Association of time-temperature curves with outcomes in temperature management for cardiac arrest.

I have diverse research interests and collaborations.  Clinical research interests include epilepsy quality-of-life interventions and therapeutics and acute care neurological issues like post-cardiac arrest management and quality-of-care issues.  I work with the Duke hyperbaric chamber team on clinical neurophysiological monitoring of ketone-related research.  

As an neurointensivist with subspecialty training in cerebrovascular disease and neurocritical care my research focus is on the application of neurocritical care interventions to help patients with acute strokes and head injuries. My current research focuses both on improving and innovation of new therapies for patients with acute stroke as well as improving the systems of care that deliver life saving treatments to patients with stroke. 

Current research studies include the use of neuroprotection strategies such as inhaled Nitric Oxide to protect the brain after removal of large vessel clots. I also involved in helping to develop and test new thrombolytic agents for use in acute stroke. 

I am also working with a multidisciplinary team of systems of care experts at DCRI to re-engineer our stroke system of care across the heart of the Stroke Belt through a project called IMPROVE-Stroke Care which is leveraging novel informatics data systems to deliver state of the art care for patients with acute stroke. 

I am also working with a number of colleagues in Neurology, Neurosurgery and Emergency medicine to apply the concept of system re-engineering to improve the outcomes of patients with acute traumatic brain injury in East Africa (Uganda, Kenya and Tanzania)

Bayesian statistical modeling with application to problems in genetic
epidemiology and cancer research; models for epidemiological risk
assessment, including hierarchical methods for combining related
epidemiological studies; ascertainment corrections for high risk
family data; analysis of high-throughput genomic data sets.

As a neurointensivist, I am interested in improving our ability to monitor brain function and impact of therapy on our patients in the critical care setting. To this end I am developing new approaches to patient monitoring that will integrate patient physiologic monitoring with brain activity recorded by electroencephalography (EEG). On the basic science side I am interested in the central nervous system's response to injury. Although much attention has been focused on closed head injury as of late, stroke and brain hemorrhage are just as common in the civilian population and pose many of the same clinical challenges as traumatic brain injury. Using mouse models of clinically relevant brain injury, including models of stroke, subarachnoid hemorrhage, lobar hemorrhage, closed head injury and penetrating brain injury, we can explore the key molecular events that lead to edema, secondary brain injury, hyperexcitability and epilepsy, and other sequelae which contribute to poor patient recovery, and significant morbidity following brain injury. By investigating the underlying mechanisms that contribute to these adaptive changes using electrophysiology and molecular biology approaches we can then find ways to prevent them from becoming maladaptive and develop new therapies for our patients with head injuries.