Publications by authors named "R David Anderson"

11,400 Publications

Establishing a Deaf and American Sign Language Inclusive Residency Training Program.

Acad Med 2021 Oct 19. Epub 2021 Oct 19.

C. Hill is a radiation oncology resident, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. C. Deville Jr is associate professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. A. Kiess is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. A. Narang is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. T. Ratnanather is associate research professor, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland. J. Bienstock is associate dean of graduate medical education, Office of the Vice Dean for Education, Johns Hopkins University School of Medicine, Baltimore, Maryland. L. Brinckerhoff is a disability and learning consultant, Learning Resources and Support Student Affairs, Harvard, Boston, Massachusetts. A. Hodukavich is an Americans with Disabilities Act compliance officer, Office of Institutional Equity, Johns Hopkins University, Baltimore, Maryland. R. Anderson is director of nursing, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. S. Alcorn is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. T. DeWeese is vice dean for clinical affairs and president of the clinical practice association, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. A. Viswanathan is professor and director, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland. B.R. Page is assistant professor, Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Improving diversity in residency programs has been increasingly emphasized as a means to address gender, racial, and ethnic disparities in medicine. However, limited attention has been given to the potential benefits of training physicians with differences other than gender or race and ethnicity. Americans with a disability represent about 27% of the U.S. population, whereas 1-3% of physician trainees report having a disability. In 2013, a national survey identified only 86 physicians or trainees reporting deafness or hearing loss as a disability. To date, there are no published strategies on how to create an inclusive program for Deaf trainees. Herein, the authors report on the development of a Deaf and American Sign Language (ASL) inclusive residency training program that can serve as an academic model for other programs, in any medical specialty, seeking to create an accessible training program for Deaf physicians and that can be adapted for trainees with other disabilities. In March 2017, the radiation oncology residency program at Johns Hopkins University matched an ASL-signing Deaf resident who would begin the program in July 2018. In preparation, department leadership engaged key stakeholders and leaders within the university's health system and among the department faculty, residents, and staff as well as the incoming resident to create an ASL inclusive program. A 5-step transition process for the training program was ultimately developed and implemented. The authors focused on engaging the Deaf trainee and interpreters, engaging health system and departmental leadership, contracting a training consultant and developing oral and written training materials for faculty and staff, and optimizing the workspace via accommodations. Through collaborative preparation, a Deaf and ASL-signing resident was successfully integrated into the residency program. The proposed 5-step transition process provides an effective, engaging model to encourage other institutions that are seeking to employ similar inclusivity initiatives.
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http://dx.doi.org/10.1097/ACM.0000000000004469DOI Listing
October 2021

Maximizing detection and optimal characterization of local abnormal ventricular activity in nonischemic cardiomyopathy: LAVA & LAVA.

Heart Rhythm O2 2021 Oct 4;2(5):529-536. Epub 2021 Sep 4.

The Hull Family Cardiac Fibrillation Management Laboratory, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Canada.

Background: Sites of local abnormal ventricular activation (LAVA) are ventricular tachycardia (VT) ablation targets. In nonischemic cardiomyopathy (NICM), minute and sparse LAVA potentials are mapped with difficulty with direction-sensitive bipolar electrograms (EGM). A method for its optimal characterization independent of electrode orientation has not been explored.

Objective: Maximize voltages and calculate overall activation direction at LAVA sites, independent of catheter and wave direction, using omnipolar technology (OT) in NICM.

Methods: Four diseased isolated human hearts from NICM patients were mapped epicardially using a high-density grid. Bipolar EGMs with at least 2 activation segments separated by at least 25 ms were identified. We used OT to maximize voltages (LAVA) and measured overall wave direction (LAVA) for both segments. Clinically relevant voltage proportion (CRVP) was used to estimate the proportion of directionally corrected bipoles. Concordance and changes in direction vectors were measured via mean vector length and angular change.

Results: OT provides maximal LAVA voltages (OT: 0.83 ± 0.09 mV vs Bi: 0.61 ± 0.06 mV, < .05) compared to bipolar EGMs. OT optimizes LAVA voltages, with 32% (CRVP) of LAVA bipoles directionally corrected by OT. OT direction vectors at LAVA sites demonstrate general concordance, with an average of 62% ± 5%. A total of 72% of direction vectors change by more than 35° at LAVA sites.

Conclusion: The omnipolar mapping approach allows maximizing voltage and determining the overall direction of wavefront activity at LAVA sites in NICM.
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http://dx.doi.org/10.1016/j.hroo.2021.08.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505212PMC
October 2021

Successful surgical repair of pulmonary dominant common arterial trunk without aortic arch obstruction in a neonate.

Ann Pediatr Cardiol 2021 Jul-Sep;14(3):416-418. Epub 2021 Aug 12.

Department of Radiology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India.

The pulmonary dominant variant of the common arterial trunk has always been reported to be associated with aortic coarctation, or interruption of the aortic arch, along with a duct-dependent systemic circulation. This mandates a complex surgical repair with attendant high surgical mortality. We report a 23-day-old baby with a pulmonary dominant trunk with mild aortic hypoplasia but with an arch free of coarctation or interruption, who underwent successful surgical repair. In the preoperative evaluation of a common arterial trunk, pulmonary dominance may not necessarily denote an adverse risk factor when the aorta is only mildly hypoplastic.
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http://dx.doi.org/10.4103/apc.apc_239_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457280PMC
August 2021

The morphogenesis of abnormal coronary arteries in the congenitally malformed heart.

J Thorac Cardiovasc Surg 2021 Oct 4. Epub 2021 Oct 4.

Biosciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom.

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http://dx.doi.org/10.1016/j.jtcvs.2021.08.084DOI Listing
October 2021

eIF2A-knockout mice reveal decreased life span and metabolic syndrome.

FASEB J 2021 Nov;35(11):e21990

Center for Gene Regulation in Health and Disease, Department of Biological, Geological and Environmental Sciences, Cleveland State University, Cleveland, Ohio, USA.

Eukaryotic initiation factor 2A (eIF2A) is a 65 kDa protein that functions in minor initiation pathways, which affect the translation of only a subset of messenger ribonucleic acid (mRNAs), such as internal ribosome entry site (IRES)-containing mRNAs and/or mRNAs harboring upstream near cognate/non-AUG start codons. These non-canonical initiation events are important for regulation of protein synthesis during cellular development and/or the integrated stress response. Selective eIF2A knockdown in cellular systems significantly inhibits translation of such mRNAs, which rely on alternative initiation mechanisms for their translation. However, there exists a gap in our understanding of how eIF2A functions in mammalian systems in vivo (on the organismal level) and ex vivo (in cells). Here, using an eIF2A-knockout (KO) mouse model, we present evidence implicating eIF2A in the biology of aging, metabolic syndrome and central tolerance. We discovered that eIF2A-KO mice have reduced life span and that eIF2A plays an important role in maintenance of lipid homeostasis, the control of glucose tolerance, insulin resistance and also reduces the abundance of B lymphocytes and dendritic cells in the thymic medulla of mice. We also show the eIF2A KO affects male and female mice differently, suggesting that eIF2A may affect sex-specific pathways. Interestingly, our experiments involving pharmacological induction of endoplasmic reticulum (ER) stress with tunicamycin did not reveal any substantial difference between the response to ER stress in eIF2A-KO and wild-type mice. The identification of eIF2A function in the development of metabolic syndrome bears promise for the further identification of specific eIF2A targets responsible for these changes.
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http://dx.doi.org/10.1096/fj.202101105RDOI Listing
November 2021
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