Cleveland Clinic Foundation 6 articles published in JoVE Medicine Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion Jay L. Alberts1,2,3,4, Michael T. Modic3, Belinda Udeh3,5, Tanujit Dey6, Kay Cherian1, Xiaoyang Lu3, Richard Figler4, Andrew Russman4, Susan M. Linder1,4 1Department of Biomedical Engineering, Cleveland Clinic Foundation, 2Center for Neurological Restoration, Cleveland Clinic Foundation, 3Office of Clinical Transformation, Cleveland Clinic Foundation, 4Concussion Center, Cleveland Clinic Foundation, 5Neurological Institute Center for Outcomes Research, Cleveland Clinic Foundation, 6Quantitative Health Sciences, Cleveland Clinic Foundation A multidisciplinary carepath to standardize disparate concussion care was developed and implemented at the Cleveland Clinic. The Cleveland Clinic Concussion (C3) mobile application was used to enable the carepath through biomechanical outcomes characterizing cognitive and motor function. Patient outcomes improved while cost of care was reduced following implementation. Cancer Research Modeling Osteosarcoma Using Li-Fraumeni Syndrome Patient-derived Induced Pluripotent Stem Cells Ruoji Zhou1,2, An Xu1, Jian Tu1,3, Mo Liu1, Julian A Gingold4, Ruiying Zhao1, Dung-Fang Lee1,2,5,6 1Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Science Center at Houston, 2Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth, 3Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-sen University, 4Women's Health Institute, Cleveland Clinic Foundation, 5Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, 6Center for Precision Health, School of Biomedical Informatics and School of Public Health, The University of Texas Health Science Center at Houston Here, we present a protocol for the generation of induced pluripotent Stem Cells (iPSCs) from Li-Fraumeni Syndrome (LFS) patient derived fibroblasts, differentiation of iPSCs via mesenchymal stem cells (MSCs) to osteoblasts, and modeling in vivo tumorigenesis using LFS patient-derived osteoblasts. Developmental Biology Analysis of Retinoic Acid-induced Neural Differentiation of Mouse Embryonic Stem Cells in Two and Three-dimensional Embryoid Bodies Junning Yang1, Chuanshen Wu2, Ioana Stefanescu1, Arie Horowitz1,3 1Department of Medicine, Cardeza Vascular Research Center, Sidney Kimmel Medical College, Thomas Jefferson University, 2Department of Molecular Cardiology, Cleveland Clinic Foundation, 3Department of Cancer Biology, Cardeza Vascular Research Center, Sidney Kimmel Medical College, Thomas Jefferson University We describe a technique for using murine embryonic stem cells for generating two or three dimensional embryoid bodies. We then explain how to induce neural differentiation of the embryoid body cells by retinoic acid, and how to analyze their state of differentiation by progenitor cell marker immunofluorescence and immunoblotting. Medicine Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note Jeffrey P. Mullin1, Saksith Smithason1, Jorge Gonzalez-Martinez1 1Department of Neurosurgery, Cleveland Clinic Stereo-electroencephalography (SEEG) aids in localization of epileptogenic zones, however, remains relatively underutilized in the United States. The goal of this abstract is to provide a brief introduction to the technique of SEEG and further a detailed technique of using robotic assistance in the placement of SEEG electrodes. Behavior Performing Behavioral Tasks in Subjects with Intracranial Electrodes Matthew A. Johnson1, Susan Thompson1, Jorge Gonzalez-Martinez2, Hyun-Joo Park1, Juan Bulacio2, Imad Najm2, Kevin Kahn4, Matthew Kerr4, Sridevi V. Sarma4, John T. Gale1,3 1Department of Neurosciences, Cleveland Clinic Foundation, 2Epilepsy Center, Cleveland Clinic Foundation, 3Department of Neurosciences and Center for Neurological Restoration, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Johns Hopkins University Patients implanted with intracranial electrodes provide a unique opportunity to record neurological data from multiple areas of the brain while the patient performs behavioral tasks. Here, we present a method of recording from implanted patients that can be reproducible at other institutions with access to this patient population. Medicine The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool Richard A. Rudick1, Deborah Miller1, Francois Bethoux1, Stephen M. Rao2, Jar-Chi Lee3, Darlene Stough1, Christine Reece2, David Schindler4, Bernadett Mamone1, Jay Alberts4 1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, 2Center for Brain Health, Cleveland Clinic Foundation, 3Quantitative Health Sciences, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.
