of 2184 patients with traumatic brain injury. Annals of surgery, 262(3), 440-8; discussion 446-8.
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  The aim of this study was to assess the change in trends in the management of traumatic brain injury (TBI) at a level I trauma center and the utilization of resources as a result of this change in management.
• Joseph, B., Khalil, M., Pandit, V., Jokar, T. O., Cheaito, A., Kulvatunyou, N., Tang, A., O'Keffe, T., Vercruysse, G., Green, D. J., Friese, R. S., & Rhee, P. (2015). Increasing organ donation after cardiac death in trauma patients Presented at the 73rd Annual Meeting of the American Association for the Surgery of Trauma, September 10-13, 2014, Philadelphia, Pennsylvania. American Journal of Surgery, 210, 468-472.
• Joseph, B., Khalil, M., Pandit, V., Kulvatunyou, N., Zangbar, B., O'Keeffe, T., Asif, A., Tang, A., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2015). Adverse effects of admission blood alcohol on long-term cognitive function in patients with traumatic brain injury. Journal of Trauma and Acute Care Surgery, 78, 403-408.
• Joseph, B., Khalil, M., Pandit, V., Kulvatunyou, N., Zangbar, B., O'Keeffe, T., Asif, A., Tang, A., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2015). Adverse effects of admission blood alcohol on long-term cognitive function in patients with traumatic brain injury. The journal of trauma and acute care surgery, 78(2), 403-8.
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  Alcohol is known to be protective in patients with traumatic brain injury (TBI); however, its impact on the long-term cognitive function is unknown. We hypothesize that intoxication at the time of injury is associated with adverse long-term cognitive function in patients sustaining TBI.
• Joseph, B., Khalil, M., Pandit, V., Orouji Jokar, T., Cheaito, A., Kulvatunyou, N., Tang, A., O'Keeffe, T., Vercruysse, G., Green, D. J., Friese, R. S., & Rhee, P. (2015). Increasing organ donation after cardiac death in trauma patients. American journal of surgery, 210(3), 468-72.
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  Organ donation after cardiac death (DCD) is not optimal but still remains a valuable source of organ donation in trauma donors. The aim of this study was to assess national trends in DCD from trauma patients.
• Joseph, B., Khalil, M., Zangbar, B., Kulvatunyou, N., Orouji, T., Pandit, V., O'Keeffe, T., Tang, A., Gries, L., Friese, R. S., Rhee, P., & Davis, J. W. (2015). Prevalence of Domestic Violence Among Trauma Patients. JAMA surgery, 150(12), 1177-83.
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  Domestic violence is an extremely underreported crime and a growing social problem in the United States. However, the true burden of the problem remains unknown.
• Joseph, B., Khalil, M., Zangbar, B., Kulvatunyou, N., Orouji, T., Pandit, V., O'Keeffe, T., Tang, A., Gries, L., Friese, R. S., Rhee, P., & Davis, J. W. (2015). Prevalence of domestic violence among trauma patients. JAMA Surgery, 150, 1177-1183.
• Joseph, B., Pandit, V., Aziz, H., Kulvatunyou, N., Zangbar, B., Green, D. J., Haider, A., Tang, A., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2015). Mild traumatic brain injury defined by Glasgow Coma Scale: Is it really mild?. Brain Injury, 29, 11-16.
• Joseph, B., Pandit, V., Aziz, H., Kulvatunyou, N., Zangbar, B., Green, D. J., Haider, A., Tang, A., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2015). Mild traumatic brain injury defined by Glasgow Coma Scale: Is it really mild?. Brain injury, 29(1), 11-6.
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  Conventionally, a Glasgow Coma Scale (GCS) score of 13-15 defines mild traumatic brain injury (mTBI). The aim of this study was to identify the factors that predict progression on repeat head computed tomography (RHCT) and neurosurgical intervention (NSI) in patients categorized as mild TBI with intracranial injury (intracranial haemorrhage and/or skull fracture).
• Joseph, B., Pandit, V., Aziz, H., Kulvatunyou, N., Zangbar, B., Tang, A., O' Keeffe, T., Jehangir, Q., Snyder, K., & Rhee, P. (2015). Transforming hemoglobin measurement in trauma patients: noninvasive spot check hemoglobin. Journal of the American College of Surgeons, 220(1), 93-8.
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  Technological advances now allow for noninvasive Hbg measurements. Previous studies have reported on the efficacy of continuous noninvasive Hgb devices. Recently, a new device, Pronto-7, a spot check pulse CO-oximeter has become available. The aim of our study was to assess noninvasive Hgb measurement in trauma patients.
• Joseph, B., Pandit, V., Haider, A. A., Kulvatunyou, N., Zangbar, B., Tang, A., Aziz, H., Vercruysse, G., O'Keeffe, T., Freise, R. S., & Rhee, P. (2015). Improving Hospital Quality and Costs in Nonoperative Traumatic Brain Injury: The Role of Acute Care Surgeons. JAMA surgery, 150(9), 866-72.
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  The role of acute care surgeons is evolving; however, no guidelines exist for the selective treatment of patients with traumatic brain injury (TBI) exclusively by acute care surgeons. We implemented the Brain Injury Guidelines (BIG) for managing TBI at our institution on March 1, 2012.
• Joseph, B., Pandit, V., Haider, A. A., Kulvatunyou, N., Zangbar, B., Tang, A., Aziz, H., Vercruysse, G., O'Keeffe, T., Freise, R. S., & Rhee, P. (2015). Improving hospital quality and costs in nonoperative traumatic brain injury the role of acute care surgeons. JAMA Surgery, 150, 866-872.
• Joseph, B., Pandit, V., Harrison, C., Lubin, D., Kulvatunyou, N., Zangbar, B., Tang, A., O'Keeffe, T., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2015). Early thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management: is it safe?. American journal of surgery, 209(1), 194-8.
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  The aim of this study was to compare the safety of early (≤48 hours), intermediate (48 to 72 hours), and late (≥72 hours) venous thromboembolism prophylaxis in patients with blunt abdominal solid organ injury managed nonoperatively.
• Joseph, B., Pandit, V., Khalil, M., Kulvatunyou, N., Aziz, H., Tang, A., OʼKeeffe, T., Hays, D., Gries, L., Lemole, M., Friese, R. S., & Rhee, P. (2015). Use of prothrombin complex concentrate as an adjunct to fresh frozen plasma shortens time to craniotomy in traumatic brain injury patients. Neurosurgery, 76(5), 601-7; discussion 607.
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  The use of prothrombin complex concentrate (PCC) to reverse acquired (coagulopathy of trauma) and induced coagulopathy (preinjury warfarin use) is well defined.
• Joseph, B., Pandit, V., Zangbar, B., Kulvatunyou, N., Khalil, M., Tang, A., O'Keeffe, T., Gries, L., Vercruysse, G., Friese, R. S., & Rhee, P. (2015). Secondary brain injury in trauma patients: the effects of remote ischemic conditioning. The journal of trauma and acute care surgery, 78(4), 698-703; discussion 703-5.
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  Management of traumatic brain injury (TBI) is focused on preventing secondary brain injury. Remote ischemic conditioning (RIC) is an established treatment modality that has been shown to improve patient outcomes secondary to inflammatory insults. The aim of our study was to assess whether RIC in trauma patients with severe TBI could reduce secondary brain injury.
• Joseph, B., Rawashdeh, B., Aziz, H., Kulvatunyou, N., Pandit, V., Jehangir, Q., O'Keeffe, T., Tang, A., Green, D. J., Friese, R. S., & Rhee, P. (2015). An acute care surgery dilemma: emergent laparoscopic cholecystectomy in patients on aspirin therapy. American journal of surgery, 209(4), 689-94.
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  The current literature regarding hemorrhagic complications in patients on long-term antiplatelet therapy undergoing emergent laparoscopic cholecystectomy is limited. The aim of our study was to describe hemorrhagic complications in patients on prehospital aspirin (ASP) therapy undergoing emergent cholecystectomy.
• Joseph, B., Zangbar, B., Haider, A. A., Kulvatunyou, N., Khalil, M., Tang, A., O'Keeffe, T., Friese, R. S., Jokar, T. O., Vercruysse, G., Latifi, R., & Rhee, P. (2015). Hips don't lie: Waist-to-hip ratio in trauma patients. Journal of Trauma and Acute Care Surgery, 79, 1055-1061.
• Joseph, B., Zangbar, B., Haider, A. A., Kulvatunyou, N., Khalil, M., Tang, A., O'Keeffe, T., Friese, R. S., Orouji Jokar, T., Vercruysse, G., Latifi, R., & Rhee, P. (2015). Hips don't lie: Waist-to-hip ratio in trauma patients. The journal of trauma and acute care surgery, 79(6), 1055-61.
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  Obesity measured by body mass index (BMI) is known to be associated with worse outcomes in trauma patients. Recent studies have assessed the impact of distribution of body fat measured by waist-hip ratio (WHR) on outcomes in nontrauma patients. The aim of this study was to assess the impact of distribution of body fat (WHR) on outcomes in trauma patients.
• Joseph, B., Zangbar, B., Khalil, M., Kulvatunyou, N., Haider, A. A., O'Keeffe, T., Tang, A., Vercruysse, G., Friese, R. S., & Rhee, P. (2015). Factors associated with failure-to-rescue in patients undergoing trauma laparotomy. Surgery (United States), 158, 393-398.
• Joseph, B., Zangbar, B., Khalil, M., Kulvatunyou, N., Haider, A. A., O'Keeffe, T., Tang, A., Vercruysse, G., Friese, R. S., & Rhee, P. (2015). Factors associated with failure-to-rescue in patients undergoing trauma laparotomy. Surgery, 158(2), 393-8.
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  Quality improvement initiatives have focused primarily on preventing in-hospital complications. Patients developing complications are at a greater risk of mortality; however, factors associated with failure-to-rescue (death after major complication) in trauma patients remain undefined. The aim of this study was to identify risk factors associated with failure-to-rescue in patients undergoing trauma laparotomy.
• Khalil, M., Pandit, V., Rhee, P., Kulvatunyou, N., Orouji, T., Tang, A., O'Keeffe, T., Gries, L., Vercruysse, G., Friese, R. S., & Joseph, B. (2015). Certified acute care surgery programs improve outcomes in patients undergoing emergency surgery: A nationwide analysis. Journal of Trauma and Acute Care Surgery, 79, 60-64.
• Khalil, M., Pandit, V., Rhee, P., Kulvatunyou, N., Orouji, T., Tang, A., O'Keeffe, T., Gries, L., Vercruysse, G., Friese, R. S., & Joseph, B. (2015). Certified acute care surgery programs improve outcomes in patients undergoing emergency surgery: A nationwide analysis. The journal of trauma and acute care surgery, 79(1), 60-3; discussion 64.
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  Differences in outcomes among trauma centers (TCs) and non-TCs (NTCs) in patients undergoing emergency general surgery (EGS) are well established. However; the impact of development of certified acute care surgery (ACS) programs on patient outcomes remains unknown. The aim of this study was to evaluate outcomes in patients undergoing EGS across TCs, NTCs, and TCs with ACS (ACS-TC).
• Kulvatunyou, N., Pandit, V., Moutamn, S., Inaba, K., Chouliaras, K., Demoya, M., Naraghi, L., Kalb, B., Arif, H., Sravanthi, R., Joseph, B., Gries, L., Tang, A. L., & Rhee, P. (2015). A multi-institution prospective observational study of small bowel obstruction: Clinical and computerized tomography predictors of which patients may require early surgery. Journal of Trauma and Acute Care Surgery, 79, 393-398.
• Michailidou, M., Kulvatunyou, N., Joseph, B., Gries, L., Friese, R. S., Green, D., O'Keeffe, T., Tang, A. L., Vercruysse, G., & Rhee, P. (2015). Blunt bilateral diaphragmatic rupture-A right side can be easily missed. Trauma case reports, 1(9-12), 84-87.
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  Blunt diaphragmatic rupture (BDR) is uncommon with a reported incidence range of 1%-2%. The true incidence is not known. Bilateral BDR is particularly rare. We presented a case of bilateral BDR and we think that the incidence is under-recognised thanks to an easily missed and difficult to diagnose right sided injury.
• Mobily, M., Branco, B. C., Joseph, B., Hernandez, N., Catalano, R. D., Judkins, D. G., Green, D. J., Kulvatunyou, N., Rhee, P., & Tang, A. L. (2015). Predictors of failure in the Advanced Trauma Life Support course. American journal of surgery, 210(5), 942-6.
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  Over 1 million healthcare providers have participated in the Advanced Trauma Life Support course. No studies have evaluated factors that predict course performance. This study aims to identify these predictors.
• Rhee, P., Inaba, K., Pandit, V., Khalil, M., Siboni, S., Vercruysse, G., Kulvatunyou, N., Tang, A., Asif, A., O'Keeffe, T., & Joseph, B. (2015). Early autologous fresh whole blood transfusion leads to less allogeneic transfusions and is safe. The journal of trauma and acute care surgery, 78(4), 729-34.
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  The practice of transfusing ones' own shed whole blood has obvious benefits such as reducing the need for allogeneic transfusions and decreasing the need for other fluids that are typically used for resuscitation in trauma. It is not widely adopted in the trauma setting because of the concern of worsening coagulopathy and the inflammatory process. The aim of this study was to assess outcomes in trauma patients receiving whole blood autotransfusion (AT) from hemothorax.
• Rhee, P., Moore, E. E., Joseph, B., Tang, A., & Vercruysse, G. (2016). Re: The term 'shrapnel' is perfectly appropriate in modern usage. The journal of trauma and acute care surgery.
• Safavi, A., Skarsgard, E. D., Rhee, P., Zangbar, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Friese, R. S., & Joseph, B. (2015). Trauma center variation in the management of pediatric patients with blunt abdominal solid organ injury: A national trauma data bank analysis. Journal of pediatric surgery.
• Tang, A. (2015). Adverse effects of admission blood alcohol on long-term cognitive function in patients with traumatic brain injury.. J Trauma Acute Care Surg, 2(78), 403-8.
• Tang, A. (2015). An acute care surgery dilemma: emergent laparoscopic cholecystectomy in patients on aspirin therapy. Am J Surg, 4(209), 589-94.
• Tang, A. (2015). Early autologous fresh whole blood transfusion leads to less allogeneic transfusions and is safe. J Trauma Acute Care Surg., 4(78), 729-34.
• Tang, A. (2015). Early thromboembolic prophylaxis in patients with blunt solid abdominal organ injuries undergoing nonoperative management: is it safe?. Am J Surg, 1(209), 194-8.
• Tang, A. (2015). Overuse of helicopter transport in the minimally injured: A health care system problem that should be corrected. American Journal of Surgery, 3(78), 310-5.
• Tang, A. (2015). Secondary brain injury in trauma patients: the effects of remote ischemic conditioning. J Trauma Acute Care Surg., 4(78), 698-703.
• Tang, A. (2015). The Elimination of Anastomosis in Open Trauma Vascular Reconstruction: A Novel Technique Using an Animal Model.. J Trauma and Acute Care Surg, 6(79), 601-6.
• Tang, A. (2015). The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds.. Trauma Acute Care Surg, 3(78), 641-8.
• Tang, A. (2015). Transforming hemoglobin measurement in trauma patients: noninvasive spot check hemoglobin. J Am Coll Surg, 1(220), 93-8.
• Tang, A. (2015). Traumatic intracranial aneurysm in blunt trauma. Brain Inj., 5(29), 601-6.
• Tang, A. (2015). Use of Prothrombin Complex Concentrate as an Adjunct to Fresh Frozen Plasma Shortens Time to Craniotomy in Traumatic Brain Injury Patients.. Neurosurg, 5(76), 607-7.
• Tang, A. L., Diven, C., Zangbar, B., Lubin, D., Joseph, B., Green, D. J., Kulvatunyou, N., Vercruysse, G., Friese, R. S., O'Keeffe, T., & Rhee, P. (2015). The elimination of anastomosis in open trauma vascular reconstruction: A novel technique using an animal model. The journal of trauma and acute care surgery, 79(6), 937-42.
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  The standard approach to vascular trauma involves arterial exposure and reconstruction using either a vein or polytetrafluoroethylene graft. We have developed a novel technique to repairing arterial injuries by deploying commercially available vascular stents through an open approach, thus eliminating the need for suture anastomosis. The objective of this study was to evaluate the feasibility, stent deployment time (SDT), and stent patency of this technique in a ewe vascular injury model.
• Tang, A. R., Rabi, D. M., Lavoie, K. L., Bacon, S. L., Pilote, L., & Kline, G. A. (2018). Prolonged hypothalamic-pituitary-adrenal axis activation after acute coronary syndrome in the GENESIS-PRAXY cohort. European journal of preventive cardiology, 2047487317734323.
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  Background Glucocorticoid excess has been linked with cardiovascular disease. Little is known about the long-term cortisol response in patients after acute coronary syndrome. Design The objective of this study was to describe the distribution of salivary cortisol in the post-acute phase of acute coronary syndrome and to describe the association of late-night salivary cortisol with cardiovascular risk factors. Methods We used late-night salivary cortisol measurements post-discharge to estimate hypothalamic-pituitary-adrenal axis activity in 309 patients aged 18-55 years enrolled in the GENESIS-PRAXY study from January 2009-April 2013. We evaluated hypothalamic-pituitary-adrenal axis activity and its association with hypertension, dyslipidemia, diabetes, smoking, family history, prior acute coronary syndrome, psychiatric diseases, acute coronary syndrome severity, as well as mortality and rate of rehospitalization at 12 months. Results Persistently elevated late-night salivary cortisol>2.92 nmol/l was seen in 99 (32.0%) patients: within the range of what may be seen in Cushing's disease. Elevated late-night salivary cortisol was associated with previous acute coronary syndrome (13.3% vs 24.2%, p = 0.02), peripheral vascular disease (3.8% vs 13.1%, p = 0.002), and smoking (32.9% vs 46.5% p = 0.02). Elevated late-night salivary cortisol was associated with higher hemoglobin A1c values (5.6 ± 3.0 vs 6.1 ± 2.9, p = 0.008) and lower high density lipoprotein values (0.94 ± 0.53 vs 0.86 ± 0.50, p = 0.01). There were no differences in psychiatric symptom scores, acute coronary syndrome severity or mortality, and rate of rehospitalization at 12 months. Conclusions Many patients post-acute coronary syndrome have prolonged, marked activation of the hypothalamic-pituitary-adrenal axis. Late-night salivary cortisol co-associates with several cardiovascular risk factors. Further studies are needed to confirm the exact role of hypothalamic-pituitary-adrenal axis activity in the pathophysiology of cardiovascular disease.
• Tang, A., Haider, A., Rhee, P., Orouji, T., Kulvatunyou, N., Hassanzadeh, T., Farman, A., O'Keeffe, T., Latifi, R., & Joseph, B. (2015). A second look at the utility of serial routine repeat computed tomographic scans in patients with traumatic brain injury. American Journal of Surgery.
• Tang, A., Huddleston, P., Attaluri, P., Cruz, A., Joseph, S., & Lavy, D. (2015). Clinical cases of nonsurgical pneumoperitoneum: categorizing the disease and treatment options. The American surgeon, 81(5), E206-8.
• Tang, A., Pandit, V., Fennell, V., Jones, T., Joseph, B., O'Keeffe, T., Friese, R. S., & Rhee, P. (2015). Intracranial pressure monitor in patients with traumatic brain injury. Journal of Surgical Research, 194, 565-570.
• Tang, A., Pandit, V., Fennell, V., Jones, T., Joseph, B., O'Keeffe, T., Friese, R. S., & Rhee, P. (2015). Intracranial pressure monitor in patients with traumatic brain injury. The Journal of surgical research, 194(2), 565-570.
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  Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring for traumatic brain injury (TBI) patients with a Glasgow Coma Scale score of 8 or less with an abnormal head computed tomography, or a normal head computed tomography scan with systolic blood pressure ≤90 mm Hg, posturing, or in patients of age ≥40. The benefits of these guidelines on outcome remain unproven. We hypothesized that adherence to BTF guidelines for ICP monitoring does not improve outcomes in patients with TBI.
• Vercruysse, G. A., Friese, R. S., Khalil, M., Ibrahim-Zada, I., Zangbar, B., Hashmi, A., Tang, A., O'Keeffe, T., Kulvatunyou, N., Green, D. J., Gries, L., Joseph, B., & Rhee, P. M. (2015). Overuse of helicopter transport in the minimally injured: A health care system problem that should be corrected. The journal of trauma and acute care surgery, 78(3), 510-5.
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  Mortality benefit has been demonstrated for trauma patients transported via helicopter but at great cost. This study identified patients who did not benefit from helicopter transport to our facility and demonstrates potential cost savings when transported instead by ground.
• Zangbar, B., Khalil, M., Rhee, P., Joseph, B., Kulvatunyou, N., Tang, A., Friese, R. S., & O'Keeffe, T. (2015). Metoprolol improves survival in severe traumatic brain injury independent of heart rate control. Journal of Surgical Research.
• Zangbar, B., Pandit, V., Rhee, P., Khalil, M., Kulvatunyou, N., O'Keeffe, T., Tang, A., Gries, L., Green, D. J., Friese, R. S., & Joseph, B. (2015). Clinical outcomes in patients on preinjury ibuprofen with traumatic brain injury. American Journal of Surgery, 209, 921-926.
• Zangbar, B., Pandit, V., Rhee, P., Khalil, M., Kulvatunyou, N., O'Keeffe, T., Tang, A., Gries, L., Green, D. J., Friese, R. S., & Joseph, B. (2015). Clinical outcomes in patients on preinjury ibuprofen with traumatic brain injury. American journal of surgery, 209(6), 921-6.
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  The aim of our study was to evaluate the clinical outcomes in patients on preinjury Ibuprofen with traumatic brain injury.
• Zangbar, B., Wynne, J., Joseph, B., Pandit, V., Meyer, D., Kulvatunyou, N., Khalil, M., O'Keeffe, T., Tang, A., Lemole, M., Friese, R. S., & Rhee, P. (2015). Traumatic intracranial aneurysm in blunt trauma. Brain injury, 29(5), 601-6.
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  Computed Tomography Angiography (CTA) is being used to identify traumatic intracranial aneurysms (TICA) in patients with findings such as skull fracture and intracranial haemorrhage on initial Computed Tomography (CT) scans after blunt traumatic brain injury (TBI). However, the incidence of TICA in patients with blunt TBI is unknown. The aim of this study is to report the incidence of TICA in patients with blunt TBI and to assess the utility of CTA in detecting these lesions.
• Awad, R., Ahmed, F., Bourbonnais-Spear, N., Mullally, M., Ta, C. A., Tang, A., Merali, Z., Maquin, P., Caal, F., Cal, V., Poveda, L., Sanchez, V. P., Trudeau, V. L., & Arnason, J. T. (2014). Ethnopharmacology of Q'eqchi' Maya antiepileptic and anxiolytic plants: Effects on the GABAergic system. JOURNAL OF ETHNOPHARMACOLOGY, 125(2), 257-264.
• Con, J., Friese, R. S., Long, D. M., Zangbar, B., O'Keeffe, T., Joseph, B., Rhee, P., & Tang, A. L. (2014). Falls from ladders: Age matters more than height. Journal of Surgical Research, 191, 262-267.
• Con, J., Friese, R. S., Long, D. M., Zangbar, B., O'Keeffe, T., Joseph, B., Rhee, P., & Tang, A. L. (2014). Falls from ladders: age matters more than height. The Journal of surgical research, 191(2), 262-7.
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  Falls from ladders account for a significant number of hospital visits. However, the epidemiology, injury pattern, and how age affects such falls are poorly described in the literature.
• Ginwalla, R., Rhee, P., Friese, R., Green, D. J., Gries, L., Joseph, B., Kulvatunyou, N., Lubin, D., O'Keeffe, T., Vercruysse, G., Wynne, J., & Tang, A. (2014). Repeal of the concealed weapons law and its impact on gun-related injuries and deaths. Journal of Trauma and Acute Care Surgery, 76, 569-575.
• Ginwalla, R., Rhee, P., Friese, R., Green, D. J., Gries, L., Joseph, B., Kulvatunyou, N., Lubin, D., O'Keeffe, T., Vercruysse, G., Wynne, J., & Tang, A. (2014). Repeal of the concealed weapons law and its impact on gun-related injuries and deaths. The journal of trauma and acute care surgery, 76(3), 569-74; discussion 574-5.
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  Senate Bill 1108 (SB-1108) allows adult citizens to carry concealed weapons without a permit and without completion of a training course. It is unclear whether the law creates a "deterrent factor" to criminals or whether it escalates gun-related violence. We hypothesized that the enactment of SB-1108 resulted in an increase in gun-related injuries and deaths (GRIDs) in southern Arizona.
• Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., Wynne, J., O' Keeffe, T., Green, D. J., Friese, R. S., Gruessner, R., & Rhee, P. (2014). Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. The American surgeon, 80(4), 335-8.
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  Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.2 ± 0.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration (P < 0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.
• Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., Wynne, J., O'Keeffe, T., Green, D. J., Friese, R. S., Gruessner, R., & Rhee, P. (2014). Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. American Surgeon, 80, 335-338.
• Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Yousuf, Z., Tang, A., O'Keeffe, T., Green, D., Friese, R. S., & Rhee, P. (2014). Prothrombin complex concentrate versus fresh-frozen plasma for reversal of coagulopathy of trauma: Is there a difference?. World journal of surgery, 38, 1875-1881.
• Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Yousuf, Z., Tang, A., O'Keeffe, T., Green, D., Friese, R. S., & Rhee, P. (2014). Prothrombin complex concentrate versus fresh-frozen plasma for reversal of coagulopathy of trauma: is there a difference?. World journal of surgery, 38(8), 1875-81.
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  The development of coagulopathy of trauma is multifactorial associated with hypoperfusion and consumption of coagulation factors. Previous studies have compared the role of factor replacement versus FPP for reversal of trauma coagulopathy. The purpose of our study was to determine the time to correction of coagulopathy and blood product requirement in patients who received PCC+FFP compared with patients who received FFP alone.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Hashmi, A., Tang, A., Sadoun, M., O'Keeffe, T., Vercruysse, G., Green, D. J., Friese, R. S., & Rhee, P. (2014). A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury. Journal of the American College of Surgeons, 219(1), 45-51.
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  A definitive consensus on the standardization of practice of a routine repeat head CT (RHCT) scan in patients with traumatic intracranial hemorrhage is lacking. We hypothesized that in examinable patients without neurologic deterioration, RHCT scan does not lead to neurosurgical intervention (craniotomy/craniectomy).
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Hashmi, A., Tang, A., Sadoun, M., O'Keeffe, T., Vercruysse, G., Green, D. J., Friese, R. S., & Rhee, P. (2014). A three-year prospective study of repeat head computed tomography in patients with traumatic brain injury. Journal of the American College of Surgeons, 219, 45-51.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Tang, A., Wynne, J., Hashmi, A., Vercruysse, G., Friese, R. S., & Rhee, P. (2014). Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: A prospective study. Journal of Surgical Research, 186, 287-291.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Tang, A., Wynne, J., Hashmi, A., Vercruysse, G., Friese, R. S., & Rhee, P. (2014). Low-dose aspirin therapy is not a reason for repeating head computed tomographic scans in traumatic brain injury: a prospective study. The Journal of surgical research, 186(1), 287-91.
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  Most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate the utility of repeat head computed tomography (RHCT) and outcomes in patients on low-dose aspirin (acetylsalicylic acid; ASA) therapy.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Wynne, J., Tang, A., Friese, R. S., & Rhee, P. (2014). Improving survival rates after civilian gunshot wounds to the brain. Journal of the American College of Surgeons, 218(1), 58-65.
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  Gunshot wounds to the brain are the most lethal of all firearm injuries, with reported survival rates of 10% to 15%. The aim of this study was to determine outcomes in patients with gunshot wounds to the brain, presenting to our institution over time. We hypothesized that aggressive management can increase survival and the rate of organ donation in patients with gunshot wounds to the brain.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Wynne, J., Tang, A., Friese, R. S., & Rhee, P. (2014). Improving survival rates after civilian gunshot wounds to the brain. Journal of the American College of Surgeons, 218, 58-65.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Sadoun, M., Tang, A., O'Keeffe, T., Green, D. J., Friese, R. S., & Rhee, P. (2014). Levothyroxine therapy before brain death declaration increases the number of solid organ donations. Journal of Trauma and Acute Care Surgery, 76, 1301-1305.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Sadoun, M., Tang, A., O'Keeffe, T., Green, D. J., Friese, R. S., & Rhee, P. (2014). Levothyroxine therapy before brain death declaration increases the number of solid organ donations. The journal of trauma and acute care surgery, 76(5), 1301-5.
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  Protocols call for the start of hormonal therapy with levothyroxine after the declaration of brain death. As the hormonal perturbations occur during the process of brain death, the role of the early initiation of levothyroxine therapy (LT) to salvage organs is not well defined. The aim of this study was to evaluate the impact of early LT (before the declaration of brain death) on the number of solid organs procured per donor.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Sadoun, M., Tang, A., O'Keeffe, T., Gries, L., Green, D. J., Friese, R. S., Lemole, M. G., & Rhee, P. (2014). Prospective validation of the brain injury guidelines: Managing traumatic brain injury without neurosurgical consultation. Journal of Trauma and Acute Care Surgery, 77, 984-988.
• Joseph, B., Aziz, H., Pandit, V., Kulvatunyou, N., Sadoun, M., Tang, A., O'Keeffe, T., Gries, L., Green, D. J., Friese, R. S., Lemole, M. G., & Rhee, P. (2014). Prospective validation of the brain injury guidelines: managing traumatic brain injury without neurosurgical consultation. The journal of trauma and acute care surgery, 77(6), 984-8.
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  To optimize neurosurgical resources, guidelines were developed at our institution, allowing the acute care surgeons to independently manage traumatic intracranial hemorrhage less than or equal to 4 mm. The aim of our study was to evaluate our established Brain Injury Guidelines (BIG 1 category) for managing patients with traumatic brain injury (TBI) without neurosurgical consultation.
• Joseph, B., Aziz, H., Sadoun, M., Kulvatunyou, N., Pandit, V., Tang, A., Wynne, J., Keeffe, T. O., Friese, R. S., Gruessner, R. W., & Rhee, P. (2014). Fatal gunshot wound to the head: The impact of aggressive management. American Journal of Surgery, 207, 89-94.
• Joseph, B., Aziz, H., Sadoun, M., Kulvatunyou, N., Pandit, V., Tang, A., Wynne, J., O' Keeffe, T., Friese, R. S., Gruessner, R. W., & Rhee, P. (2014). Fatal gunshot wound to the head: the impact of aggressive management. American journal of surgery, 207(1), 89-94.
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  Patients with fatal gunshot wounds (GSWs) to the head often have poor outcomes but are ideal candidates for organ donation. The purpose of this study was to evaluate the effects of aggressive management on organ donation in patient with fatal GSWs to the head.
• Joseph, B., Aziz, H., Snell, M., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J., Friese, R. S., & Rhee, P. (2014). The physiological effects of hyperosmolar resuscitation: 5% vs 3% hypertonic saline. American Journal of Surgery, 208, 697-702.
• Joseph, B., Aziz, H., Snell, M., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J., Friese, R. S., & Rhee, P. (2014). The physiological effects of hyperosmolar resuscitation: 5% vs 3% hypertonic saline. American journal of surgery, 208(5), 697-702.
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  Use of 5% normal saline (NS) is gaining renewed interest. The primary aim of our study was to compare the physiological effects after the administration of different concentrations of hypertonic saline (3% vs 5%NS) in the initial resuscitation of trauma.
• Joseph, B., Aziz, H., Zangbar, B., Kulvatunyou, N., Pandit, V., O'Keeffe, T., Tang, A., Wynne, J., Friese, R. S., & Rhee, P. (2014). Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests: Which laboratory values matter?. Journal of Trauma and Acute Care Surgery, 76, 121-125.
• Joseph, B., Aziz, H., Zangbar, B., Kulvatunyou, N., Pandit, V., O'Keeffe, T., Tang, A., Wynne, J., Friese, R. S., & Rhee, P. (2014). Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests: which laboratory values matter?. The journal of trauma and acute care surgery, 76(1), 121-5.
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  Coagulopathy is a major determinant of disability and death in patients with traumatic intracranial hemorrhage. However, the correlation between coagulopathy defined by routine coagulation tests and clinical outcomes in traumatic brain injury (TBI) is not well defined. The aim of our study was to determine the effect of coagulopathy diagnosed by routine laboratory tests on outcomes in TBI patients.
• Joseph, B., Friese, R. S., Sadoun, M., Aziz, H., Kulvatunyou, N., Pandit, V., Wynne, J., Tang, A., O'Keeffe, T., & Rhee, P. (2014). The BIG (brain injury guidelines) project: Defining the management of traumatic brain injury by acute care surgeons. Journal of Trauma and Acute Care Surgery, 76, 965-969.
• Joseph, B., Friese, R. S., Sadoun, M., Aziz, H., Kulvatunyou, N., Pandit, V., Wynne, J., Tang, A., O'Keeffe, T., & Rhee, P. (2014). The BIG (brain injury guidelines) project: defining the management of traumatic brain injury by acute care surgeons. The journal of trauma and acute care surgery, 76(4), 965-9.
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  It is becoming a standard practice that any "positive" identification of a radiographic intracranial injury requires transfer of the patient to a trauma center for observation and repeat head computed tomography (RHCT). The purpose of this study was to define guidelines-based on each patient's history, physical examination, and initial head CT findings-regarding which patients require a period of observation, RHCT, or neurosurgical consultation.
• Joseph, B., Khalil, M., Pandit, V., Kulvatunyou, N., Zangbar, B., Tang, A., O'Keeffe, T., Snyder, K., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2014). Hypothermia in organ donation: A friend or foe?. Journal of Trauma and Acute Care Surgery, 77, 559-563.
• Joseph, B., Khalil, M., Pandit, V., Kulvatunyou, N., Zangbar, B., Tang, A., O'Keeffe, T., Snyder, K., Green, D. J., Gries, L., Friese, R. S., & Rhee, P. (2014). Hypothermia in organ donation: a friend or foe?. The journal of trauma and acute care surgery, 77(4), 559-63.
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  Hypothermia is a known predictor of mortality in trauma patients; however, its impact on organ procurement has not been defined. The aim of this study was to assess the effect of hypothermia on organ procurement. We hypothesized that admission hypothermia impedes successful organ procurement.
• Joseph, B., Pandit, V., Aziz, H., Kulvatunyou, N., Hashmi, A., Tang, A., O'Keeffe, T., Wynne, J., Vercruysse, G., Friese, R. S., & Rhee, P. (2014). Clinical outcomes in traumatic brain injury patients on preinjury clopidogrel: A prospective analysis. Journal of Trauma and Acute Care Surgery, 76, 817-820.
• Joseph, B., Pandit, V., Aziz, H., Kulvatunyou, N., Hashmi, A., Tang, A., O'Keeffe, T., Wynne, J., Vercruysse, G., Friese, R. S., & Rhee, P. (2014). Clinical outcomes in traumatic brain injury patients on preinjury clopidogrel: a prospective analysis. The journal of trauma and acute care surgery, 76(3), 817-20.
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  Patients receiving antiplatelet medications are considered to be at an increased risk for traumatic intracranial hemorrhage after blunt head trauma. However, most studies have categorized all antiplatelet drugs into one category. The aim of our study was to evaluate clinical outcomes and the requirement of a repeat head computed tomography (RHCT) in patients on preinjury clopidogrel therapy.
• Joseph, B., Pandit, V., Hadeed, G., Kulvatunyou, N., Zangbar, B., Tang, A., O'Keeffe, T., Wynne, J., Green, D. J., Friese, R. S., & Rhee, P. (2014). Unveiling posttraumatic stress disorder in trauma surgeons: A national survey. Journal of Trauma and Acute Care Surgery, 77, 148-154.
• Joseph, B., Pandit, V., Hadeed, G., Kulvatunyou, N., Zangbar, B., Tang, A., O'Keeffe, T., Wynne, J., Green, D. J., Friese, R. S., & Rhee, P. (2014). Unveiling posttraumatic stress disorder in trauma surgeons: a national survey. The journal of trauma and acute care surgery, 77(1), 148-54; discussion 154.
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  The significance of posttraumatic stress disorder (PTSD) in trauma patients is well recognized. The impact trauma surgeons endure in managing critical trauma cases is unknown. The aim of our study was to assess the incidence of PTSD among trauma surgeons and identify risk factors associated with the development of PTSD.
• Joseph, B., Pandit, V., Meyer, D., Butvidas, L., Kulvatunyou, N., Khalil, M., Tang, A., Zangbar, B., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2014). The significance of platelet count in traumatic brain injury patients on antiplatelet therapy. Journal of Trauma and Acute Care Surgery, 77, 417-421.
• Joseph, B., Pandit, V., Meyer, D., Butvidas, L., Kulvatunyou, N., Khalil, M., Tang, A., Zangbar, B., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2014). The significance of platelet count in traumatic brain injury patients on antiplatelet therapy. The journal of trauma and acute care surgery, 77(3), 417-21.
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  Platelet dysfunction has been attributed to progression of initial intracranial hemorrhage (ICH) on repeat head computed tomographic (RHCT) scans in patients on prehospital antiplatelet therapy. However, there is little emphasis on the effect of platelet count and progression of ICH in patients with traumatic brain injury. The aim of this study was to determine the platelet count cutoff for progression on RHCT and neurosurgical intervention in patients on antiplatelet therapy.
• Joseph, B., Pandit, V., Rhee, P., Aziz, H., Sadoun, M., Wynne, J., Tang, A., Kulvatunyou, N., O'Keeffe, T., Fain, M. J., & Friese, R. S. (2014). Predicting hospital discharge disposition in geriatric trauma patients: Is frailty the answer?. Journal of Trauma and Acute Care Surgery, 76, 196-200.
• Joseph, B., Pandit, V., Rhee, P., Aziz, H., Sadoun, M., Wynne, J., Tang, A., Kulvatunyou, N., O'Keeffe, T., Fain, M. J., & Friese, R. S. (2014). Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer?. The journal of trauma and acute care surgery, 76(1), 196-200.
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  The frailty index (FI) has been shown to predict outcomes in geriatric patients. However, FI has never been applied as a prognostic measure after trauma. The aim of our study was to identify hospital admission factors predicting discharge disposition in geriatric trauma patients.
• Joseph, B., Pandit, V., Wynne, J., Aziz, H., Tang, A., Kulvatunyou, N., Webster, A., O'Keeffe, T., Ziemba, M., Friese, R. S., Weinstein, R. S., & Rhee, P. (2014). Telephotography in trauma: A 2-year clinical experience. Telemedicine and e-Health, 20, 342-345.
• Joseph, B., Pandit, V., Wynne, J., Aziz, H., Tang, A., Kulvatunyou, N., Webster, A., O'Keeffe, T., Ziemba, M., Friese, R. S., Weinstein, R. S., & Rhee, P. (2014). Telephotography in trauma: a 2-year clinical experience. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 20(4), 342-5.
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  Smartphones can be used to record and transmit high-quality clinical photographs. The aim of this study was to describe our experience with smartphone telephotography in the care of trauma patients. We hypothesized that smartphone telephotography can be safely and effectively implemented on a trauma service.
• Joseph, B., Pandit, V., Zangbar, B., Kulvatunyou, N., Hashmi, A., Green, D. J., O'Keeffe, T., Tang, A., Vercruysse, G., Fain, M. J., Friese, R. S., & Rhee, P. (2014). Superiority of frailty over age in predicting outcomes among geriatric trauma patients: A prospective analysis. JAMA Surgery, 149, 766-772.
• Joseph, B., Pandit, V., Zangbar, B., Kulvatunyou, N., Hashmi, A., Green, D. J., O'Keeffe, T., Tang, A., Vercruysse, G., Fain, M. J., Friese, R. S., & Rhee, P. (2014). Superiority of frailty over age in predicting outcomes among geriatric trauma patients: a prospective analysis. JAMA surgery, 149(8), 766-72.
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  The Frailty Index (FI) is a known predictor of adverse outcomes in geriatric patients. The usefulness of the FI as an outcome measure in geriatric trauma patients is unknown.
• Joseph, B., Pandit, V., Zangbar, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Green, D. J., Vercruysse, G., Fain, M. J., Friese, R. S., & Rhee, P. (2014). Validating trauma-specific frailty index for geriatric trauma patients: A prospective analysis. Journal of the American College of Surgeons, 219, 10-17.e1.
• Joseph, B., Pandit, V., Zangbar, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Green, D. J., Vercruysse, G., Fain, M. J., Friese, R. S., & Rhee, P. (2014). Validating trauma-specific frailty index for geriatric trauma patients: a prospective analysis. Journal of the American College of Surgeons, 219(1), 10-17.e1.
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  The Frailty Index has been shown to predict discharge disposition in geriatric patients. The aim of this study was to validate the modified 15-variable Trauma-Specific Frailty Index (TSFI) to predict discharge disposition in geriatric trauma patients. We hypothesized that TSFI can predict discharge disposition in geriatric trauma patients.
• Joseph, B., Sadoun, M., Aziz, H., Tang, A., Wynne, J. L., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Friese, R. S., & Rhee, P. (2014). Repeat head computed tomography in anticoagulated traumatic brain injury patients: Still warranted. American Surgeon, 80, 43-47.
• Joseph, B., Sadoun, M., Aziz, H., Tang, A., Wynne, J. L., Pandit, V., Kulvatunyou, N., O'Keeffe, T., Friese, R. S., & Rhee, P. (2014). Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted. The American surgeon, 80(1), 43-7.
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  Anticoagulation agents are proven risk factors for intracranial hemorrhage (ICH) in traumatic brain injury (TBI). The aim of our study is to describe the epidemiology of prehospital coumadin, aspirin, and Plavix (CAP) patients with ICH and evaluate the use of repeat head computed tomography (CT) in this group. We performed a retrospective study from our trauma registry. All patients with intracranial hemorrhage on initial CT with prehospital CAP therapy were included. Demographics, CT scan findings, number of repeat CT scans, progressive findings, and neurosurgical intervention were abstracted. A comparison between prehospital CAP and no-CAP patients was done using χ(2) and Mann-Whitney U test. A total of 1606 patients with blunt TBI charts were reviewed of whom 508 patients had intracranial bleeding on initial CT scan and 72 were on prehospital CAP therapy. CAP patients were older (P < 0.001), had higher Injury Severity Score and head Abbreviated Injury Scores on admission (P < 0.001), were more likely to present with an abnormal neurologic examination (P = 0.004), and had higher hospital and intensive care unit lengths of stay (P < 0.005). Eighty-four per cent of patients were on antiplatelet therapy and 27 per cent were on warfarin. The CAP patients have a threefold increase in the rate of worsening repeat head CT (26 vs 9%, P < 0.05). Prehospital CAP therapy is high risk for progression of bleeding on repeat head CT. Routine repeat head CT remains an important component in this patient population and can provide useful information.
• Joseph, B., Zangbar, B., Pandit, V., Kulvatunyou, N., Haider, A., O'Keeffe, T., Khalil, M., Tang, A., Vercruysse, G., Gries, L., Friese, R. S., & Rhee, P. (2014). Mortality after trauma laparotomy in geriatric patients. Journal of Surgical Research, 190, 662-666.
• Joseph, B., Zangbar, B., Pandit, V., Kulvatunyou, N., Haider, A., O'Keeffe, T., Khalil, M., Tang, A., Vercruysse, G., Gries, L., Friese, R. S., & Rhee, P. (2014). Mortality after trauma laparotomy in geriatric patients. The Journal of surgical research, 190(2), 662-6.
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  Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy.
• Joseph, B., Zangbar, B., Pandit, V., Vercruysse, G., Aziz, H., Kulvatunyou, N., Wynne, J., O'Keeffe, T., Tang, A., Friese, R. S., & Rhee, P. (2014). The conjoint effect of reduced crystalloid administration and decreased damage-control laparotomy use in the development of abdominal compartment syndrome. Journal of Trauma and Acute Care Surgery, 76, 457-461.
• Joseph, B., Zangbar, B., Pandit, V., Vercruysse, G., Aziz, H., Kulvatunyou, N., Wynne, J., O'Keeffe, T., Tang, A., Friese, R. S., & Rhee, P. (2014). The conjoint effect of reduced crystalloid administration and decreased damage-control laparotomy use in the development of abdominal compartment syndrome. The journal of trauma and acute care surgery, 76(2), 457-61.
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  Anticipation of abdominal compartment syndrome (ACS) is a factor for performing damage-control laparotomy (DCL). Recent years have seen changes in resuscitation patterns and a decline in the use of DCL. We hypothesized that reductions in both crystalloid resuscitation and the use of DCL is associated with a reduced rate of ACS in trauma patients.
• Kulvatunyou, N., Erickson, L., Vijayasekaran, A., Gries, L., Joseph, B., Friese, R. F., O'Keeffe, T., Tang, A. L., Wynne, J. L., & Rhee, P. (2014). Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. British Journal of Surgery, 101, 17-22.
• Kulvatunyou, N., Kulvatunyou, N., Erickson, L., Erickson, L., Vijayasekaran, A., Vijayasekaran, A., Gries, L. M., Gries, L. M., Joseph, B. A., Joseph, B. A., Friese, R. S., Friese, R. S., Okeeffe, T. S., Okeeffe, T. S., Tang, A., Tang, A., wynne, J., wynne, J., Rhee, P., , Rhee, P., et al. (2014). Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. British Journal of Surgery, 101(2), 17-22.
• Kulvatunyou, N., Watt, J., Friese, R. S., Gries, L., Green, D. J., Joseph, B., O'Keeffe, T., Tang, A. L., Vercruysse, G., & Rhee, P. (2014). Management of acute mild gallstone pancreatitis under acute care surgery: Should patients be admitted to the surgery or medicine service?. American Journal of Surgery, 208, 981-987.
• Kulvatunyou, N., Watt, J., Friese, R. S., Gries, L., Green, D. J., Joseph, B., O'Keeffe, T., Tang, A. L., Vercruysse, G., & Rhee, P. (2014). Management of acute mild gallstone pancreatitis under acute care surgery: should patients be admitted to the surgery or medicine service?. American journal of surgery, 208(6), 981-7; discussion 986-7.
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  We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs.
• Michailidou, M., Kulvatunyou, N., Friese, R. S., Gries, L., Green, D. J., Joseph, B., O'Keeffe, T., Tang, A. L., Vercruysse, G., & Rhee, P. (2014). Time and cost analysis of gallbladder surgery under the acute care surgery model. Journal of Trauma and Acute Care Surgery, 76, 710-714.
• Michailidou, M., Kulvatunyou, N., Friese, R. S., Gries, L., Green, D. J., Joseph, B., O'Keeffe, T., Tang, A. L., Vercruysse, G., & Rhee, P. (2014). Time and cost analysis of gallbladder surgery under the acute care surgery model. The journal of trauma and acute care surgery, 76(3), 710-4.
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  The acute care surgery (ACS) model has been shown to improve work flow efficiency and to reduce hospital stay. We hypothesized that, in patients with gallbladder (GB) disease who were admitted through our emergency department (ED) and then underwent surgery, the ACS model shortened the time to surgery, decreased the length of hospital stay, and reduced hospital costs.
• Pandit, V., Patel, N., Rhee, P., Kulvatunyou, N., Aziz, H., Green, D. J., O'Keeffe, T., Zangbar, B., Tang, A., Gries, L., Friese, R. S., & Joseph, B. (2014). Effect of alcohol in traumatic brain injury: Is it really protective?. Journal of Surgical Research, 190, 634-639.
• Pandit, V., Patel, N., Rhee, P., Kulvatunyou, N., Aziz, H., Green, D. J., O'Keeffe, T., Zangbar, B., Tang, A., Gries, L., Friese, R. S., & Joseph, B. (2014). Effect of alcohol in traumatic brain injury: is it really protective?. The Journal of surgical research, 190(2), 634-9.
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  Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI.
• Pandit, V., Rhee, P., Hashmi, A., Kulvatunyou, N., Tang, A., Khalil, M., O'Keeffe, T., Green, D., Friese, R. S., & Joseph, B. (2014). Shock index predicts mortality in geriatric trauma patients: An analysis of the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery, 76, 1111-1115.
• Pandit, V., Rhee, P., Hashmi, A., Kulvatunyou, N., Tang, A., Khalil, M., O'Keeffe, T., Green, D., Friese, R. S., & Joseph, B. (2014). Shock index predicts mortality in geriatric trauma patients: an analysis of the National Trauma Data Bank. The journal of trauma and acute care surgery, 76(4), 1111-5.
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  Heart rate and systolic blood pressure are unreliable in geriatric trauma patients. Shock index (SI) (heart rate/systolic blood pressure) is a simple marker of worse outcomes after injury. The aim of this study was to assess the utility of SI in predicting outcomes. We hypothesized that SI predicts mortality in geriatric trauma patients.
• Safavi, A., Rhee, P., Pandit, V., Kulvatunyou, N., Tang, A., Aziz, H., Green, D., O'Keeffe, T., Vercruysse, G., Friese, R. S., & Joseph, B. (2014). Children are safer in states with strict firearm laws: A National Inpatient Sample study. Journal of Trauma and Acute Care Surgery, 76, 146-151.
• Safavi, A., Rhee, P., Pandit, V., Kulvatunyou, N., Tang, A., Aziz, H., Green, D., O'Keeffe, T., Vercruysse, G., Friese, R. S., & Joseph, B. (2014). Children are safer in states with strict firearm laws: a National Inpatient Sample study. The journal of trauma and acute care surgery, 76(1), 146-50; discussion 150-1.
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  Firearm control laws vary across the United States and remain state specific. The aim of this study was to determine the relationship between variation in states' firearm control laws and the risk of firearm-related injuries in pediatric population. We hypothesized that strict firearm control laws impact the incidence of pediatric firearm injury.
• Shearin, A. E., Patanwala, A. E., Tang, A., & Erstad, B. L. (2014). Predictors of hypotension associated with propofol in trauma patients. Journal of trauma nursing : the official journal of the Society of Trauma Nurses, 21(1), 4-8.
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  Propofol use may lead to hypotension in trauma patients intubated in the emergency department. In this study, predictors of hypotension were identified. We hypothesized that demographic variables could be associated with hypotension. Hypotension occurred in 33 of 200 patients. In the multivariate analysis, hypotension was associated with patient age greater than 55 years (odds ratios [OR], 3.61; 95% confidence interval [CI], 1.32-9.86; P = .012), obesity (OR, 2.66; 95% CI, 1.08-6.55; P = .034), and lower baseline blood pressure (OR, 1.59 [per 10-mm Hg decrease]; 95% CI, 1.29-1.96; P = .000). Age greater than 55 years, obesity, and lower baseline systolic blood pressure are associated with a higher risk of propofol-induced hypotension in trauma patients.
• Shearin, A. E., Patanwala, A. E., Tang, A., & Erstad, B. L. (2014). Predictors of hypotension associated with propofol in trauma patients. Journal of trauma nursing : the official journal of the Society of Trauma Nurses, 21, 4-8.
• Tang, A., Hashmi, A., Pandit, V., Joseph, B., Kulvatunyou, N., Vercruysse, G., Zangbar, B., Gries, L., O'Keeffe, T., Green, D., Friese, R., & Rhee, P. (2014). A critical analysis of secondary overtriage to a Level I trauma center. The journal of trauma and acute care surgery, 77(6), 969-73.
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  Trauma centers often receive transfers from lower-level trauma centers or nontrauma hospitals. The aim of this study was to analyze the incidence and pattern of secondary overtriage to our Level I trauma center.
• Tang, A., Hashmi, A., Pandit, V., Joseph, B., Kulvatunyou, N., Vercruysse, G., Zangbar, B., Gries, L., O'Keeffe, T., Green, D., Friese, R., & Rhee, P. (2014). A critical analysis of secondary overtriage to a Level i trauma center. Journal of Trauma and Acute Care Surgery, 77, 969-973.
• Trojan, B., Tang, A., Chandrapal, J., Filleur, S., & Nelius, T. (2014). The Clinical Usefulness of Nuclear Matrix Protein-22 in Patients with End-Stage Renal Disease and Microscopic Hematuria. RENAL FAILURE, 35(1), 72-76.
• Waye, A., Annal, M., Tang, A., Picard, G., Harnois, F., Guerrero-Analco, J. A., Saleem, A., Hewitt, L. M., Milestone, C. B., MacLatchy, D. L., Trudeau, V. L., & Arnason, J. T. (2014). Canadian boreal pulp and paper feedstocks contain neuroactive substances that interact in vitro with GABA and dopaminergic systems in the brain. The Science of the total environment, 468-469, 315-25.
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  Pulp and paper wood feedstocks have been previously implicated as a source of chemicals with the ability to interact with or disrupt key neuroendocrine endpoints important in the control of reproduction. We tested nine Canadian conifers commonly used in pulp and paper production as well as 16 phytochemicals that have been observed in various pulp and paper mill effluent streams for their ability to interact in vitro with the enzymes monoamine oxidase (MAO), glutamic acid decarboxylase (GAD), and GABA-transaminase (GABA-T), and bind to the benzodiazepine-binding site of the GABA(A) receptor (GABA(A)-BZD). These neuroendocrine endpoints are also important targets for treatment of neurological disorders such as anxiety, epilepsy, or depression. MAO and GAD were inhibited by various conifer extracts of different polarities, including major feedstocks such as balsam fir, black spruce, and white spruce. MAO was selectively stimulated or inhibited by many of the tested phytochemicals, with inhibition observed by a group of phenylpropenes (e.g. isoeugenol and vanillin). Selective GAD inhibition was also observed, with all of the resin acids tested being inhibitory. GABA(A)-BZD ligand displacement was also observed. We compiled a table identifying which of these phytochemicals have been described in each of the species tested here. Given the diversity of conifer species and plant chemicals with these specific neuroactivities, it is reasonable to propose that MAO and GAD inhibition reported in effluents is phytochemical in origin. We propose disruption of these neuroendocrine endpoints as a possible mechanism of reproductive inhibition, and also identify an avenue for potential research and sourcing of conifer-derived neuroactive natural products.
• Zangbar, B., Pandit, V., Rhee, P., Khalil, M., Kulvatunyou, N., O'Keeffe, T., Tang, A., Gries, L., Green, D. J., Friese, R. S., & Joseph, B. (2014). Clinical outcomes in patients on preinjury ibuprofen with traumatic brain injury. American Journal of Surgery.
• Aziz, H., Rhee, P., Pandit, V., Ibrahim-Zada, I., Kulvatunyou, N., Wynne, J., Zangbar, B., O'Keeffe, T., Tang, A., Friese, R. S., & Joseph, B. (2013). Mild and moderate pediatric traumatic brain injury: Replace routine repeat head computed tomography with neurologic examination. Journal of Trauma and Acute Care Surgery, 75, 550-554.
• Aziz, H., Rhee, P., Pandit, V., Ibrahim-Zada, I., Kulvatunyou, N., Wynne, J., Zangbar, B., O'Keeffe, T., Tang, A., Friese, R. S., & Joseph, B. (2013). Mild and moderate pediatric traumatic brain injury: replace routine repeat head computed tomography with neurologic examination. The journal of trauma and acute care surgery, 75(4), 550-4.
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  Opinion is divided on the role of routine repeat head computed tomography (RHCT) for guiding clinical management in pediatric patients with blunt head trauma. We hypothesize that routine RHCT does not lead to change in management in mild and moderate traumatic brain injury (TBI).
• Branco, B. C., Inaba, K., Lam, L., Konstantinidis, A., Tang, A. L., Talving, P., Salim, A., & Demetriades, D. (2013). Implementing acute care surgery at a level I trauma center: 1-year prospective evaluation of the impact of this shift on trauma volumes and outcomes. American journal of surgery, 206(1), 130-5.
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  The purpose of this study was to evaluate the impact of the transition to acute care surgery (ACS) on trauma volumes and outcomes.
• Branco, B. C., Inaba, K., Lam, L., Konstantinidis, A., Tang, A. L., Talving, P., Salim, A., & Demetriades, D. (2013). Implementing acute care surgery at a level i trauma center: 1-year prospective evaluation of the impact of this shift on trauma volumes and outcomes. American Journal of Surgery, 206, 130-135.
• Branco, B. C., Tang, A. L., Rhee, P., Fraga, G. P., Nascimento, B., Rizoli, S., & O'Keeffe, T. (2013). Selective nonoperative management of high grade splenic trauma. Revista do Colegio Brasileiro de Cirurgioes, 40, 246-250.
• Branco, B., Tang, A., Rhee, P., Fraga, G., Nascimento, B., Rizoli, B., & Okeeffe, T. S. (2013). Selective non operative management of high grade splenic trauma. Journal of the Brazilian College of Surgeons (Revista do Colégio Brasileiro de Cirurgiões),, 40(3), 246-250.
• Bukur, M., Branco, B. C., Inaba, K., Cestero, R., Kobayashi, L., Tang, A., & Demetriades, D. (2013). The Impact of American College of Surgeons Trauma Center Designation and Outcomes after Early Thoracotomy: A National Trauma Databank Analysis. AMERICAN SURGEON, 78(1), 36-41.
• Elofson, K. A., Rhoads, S. F., Tang, A., Gaither, J. B., & Patanwala, A. E. (2013). Long-acting neuromuscular blocker use during Prehospital transport of trauma patients. Air Medical Journal, 32, 203-207.
• Elofson, K., Rhoads, S., Tang, A., Gaither, J. B., & Patanwala, A. (2013). Long acting neuromuscular blocker use during prehospital transport in trauma patients. Air Medical Journal, 32(4), 203-207.
• Glazer, E. S., Kulvatunyou, N., Green, D. J., Gries, L., Joseph, B., O'Keeffe, T., Tang, A. L., Wynne, J. L., Friese, R. S., & Rhee, P. M. (2013). Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement: An extreme bumper height and complications. Journal of Trauma and Acute Care Surgery, 75, 859-863.
• Glazer, E. S., Kulvatunyou, N., Green, D. J., Gries, L., Joseph, B., O'Keeffe, T., Tang, A. L., Wynne, J. L., Friese, R. S., & Rhee, P. M. (2013). Contemporary acute care surgery percutaneous endoscopic gastrostomy tube placement: an extreme bumper height and complications. The journal of trauma and acute care surgery, 75(5), 859-63.
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  As the role of acute care surgery (ACS) becomes more prevalent, clinicians in this specialty will be placing more percutaneous endoscopic gastrostomy (PEG) tubes. In this contemporary series of ACS PEG procedures, we hypothesized that technical aspects of PEG tube placement may play an important role.
• Joseph, B., Aziz, H., Sadoun, M., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J., Gries, L., Green, D. J., Friese, R. S., & Rhee, P. (2013). The acute care surgery model: Managing traumatic brain injury without an inpatient neurosurgical consultation. Journal of Trauma and Acute Care Surgery, 75, 102-105.
• Joseph, B., Aziz, H., Sadoun, M., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J., Gries, L., Green, D. J., Friese, R. S., & Rhee, P. (2013). The acute care surgery model: managing traumatic brain injury without an inpatient neurosurgical consultation. The journal of trauma and acute care surgery, 75(1), 102-5; discussion 105.
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  Neurosurgical services are a limited resource and effective use of them would improve the health care system. Acute care surgeons (ACS) are accustomed to treating mild traumatic brain injury (TBI) including those with minor radiographic intracranial injuries. We hypothesized that ACS safely manage mild TBI with intracranial hemorrhage (ICH) on head computed tomographic (CT) scan without neurosurgical consultation (NC).
• Joseph, B., Hadjizacharia, P., Aziz, H., Kulvatunyou, N., Tang, A., Pandit, V., Wynne, J., O'Keeffe, T., Friese, R. S., & Rhee, P. (2013). Prothrombin complex concentrate: An effective therapy in reversing the coagulopathy of traumatic brain injury. Journal of Trauma and Acute Care Surgery, 74, 248-253.
• Joseph, B., Hadjizacharia, P., Aziz, H., Kulvatunyou, N., Tang, A., Pandit, V., Wynne, J., O'Keeffe, T., Friese, R. S., & Rhee, P. (2013). Prothrombin complex concentrate: an effective therapy in reversing the coagulopathy of traumatic brain injury. The journal of trauma and acute care surgery, 74(1), 248-53.
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  Coagulopathy in patients with traumatic brain injury (TBI) is a well-studied concept. Prothrombin complex concentrate (PCC) has been shown to be an effective treatment modality for correction of TBI coagulopathy. However, its use and effectiveness compared with recombinant factor VII (rFVIIa) in TBI has not been established. The purpose of this study was to compare PCC and rFVIIa for the correction of TBI coagulopathy.
• Joseph, B., Hadjizacharia, P., Aziz, H., Snyder, K., Wynne, J., Kulvatunyou, N., Tang, A., O'Keeffe, T., Latifi, R., Friese, R., & Rhee, P. (2013). Continuous noninvasive hemoglobin monitor from pulse Ox: Ready for prime time?. World journal of surgery, 37, 525-529.
• Joseph, B., Hadjizacharia, P., Aziz, H., Snyder, K., Wynne, J., Kulvatunyou, N., Tang, A., O'Keeffe, T., Latifi, R., Friese, R., & Rhee, P. (2013). Continuous noninvasive hemoglobin monitor from pulse ox: ready for prime time?. World journal of surgery, 37(3), 525-9.
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  Advances in technology have allowed for continuous noninvasive hemoglobin monitoring (SpHb), which may enable earlier detection of hemorrhage and more efficient surgical and/or blood transfusion management. The use of SpHb has not been described in the trauma population. The purpose of the present study was to evaluate the accuracy of a SpHb measurement device in severely injured trauma patients.
• Joseph, B., Pandit, V., Aziz, H., Tang, A., Kulvatunyou, N., Wynne, J., Hsu, P., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2013). Rehabilitation after trauma; Does age matter?. Journal of Surgical Research, 184, 541-545.
• Joseph, B., Pandit, V., Aziz, H., Tang, A., Kulvatunyou, N., Wynne, J., Hsu, P., O'Keeffe, T., Gries, L., Friese, R. S., & Rhee, P. (2013). Rehabilitation after trauma; does age matter?. The Journal of surgical research, 184(1), 541-5.
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  Variability exits in the ability to predict overall recovery after trauma and inpatient rehabilitation. The aim of this study was to identify factors predicting functional improvement in trauma patients undergoing inpatient rehabilitation.
• Joseph, B., Pandit, V., Khreiss, M., Aziz, H., Kulvatunyou, N., Tang, A., Wynne, J., O'Keeffe, T., Friese, R. S., Weinstein, R. S., & Rhee, P. (2013). Improving communication in Level 1 trauma centers: Replacing pagers with smartphones. Telemedicine and e-Health, 19, 150-154.
• Joseph, B., Pandit, V., Khreiss, M., Aziz, H., Kulvatunyou, N., Tang, A., Wynne, J., O'Keeffe, T., Friese, R. S., Weinstein, R. S., & Rhee, P. (2013). Improving communication in level 1 trauma centers: replacing pagers with smartphones. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 19(3), 150-4.
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  Communication among healthcare providers continues to change, and 90% of healthcare providers are now carrying cellular phones. Compared with pagers, the rate and amount of information immediately available via cellular phones are far superior. Wireless devices such as smartphones are ideal in acute trauma settings as they can transfer patient information quickly in a coordinate manner to all the team members responsible for patient care.
• Joseph, B., Pandit, V., Sadoun, M., Larkins, C. G., Kulvatunyou, N., Tang, A., Mino, M., Friese, R. S., & Rhee, P. (2013). A prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage. Journal of Trauma and Acute Care Surgery, 75, 990-994.
• Joseph, B., Pandit, V., Sadoun, M., Larkins, C. G., Kulvatunyou, N., Tang, A., Mino, M., Friese, R. S., & Rhee, P. (2013). A prospective evaluation of platelet function in patients on antiplatelet therapy with traumatic intracranial hemorrhage. The journal of trauma and acute care surgery, 75(6), 990-4.
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  Platelet transfusion is increasingly used in patients with traumatic intracranial hemorrhage (ICH) on aspirin therapy to minimize the progression of ICH. We hypothesized (null) that platelet transfusion in this cohort of patients does not improve platelet function.
• Lubin, D., Tang, A. L., Friese, R. S., Martin, M., Green, D. J., Jones, T., Means, R. R., Ginwalla, R., O'Keeffe, T. S., Joseph, B. A., Wynne, J. L., Kulvatunyou, N., Vercruysse, G., Gries, L., & Rhee, P. (2013). Modified Veress needle decompression of tension pneumothorax: A randomized crossover animal study. Journal of Trauma and Acute Care Surgery, 75, 1071-1075.
• Lubin, D., Tang, A. L., Friese, R. S., Martin, M., Green, D. J., Jones, T., Means, R. R., Ginwalla, R., O'Keeffe, T. S., Joseph, B. A., Wynne, J. L., Kulvatunyou, N., Vercruysse, G., Gries, L., & Rhee, P. (2013). Modified Veress needle decompression of tension pneumothorax: a randomized crossover animal study. The journal of trauma and acute care surgery, 75(6), 1071-5.
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  The current prehospital standard of care using a large bore intravenous catheter for tension pneumothorax (tPTX) decompression is associated with a high failure rate. We developed a modified Veress needle (mVN) for this condition. The purpose of this study was to evaluate the effectiveness and safety of the mVN as compared with a 14-gauge needle thoracostomy (NT) in a swine tPTX model.
• Shearin, A. E., Patanwala, A. E., Tang, A., & Erstad, B. L. (2013). Hypotension associated with propofol in trauma patients in the emergency department.. PHARMACOTHERAPY, 32(10), E201-E201.
• Tang, A. (2013). Hypotension associated with propofol in trauma patients in the emergency department.. Pharmacotherapy, 201.
• Tang, A., Chiew, S. K., Rashkovetsky, R., Becher, H., & Choy, J. B. (2013). Feasibility of sonographer-administered echocontrast in a large-volume tertiary-care echocardiography laboratory. The Canadian journal of cardiology, 29(3), 391-5.
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  Contrast echocardiography has been shown to improve diagnostic quality, especially in technically difficult patients. However, the learning curve and increased time for preparation and image acquisition have led to low use.
• Trojan, B., Tang, A., Chandrapal, J., Filleur, S., & Nelius, T. (2013). The clinical usefulness of nuclear matrix protein-22 in patients with end-stage renal disease and microscopic hematuria. Renal failure, 35(1), 72-6.
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  To evaluate the sensitivity, specificity, and false-positive rate of the nuclear matrix protein-22 (NMP22) test in patients with end-stage renal disease (ESRD) and microscopic hematuria in order to avoid unnecessary follow-up tests for patients with false-positive NMP22 test results.
• Ayazi, S., Derreester, S. R., Peyre, C. G., Desai, U., Leers, J. M., Ungnapatanin, N., Tang, A., Lipham, J. C., Hagen, J. A., & Demeester, T. R. (2012). Patient dissatisfaction following antireflux surgery, incidence and contributing factors. GASTROENTEROLOGY, 132(4), A850-A850.
• Bukur, M., Branco, B. C., Inaba, K., Cestero, R., Kobayashi, L., Tang, A., & Demetriades, D. (2012). The impact of American College of Surgeons trauma center designation and outcomes after early thoracotomy: A national trauma databank analysis. American Surgeon, 78, 36-41.
• Bukur, M., Castelo Branco, B., Inaba, K., Cestero, R., Kobayashi, L., Tang, A., & Demetriades, D. (2012). The impact of American College of Surgeons trauma center designation and outcomes after early thoracotomy: a National Trauma Databank analysis. The American surgeon, 78(1), 36-41.
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  Trauma centers are designated by the American College of Surgeons (ACS) into four different levels based on resources, volume, and scientific and educational commitment. The purpose of this study was to evaluate the relationship between ACS center designation and outcomes after early thoracotomy for trauma. The National Trauma Databank (v. 7.0) was used to identify all patients who required early thoracotomy. Demographics, clinical data, and outcomes were extracted. Patients were categorized according to ACS trauma center designation. Multivariate logistic regression was used to evaluate the impact of ACS trauma center designation on mortality. From 2002 to 2006, 1834 (77.4%) patients were admitted to a Level I ACS verified trauma center, 474 (20.0%) to a Level II, and 59 (3.6%) to a Level III/IV facility. After adjusting for differences between the groups, there were no significant differences in mortality (overall: 53.3% for Level I, 63.1% for Level II, and 52.5% for Level III/IV, adjusted P = 0.417; or for patients arriving in cardiac arrest: 74.9% vs 87.1% vs 85.0%, P = 0.261). Subgroup analysis did not show any significant difference in survival irrespective of mechanism of injury. Glasgow Coma Scale score ≤ 8, Injury Severity Score > 16, no admission systolic blood pressure, time from admission to thoracotomy, and nonteaching hospitals were found to be independent predictors of death. For trauma patients who have sustained injuries requiring early thoracotomy, ACS trauma center designation did not significantly impact mortality. Nonteaching institutions however, were independently associated with poorer outcomes after early thoracotomy. These findings may have important implications in educational commitment of institutions. Further prospective evaluation of these findings is warranted.
• Cheung, A., Goh, S. K., Tang, A., & Keng, T. B. (2012). Complications of total knee arthroplasty. CURRENT ORTHOPAEDICS, 22(4), 274-283.
• Gaughan, C. B., Tang, A., Lipham, J. C., Peyre, C. G., Rizzetto, C., Boland, B., Ungnapatanin, N., Hagen, J. A., Demeester, S. R., Bremner, C. G., & Demeester, T. R. (2012). Measurement of gastroesophageal reflux in the pharynx: A new technology. GASTROENTEROLOGY, 132(4), A285-A285.
• Hou, J. G., Murphy, P., Tang, A. W., Khandelwal, N., Duncan, I., & Pegus, C. L. (2012). Impact of an online prescription management account on medication adherence. The American journal of managed care, 18(3), e86-90.
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  To assess medication adherence rates of patients utilizing an online prescription management account compared with nonusers.
• Joseph, B. A., Joseph, B. A., Kulvatunyou, N., Kulvatunyou, N., Okeeffe, T. S., Okeeffe, T. S., Tang, A., Tang, A., Friese, R. S., Friese, R. S., Joseph, B. A., Kulvatunyou, N., Okeeffe, T. S., Tang, A., Friese, R. S., Joseph, B. A., Kulvatunyou, N., Okeeffe, T. S., Tang, A., & Friese, R. S. (2012). Does the added workload of emergency general surgery negatively impact trauma outcome. Journal of Surgical Research, 179(2), 347.
• Joseph, B. A., Joseph, B. A., Kulvatunyou, N., Kulvatunyou, N., Tang, A., Tang, A., Okeeffe, T. S., Okeeffe, T. S., Friese, R. S., Friese, R. S., Joseph, B. A., Kulvatunyou, N., Tang, A., Okeeffe, T. S., Friese, R. S., Joseph, B. A., Kulvatunyou, N., Tang, A., Okeeffe, T. S., & Friese, R. S. (2012). Are all trauma centers equal: analyzing pediatric outcomes. Journal of the American College of Surgeons, Volume: 215(Issue: 3), s100. doi:DOI: 10.1016/j.jamcollsurg.2012.06.266
• Kulvatunyou, N., Friese, R. S., Joseph, B., O'Keeffe, T., Wynne, J. L., Tang, A. L., & Rhee, P. (2012). Incidence and pattern of cervical spine injury in blunt assault: It is not how they are hit, but how they fall. Journal of Trauma and Acute Care Surgery, 72, 271-275.
• Kulvatunyou, N., Friese, R. S., Joseph, B., O'Keeffe, T., Wynne, J. L., Tang, A. L., & Rhee, P. (2012). Incidence and pattern of cervical spine injury in blunt assault: it is not how they are hit, but how they fall. The journal of trauma and acute care surgery, 72(1), 271-5.
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  The injury mechanism of blunt cervical spine injury (CSI) involves two forces: (1) an acceleration-deceleration force or change in velocity (delta v) that causes significant head and neck movement, resulting in flexion-extension injury pattern and (2) a direct force to the head or face against an immovable object with force transmitted down the cervical spine. Combining those two forces creates what bioengineers call imparted energy (IE). In blunt assault to the head or face, IE is low; hence, the reported incidence of CSI is low. The goal of our study was to identify the incidence, pattern, and outcome of CSI in blunt assaulted patients.
• Kulvatunyou, N., Joseph, B., Friese, R. S., Green, D., Gries, L., O'Keeffe, T., Tang, A. L., Wynne, J. L., & Rhee, P. (2012). 14 French pigtail catheters placed by surgeons to drain blood on trauma patients: Is 14-Fr too small?. Journal of Trauma and Acute Care Surgery, 73, 1423-1427.
• Kulvatunyou, N., Joseph, B., Gries, L., Friese, R. S., Green, D., O'Keeffe, T., Wynne, J. L., Tang, A. L., & Rhee, P. (2012). A prospective cohort study of 200 acute care gallbladder surgeries: The same disease but a different approach. Journal of Trauma and Acute Care Surgery, 73, 1039-1045.
• Kulvatunyou, N., Joseph, B., Gries, L., Friese, R. S., Green, D., O'Keeffe, T., Wynne, J. L., Tang, A. L., & Rhee, P. (2012). A prospective cohort study of 200 acute care gallbladder surgeries: the same disease but a different approach. The journal of trauma and acute care surgery, 73(5), 1039-45.
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  For patients who present to the emergency department (ED) with symptomatic cholelithiasis, surgery is indicated only if they are diagnosed of acute cholecystitis (AC). We hypothesized that, because preoperative signs and diagnostic tests are not sensitive enough to diagnose AC, coupled with the potential health care burden of non-AC gallbladder, surgery may be offered sooner.
• Latifi, R., Joseph, B., Kulvatunyou, N., Wynne, J. L., O'Keeffe, T., Tang, A., Friese, R., & Rhee, P. M. (2012). Enterocutaneous fistulas and a hostile abdomen: Reoperative surgical approaches. World journal of surgery, 36, 516-523.
• Latifi, r., Joseph, B. A., Kulvatunyou, N., Wynne, J., Okeeffe, T. S., Tang, A., Friese, R. S., & Rhee, P. (2012). Enterocutaneous Fistulae and the Hostile Abdomen: Re-operative Surgical Approaches. World Journal of Surgery, 36(3), 516-523.
• Murphy, P., Cocohoba, J., Tang, A., Pietrandoni, G., Hou, J., & Guglielmo, B. J. (2012). Impact of HIV-specialized pharmacies on adherence and persistence with antiretroviral therapy. AIDS patient care and STDs, 26(9), 526-31.
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  Patient adherence (the degree to which patients follow their therapeutic regimen as prescribed within a set period of time) and persistence (the time to treatment discontinuation, with a permissible gap) with drug therapy are essential components of HIV/AIDS treatment. Select community pharmacies offer specialized services for HIV/AIDS patients to help combat some of the barriers to adherence and persistence. We assessed adherence and persistence with antiretroviral therapy (ART) for patients using HIV-specialized pharmacies in nine cities from seven states compared to traditional community pharmacy users over a 1-year period. Data were limited to one pharmacy chain. Propensity scoring was used to obtain 1:1 matches for "Specialized" and "Traditional" pharmacy users based on age, gender, number of prescription-inferred chronic conditions (obtained by mapping a patient's prescriptions to the Medi-Span Drug Indications Database), and presence of prescription anxiety and/or depression medication, resulting in 7064 patients in each group. Proportion of days covered (PDC) was used to measure adherence. Specialized pharmacy users had a significantly greater mean (74.1% versus 69.2%, p
• Oliver, M., Inaba, K., Tang, A., Branco, B. C., Barmparas, G., Schnüriger, B., Lustenberger, T., & Demetriades, D. (2012). The changing epidemiology of spinal trauma: A 13-year review from a Level i trauma centre. Injury, 43, 1296-1300.
• Campbell, J., Tirapelle, L., Yates, K., Clark, R., Inaba, K., Green, D., Plurad, D., Lam, L., Tang, A., Cestero, R., & Sullivan, M. (2011). The effectiveness of a cognitive task analysis informed curriculum to increase self-efficacy and improve performance for an open cricothyrotomy. Journal of Surgical Education, 68, 403-407.
• Con, J., Joseph, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J. L., Friese, R. S., Rhee, P., & Latifi, R. (2011). Evidence-based immune-modulating nutritional therapy in critically ill and injured patients. European Surgery - Acta Chirurgica Austriaca, 43, 13-18.
• Diven, C., Diven, C., Joseph, B. A., Joseph, B. A., Kulvatunyou, N., Kulvatunyou, N., Friese, R. S., Friese, R. S., Tang, A., Tang, A., Okeeffe, T. S., Okeeffe, T. S., Diven, C., Joseph, B. A., Kulvatunyou, N., Friese, R. S., Tang, A., & Okeeffe, T. S. (2011). Albuterol and Ipratropium Are Associated With Increased Ventilator-Associated Pneumonia Rates in Intubated Trauma Patients. Critical Care Medicine, 39(12), 197.
• Doucleff, M., Luk, M., & Tang, A. (2011). SnapShot: Cell PictureShow. Cell, 147(7), 1642.
• Joseph, B. A., Tang, A., Friese, R. S., Okeeffe, T. S., Kulvatunyou, N., Con, J., Rhee, P., Latifi, R., Joseph, B. A., Tang, A., Friese, R. S., Okeeffe, T. S., Kulvatunyou, N., Con, J., Rhee, P., Latifi, R., Joseph, B. A., Tang, A., Friese, R. S., , Okeeffe, T. S., et al. (2011). Evidence based immune-modulating nutritional therapy in critically ill and injured patients. European Surgery, 91(3), 579-593.
• Joseph, B., Kulvatunyou, N., Tang, A., O'Keeffe, T., Wynne, J. L., Friese, R. S., Rhee, P., & Latifi, R. (2011). Total parenteral nutrition in critically ill and injured patients. European Surgery - Acta Chirurgica Austriaca, 43, 19-23.
• Kulvatunyou, N., Joseph, B. A., Tang, A., Okeeffe, T. S., Wynne, J., Friese, R. S., Latifi, R., Rhee, P., Kulvatunyou, N., Joseph, B. A., Tang, A., Okeeffe, T. S., Wynne, J., Friese, R. S., Latifi, R., & Rhee, P. (2011). Gut access in critically ill and injured patients: where have we gone thus far?. European Surgery, 43(1), 24-29.
• Kulvatunyou, N., Joseph, B., Tang, A., O'Keeffe, T., Wynne, J. L., Friese, R. S., Latifi, R., & Rhee, P. (2011). Gut access in critically ill and injured patients: Where have we gone thus far?. European Surgery - Acta Chirurgica Austriaca, 43, 24-29.
• Kulvatunyou, N., Vijayasekaran, A., Hansen, A., Wynne, J. L., O'Keeffe, T., Friese, R. S., Joseph, B., Tang, A., & Rhee, P. (2011). Two-year experience of using pigtail catheters to treat traumatic pneumothorax: A changing trend. Journal of Trauma - Injury, Infection and Critical Care, 71, 1104-1107.
• Plurad, D., Talving, P., Tang, A., Green, D., Lam, L., Inaba, K., & Demetriades, D. (2011). Alcohol ingestion is independently associated with complications after work place injuries: A National Trauma Data Bank analysis of injury severity and outcomes. Journal of Trauma - Injury, Infection and Critical Care, 71, 1035-1039.
• Plurad, D., Talving, P., Tang, A., Green, D., Lam, L., Inaba, K., & Demetriades, D. (2011). Alcohol ingestion is independently associated with complications after work place injuries: a national trauma data bank analysis of injury severity and outcomes. The Journal of trauma, 71(4), 1035-9.
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  Work place injuries have socioeconomic and workforce health implications. Results of clinical studies on the effect of alcohol (ETOH) ingestion on short-term outcomes in trauma are varied. We performed this study to estimate the prevalence of ETOH-related injury in the workplace and its relevance to outcomes.
• Raoof, M., Joseph, B. A., Friese, R. S., Kulvatunyou, N., O'Keeffe, T., Tang, A., Wynne, J., Latifi, R., & Rhee, P. (2011). Organ donation after traumatic cardiopulmonary arrest. American Journal of Surgery, 202, 701-706.
• Tang, A. L., Inaba, K., Branco, B. C., Oliver, M., Bukur, M., Salim, A., Rhee, P., Herrold, J., & Demetriades, D. (2011). Postdischarge complications after penetrating cardiac injury: A survivable injury with a high postdischarge complication rate. Archives of Surgery, 146, 1061-1066.
• Tang, A. L., Inaba, K., Branco, B. C., Oliver, M., Bukur, M., Salim, A., Rhee, P., Herrold, J., & Demetriades, D. (2011). Postdischarge complications after penetrating cardiac injury: a survivable injury with a high postdischarge complication rate. Archives of surgery (Chicago, Ill. : 1960), 146(9), 1061-6.
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  A significant rate of postdischarge complications is associated with penetrating cardiac injuries.
• Ong, J. C., Chin, P. L., Lin, C. P., Fook-Chong, S. M., Tang, A., Yang, K. Y., Ying, Y. K., Tay, B. K., & Keng, T. B. (2010). Continuous infiltration of local anaesthetic following total knee arthroplasty. Journal of orthopaedic surgery (Hong Kong), 18(2), 203-7.
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  To determine whether continuous infiltration of local anaesthetic can reduce the pain score and morphine use over 48 hours after total knee arthroplasty (TKA).
• Tang, A. L., & Inaba, K. (2010). From trauma to acute care surgery: With an eye to the future. Scandinavian Journal of Surgery, 99, 61-63.
• Awad, R., Ahmed, F., Bourbonnais-Spear, N., Mullally, M., Ta, C. A., Tang, A., Merali, Z., Maquin, P., Caal, F., Cal, V., Poveda, L., Vindas, P. S., Trudeau, V. L., & Arnason, J. T. (2009). Ethnopharmacology of Q'eqchi' Maya antiepileptic and anxiolytic plants: effects on the GABAergic system. Journal of ethnopharmacology, 125(2), 257-64.
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  The Q'eqchi' Maya possess a large selection of plants to treat neurological disorders, including epilepsy and susto (fright), a culture-bound illness related to anxiety disorders.
• Ayazi, S., Lipham, J. C., Hagen, J. A., Tang, A. L., Zehetner, J., Leers, J. M., Oezcelik, A., Abate, E., Banki, F., DeMeester, S. R., & DeMeester, T. R. (2009). A new technique for measurement of pharyngeal pH: Normal values and discriminating pH threshold. Journal of Gastrointestinal Surgery, 13, 1422-1429.
• Bress, N. E., Kruger, R. P., & Tang, A. A. (2009). SnapShot: Convenient, comprehensive, and now clickable. Cell, 138(5), 1034.
• Leers, J. M., Demeester, S. R., Ayazi, S., Tang, A. L., Peyre, C. G., Lipham, J. C., Hagen, J. A., & Demeester, T. R. (2009). Recurrence of intramucosal esophageal adenocarcinoma arising in a former esophagostomy site: A unique case report. Diseases of the Esophagus, 22, E17-E20.
• Murphy, P., Cocohoba, J., Tang, A., Pietrandoni, G., Hou, J., & Guglielmo, B. J. (2009). Impact of HIV-Specialized Pharmacies on Adherence and Persistence with Antiretroviral Therapy. AIDS PATIENT CARE AND STDS, 26(9), 526-531.
• Waye, A., Annal, M., Tang, A., Picard, G., Harnois, F., Guerrero-Analco, J. A., Saleem, A., Hewitt, L. M., Milestone, C. B., MacLatchy, D. L., Trudeau, V. L., & Arnason, J. T. (2009). Canadian boreal pulp and paper feedstocks contain neuroactive substances that interact in vitro with GABA and dopaminergic systems in the brain. SCIENCE OF THE TOTAL ENVIRONMENT, 468, 315-325.
• Ayazi, S., Lipham, J. C., Hagen, J. A., Tang, A., Leers, J. M., Oezcelik, A., Abate, E., DeMeester, S. R., Banki, F., & DeMeester, T. R. (2008). Measurement of pharyngeal pH: A new technology and normal values. GASTROENTEROLOGY, 134(4), A599-A599.
• Zhang, X., Potty, A., Jackson, G. W., Stepanov, V., Tang, A., Liu, Y., Kourentzi, K., Strych, U., Fox, G. E., & Willson, R. C. (2008). Engineered 5S ribosomal RNAs displaying aptamers recognizing vascular endothelial growth factor and malachite green. JOURNAL OF MOLECULAR RECOGNITION, 22(2), 154-161.
• Hou, J. G., Murphy, P., Tang, A. W., Khandelwal, N., Duncan, I., & Pegus, C. L. (2007). Impact of an Online Prescription Management Account on Medication Adherence. AMERICAN JOURNAL OF MANAGED CARE, 18(3), E86-E90.
• Joseph, S., Figueroa-Bodine, J., Cruz, A. S., Tang, A., Arbour, A., & Raines, D. (2007). Small Bowel Length Correlates With Height in Adults: Implications for General Surgery and Gastroenterology. GASTROENTEROLOGY, 146(5), S1076-S1077.
• Peyre, C. G., DeMeester, S. R., Rizzetto, C., Bansal, N., Tang, A. L., Ayazi, S., Leers, J. M., Lipham, J. C., Hagen, J. A., & DeMeester, T. R. (2007). Vagal-sparing esophagectomy: The ideal operation for intramucosal adenocarcinoma and Barrett with high-grade dysplasia. Annals of Surgery, 246, 665-671.
• Peyre, C. G., DeMeester, S. R., Rizzetto, C., Bansal, N., Tang, A. L., Ayazi, S., Leers, J. M., Lipham, J. C., Hagen, J. A., & DeMeester, T. R. (2007). Vagal-sparing esophagectomy: the ideal operation for intramucosal adenocarcinoma and barrett with high-grade dysplasia. Annals of surgery, 246(4), 665-71; discussion 671-4.
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  Our aim was to compare outcome of vagal-sparing esophagectomy with transhiatal and en bloc esophagectomy in patients with intramucosal adenocarcinoma or high-grade dysplasia.
• Tang, A. (2007). Objective Documentation of the link between gastroesophageal reflux disease and obesity. American Journal of Gastroenterology, 132(4), supp. 2: A264.
• Kasper, F. K., Seidlits, S. K., Tang, A., Crowther, R. S., Carney, D. H., Barry, M. A., & Mikos, A. G. (2005). In vitro release of plasmid DNA from oligo(poly(ethylene glycol) fumarate) hydrogels. Journal of controlled release : official journal of the Controlled Release Society, 104(3), 521-39.
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  This research investigates the release of plasmid DNA in vitro from novel, injectable hydrogels based on the polymer oligo(poly(ethylene glycol) fumarate) (OPF). These biodegradable hydrogels can be crosslinked under physiological conditions to physically entrap plasmid DNA. The DNA release kinetics were characterized fluorescently with the PicoGreen and OliGreen Reagents as well as through the use of radiolabeled plasmid. Further, the ability of the released DNA to be expressed was assessed through bacterial transformations. It was found that plasmid DNA can be released in a sustained, linear fashion over the course of 45-62 days, with the release kinetics depending upon the molecular weight of the poly(ethylene glycol) from which the OPF was synthesized. Two formulations of OPF were synthesized from poly(ethylene glycol) of a nominal molecular weight of either 3.35K (termed OPF 3K) or 10K (termed OPF 10K). By the time the gels had completely degraded, 97.8+/-0.3% of the initially loaded DNA was recovered from OPF 3K hydrogels, with 80.8+/-1.9% of the initial DNA retaining its double-stranded form. Likewise, for OPF 10K gels, 92.1+/-4.3% of the initially loaded DNA was recovered upon complete degradation of the gels, with 81.6+/-3.8% of the initial DNA retaining double-stranded form. Experiments suggest that the release of plasmid DNA from OPF hydrogels is dominated by the degradation of the gels. Bacterial transformation results indicated that the DNA retained bioactivity over the course of 42 days of release. Thus, these studies demonstrate the potential of OPF hydrogels in controlled gene delivery applications.
• Martin, M. J., Tang, A. L., Fischman, S. M., Casillas, R., & Demetriades, D. (2005). The importance of radiologic and minimally invasive adjuncts in the nonoperative management of major penetrating liver injury. Injury Extra, 36, 463-465.
• Terao, J., Tang, A., Michels, J. J., Krivokapic, A., & Anderson, H. L. (2004). Synthesis of poly(para-phenylenevinylene) rotaxanes by aqueous Suzuki coupling. Chemical communications (Cambridge, England), 56-7.
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  PPV-based polyrotaxanes have been prepared by coupling vinyl boronic acids to aryl iodides in the presence of cyclodextrins, and the crystal structure of a [2]rotaxane of this type has been determined.
• Hedberg, E. L., Tang, A., Crowther, R. S., Carney, D. H., & Mikos, A. G. (2002). Controlled release of an osteogenic peptide from injectable biodegradable polymeric composites. Journal of controlled release : official journal of the Controlled Release Society, 84(3), 137-50.
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  Poly(D,L-lactic-co-glycolic acid)/poly(ethylene glycol) (PLGA/PEG) blend microparticles loaded with the osteogenic peptide TP508 were added to a mixture of poly(propylene fumarate) (PPF), poly(propylene fumarate)-diacrylate (PPF-DA), and sodium chloride (NaCl) for the fabrication of PPF composite scaffolds that could allow for tissue ingrowth as well as for the controlled release of TP508 when implanted in an orthopedic defect site. In this study, PPF composites were fabricated and the in vitro release kinetics of TP508 were determined. TP508 loading within the PLGA/PEG microparticles, PEG content within the PLGA/PEG microparticles, the microparticle content of the PPF composite polymer component, and the leachable porogen initial mass percent of the PPF composites were varied according to a fractional factorial design and the effect of each variable on the release kinetics was determined for up to 28 days. Each composite formulation released TP508 with a unique release profile. The initial release (release through day 1) of the PLGA/PEG microparticles was reduced upon inclusion in the PPF composite formulations. Day 1 normalized cumulative mass release from PPF composites ranged from 0.14+/-0.01 to 0.41+/-0.01, whereas the release from PLGA/PEG microparticles ranged from 0.31+/-0.02 to 0.58+/-0.01. After 28 days, PPF composites released 53+/-4% to 86+/-2% of the entrapped peptide resulting in cumulative mass releases ranging from 0.14+/-0.01 microg TP508/mm(3) scaffold to 2.46+/-0.05 microg TP508/mm(3) scaffold. The results presented here demonstrate that PPF composites can be used for the controlled release of TP508 and that alterations in the composite's composition can lead to modulation of the TP508 release kinetics. These composites can be used to explore the effects varied release kinetics and dosages on the formation of bone in vivo.

Presentations

• Del Sol Driesen, A., Romero Arenas, M., Arora, T., Tang, A., Nfonsam, V. N., O'Grady, C., Riall, T. S., & Morris-Wiseman, L. (2020, May). Do General Surgery Residency Program Websites Feature Diversity?. Association of Program Directors in Surgery, Surgical Education Week. Virtual: Association of Program Directors in Surgery.
• Tang, A. (2018, August/ Summer). Trauma and Pregnancy. Southwestern Regional Trauma Conference. Tucson, Arizona.
• Tang, A. (2018, January/ Winter). Banner UMC Trauma Center - A Resource for Southern Arizona. Friends of UMC. La Hacienda Del Sol.
• Tang, A. (2018, Multiple). Stop the Bleed. Stop the Bleed. Multiple Locations.
• Tang, A. (2018, November/ Fall). DUI Task Force Press Conference. Press Conference. Pima Community College, Tucson, AZ.
• Tang, A. (2018, October/ Fall). Our Trauma Center. American Airline Tucson Vanguards. American Legion Post 36, Tucson, AZ.
• Tang, A. (2018, October/ Fall). Trauma Potpourri. Border Patrol Search, Trauma Rescue (BORSTAR) Conference. Tucson, AZ.
• Tang, A. (2017, March/ Spring). Remote Ischemic Conditioning Attenuates Cognitive and Motor Deficits from moderate Traumatic Brain Imaging. Westen Trauma Association Annual Meeting. Snowbird, UT.
• Tang, A. (2016, summer). A critical analysis of prehospital use of Tranexamic Acid. Southwestern Regional Trauma Conference. Tucson, Az.
• Tang, A. (2016, summer). Pelvic Trauma. Nurse Intermediary, charge nurse and Trauma CE Meeting for BUMCT Emergency Department. Tucson, Az.
• Tang, A. (2016, summer). Seconday Survey and Transfer to Definitive Care. Rural Trauma Team Development Course. Wilcox, Az.
• Tang, A. (2016, winter). Spine and Spinal Cord Trauma. Border Patrol Search, Trauma and Rescue Conference. Tucson, Az.
• Tang, A. (2015, Summer). "Dude What Happened?". Southwestern Regional Trauma Conference. Tucson, Az.
• Tang, A. (2014, summer). A Panel Discussion- Shifting Paradigms of training surgery residents in 2014. General Surgery Grand Rounds. Tucson, Az.
• Tang, A. (2014, summer). Advances in Chest Trauma. Southwestern Regional Trauma Conference. Tucson, Az.
• Tang, A. (2014, summer). The Milestones. General Surgery Grand Rounds. Tucson, Az.
• Tang, A. (2014, summer). Traumatic Brain Injury. Emergency Department Core Content Lecture Series. Tucson, AZ.
• Tang, A. (2014, winter). A critical analysis of secondary overtriage to a level 1 trauma center. 44th annual meeting of the Western Trauma Association. Steamboat Springs, CO.
• Tang, A. (2013, fall). A Career in Medicine: Why and How. University of Arizona Physiology Club. Tucson, AZ.
• Tang, A. (2013, spring). Burn Care. Emergency Pediatric Interdiscplinary Care Conference. Tucson, AZ.
• Tang, A. (2013, spring). Clearing the pediatric cervical spine after trauma. Emergency Pediatric Inerdisciplinary Care Conference. Tucson, Az.
• Tang, A. (2013, spring). My path to a trauma surgeon. University of Arizona Physiology Club. Tucson, Az.
• Tang, A. (2013, spring). Predictors of ATLS Failure. Surgical Education Research Fellowship Forum. Orlando, FL.
• Tang, A. (2012, fall). Traumatic Brain Injury. Tucson Fire Department Continuing Education Day. Tucson AZ.
• Tang, A. (2012, summer). Alcohol Withdrawal and the CIWA-AR Protocol. Orthopedic Grand Rounds. Tucson, AZ.
• Tang, A. (2012, summer). Extremity Trauma. Northwest Fire Department Trauma Pre Hospital Conference. Tucson, Az.
• Tang, A. (2012, summer). Spine and Spinal Cord Trauma. Northwest Fire Department Trauma Prehospital Conference. Tucson, AZ.
• Tang, A. (2011, fall). Abdominal Trauma. Southwest Fire Department Pre-Hospital Conference. Tucson, Az.
• Tang, A. (2011, fall). Assessment of an intervention bundle for traumatic brain injury- when are intracranial pressure monitors necessary. AAST. Chicago, IL.
• Tang, A. (2011, fall). Traumatic Brain Injury. Southwest Fire Department Pre Hospital Conference. Tucson, Az.
• Tang, A. (2011, spring). Traumatic Brain Injury: A trauma surgeons perspective. Traumatic Brain injury: Saving and Restoring lives. Tucson, Az.
• Tang, A. (2011, summer). Care of the Gravid Patients. Obstetrics and Gynecology Grand Rounds. Tucson, AZ.
• Tang, A. (2011, summer). Shock. Northwest Fire Department Trauma Pre Hospital Conference. Tucson, Az.
• Tang, A. (2011, summer). Spine Trauma. Northwest Fire Department Pre Hospital Conference. Tucson, Az.
• Tang, A. (2011, winter). Penetrating Cardicac Injury: A Survivable injury with a high post compliaction rate. Pacific Coast Surgical Association. Scottsdale, Az.
• Tang, A. (2011, winter). The Effects of Pregnancy on Mortality Following Traumatic Injuries: A National Tauma Databank Review. 22nd Annual Scientific Meeting,South California Chapter of the American College of Surgeons. Santa Barabara, Ca.
• Tang, A. (2010, Summer). Thoracic Trauma. Paramedic Lectures. Tucson, Az: NW fire district /SW Ambulance and Rural Metro Ambulance.
• Tang, A. (2010, Summer). Two for One: Pregnancy and Trauma. Southwest Regional Trauma Conference. Tucson, Az.
• Tang, A. (2010, fall). Burn Trauma. Continuing education lecture. Tucson, Az: Golder Ranch Station 370.
• Tang, A. (2010, summer). Haitian Trauma. Southwest regional trauma conference. Tucson, AZ.

Poster Presentations

• Tang, A. (2011, summer). Needle Decompression. Southwest Regional Trauma Conference. Tucson, Az.

Others

• Tang, A. (2018, August). Surgeon Who Lead Trauma Operation After Vegas Shooting Comes to Tucson. News Tucson - KOVA.
• Tang, A. (2018, October). Banner-UMC Trauma Center Recognized. KGUN-TV.