Digital Commons Network^™

The Impact Of Rapid Infusers On The Hemostatic Potential Of Cryoprecipitate Products, Connor D Purvis, Samantha Redden, Andrew Jacobson, Yao-Wei Wang, Julie Campbell, Jessica Cardenas, Jan-Michael Van Gent, Bryan A Cotton

Faculty, Staff and Student Publications

Background: In cases of massive transfusion, intravenous access can be limited. Additionally, delivering different products through separate lines and infusion methods adds unnecessary steps. RBC, plasma, and whole blood (WB) are delivered via rapid infusers; cryoprecipitate (CRYO) is infused through separate access and is not approved with these devices.

Study design and methods: We examined the impact of different transfusion methods on hemostatic performance and factor activity using two available CRYO products. Ten bags of CRYO, ten bags pathogen-reduced CRYO (Intercept® Fibrinogen Complex, IFC), and 20 units of WB were obtained. Each CRYO bag was infused with one unit of …

Estrogen As A Therapeutic Agent: Targeting Endotheliopathy And Coagulopathy In Trauma, Niruktha Raghavan, Mira Patel, Bryan A Cotton, Julia Coleman, Donald Jenkins

Faculty, Staff and Student Publications

Background: Traumatic injury remains a leading cause of death, often due to uncontrolled hemorrhage and trauma-induced coagulopathy (TIC). TIC is critically triggered by the endotheliopathy of trauma, involving endothelial cell injury and glycocalyx degradation. Despite conventional advances, the stable casualty rate underscores the urgent need for new precision resuscitation strategies that acknowledge factors like biological sex.

Design: The central hypothesis is that estrogen confers a survival advantage in hormonally active females through a dual action: endothelial cell stabilization (halting glycocalyx shedding) and its inherent procoagulant effect. The analysis assesses the therapeutic potential of both exogenous estrogen and female-derived blood products …

Declaring Futility After Traumatic Injury And The Burden Of Failure On The Surgeon, Jan-Michael Van Gent, Bryan A Cotton

Faculty, Staff and Student Publications

In this edition of the THOR supplement in Transfusion, there are two articles that deal with resuscitation futility and transfusion. In one article, Yazer et al. delve into the details of the studies outlined in this editorial and summarize the literature on the topic of transfusion and futility. The second article by Dr. Jay Malone discusses the ethical issues surrounding massive transfusion and resuscitation. Taken together, these articles address the clinical and ethical issues surrounding this very emotive and difficult topic.

Antidepressant-Like Effects Of Extinction Learning As An Animal Model Of Behavioral Therapy, Jing Liu, Sarah E Bulin, David A Morilak

Faculty, Staff and Student Publications

Exposure-based behavioral therapy, the most effective treatment for posttraumatic stress disorder (PTSD), also reduces depressive symptoms. However, neurobiological mechanisms underlying the beneficial effects of exposure-based behavioral therapy on depression remain unknown. Our lab has established fear extinction as a rat model of exposure therapy to investigate the mechanisms underlying its therapeutic behavioral effects in chronically stressed rats. In this study, we demonstrated that extinction learning reduced immobility in the forced-swim test and reversed chronic stress-induced reduction in sucrose preference. Chemogenetic inactivation of pyramidal neurons in the ventral medial prefrontal cortex (vmPFC) prevented these antidepressant-like effects of extinction. Extinction learning enhanced …

Creating Space For New Ideas And Advancing Gender Equity In Physical Activity And Health Research: Reflections On The Nature Portfolio Physical Activity Series, Andrea Ramírez Varela, Deborah Salvo, Pedro C Hallal, Erica Hinckson

Faculty, Staff and Student Publications

No abstract provided.

Computational Modeling Meets 3d Bioprinting: Emerging Synergies In Cardiovascular Disease Modeling, Tanmay Mukherjee, Mehdi Salar Amoli, Sarah Rezapourdamanab, Lama Rita El Shammas, Martin L Tomov, Emilio A Mendiola, Vahid Serpooshan, Reza Avazmohammadi

Faculty, Staff and Student Publications

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, underscoring the need for improved strategies in diagnosis, treatment, and disease modeling. Traditional in vitro models often fall short in replicating human CV physiology, prompting efforts to advance cardiac tissue engineering and computational modeling. Among these, three-dimensional (3D) bioprinting has emerged as a transformative tool, enabling the creation of biomimetic CV constructs that more faithfully replicate native tissue structure and function. However, challenges persist in achieving appropriate mechanical properties and long-term performance of engineered CV constructs. Computational modeling offers powerful solutions to assist with these challenges, providing predictive insights into …

Are Drains After Trauma Splenectomy Associated With Organ Space Surgical Site Infections?, Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Seokhun Kim, William D Rieger, Renee W Green, Gabrielle E Hatton, Lillian S Kao

Faculty, Staff and Student Publications

Introduction: Left upper quadrant (LUQ) drain use after trauma splenectomy varies, with minimal existing data to guide practice. We aimed to investigate the association of LUQ drains with organ space surgical site infection (OS-SSI) after splenectomy. We hypothesized that LUQ drains after trauma splenectomy are associated with increased odds of OS-SSI.

Patients and methods: A retrospective study of adult blunt trauma patients who underwent splenectomy from 7/2018 to 6/2024 was performed. We excluded patients who survived < 5 days after operation, and those with an intraoperatively identified pancreatic injury. Demographics, surgical details, and drain information were abstracted from the medical record. Inverse probability of treatment weighting (IPTW) was used to balance variables between patients who did and did not receive an LUQ drain after splenectomy. Multivariable logistic regression with IPTW was performed to estimate the association of LUQ drains with OS-SSI.

Results: Of 179 patients, 68% (n = 121) were male, the median age was 38 years (interquartile range 28, 55), and 27% (n = …

An Assessment Of Green Plasma: The In Vitro Hemostatic Superiority Of A Currently Discarded Blood Product, Samantha C Redden, David J Sun, Yao-Wei W Wang, Elizabeth Hartwell, Jessica C Cardenas, Scott D Olson, Bryan A Cotton

Faculty, Staff and Student Publications

Introduction: Recent studies have linked trauma patient outcomes to the plasma donor's sex, with premenopausal females associated with improved survival and lower organ failure. Currently, green-colored plasma (due to oral contraceptive use) is removed from the donor pool. We set out to evaluate the hemostatic potential of green plasma.

Study design & methods: We obtained 90 units of plasma from our regional blood center: 30 units of visible green plasma and 60 units of standard-color plasma divided between male and female donors. We collected clinical data such as age, sex, ethnicity, and number of pregnancies. We then assessed the hemostatic …

Growth Hormone Pathway As A Prognostic And Therapeutic Biomarker In Patients With Unresectable Hepatocellular Carcinoma Treated With Radiation Therapy, Joe R Eid, Safa Kaseb, Lianchun Xiao, Ryan Sun, Mahesh Kumar Kannan, Manal Hassan, Asif Rashid, Hop S Tran Cao, Hesham M Amin, Eugene J Koay

Faculty, Staff and Student Publications

Purpose: Radiation therapy (RT) has emerged as an effective local therapy option for patients with unresectable hepatocellular carcinoma (HCC) and is associated with improved overall survival (OS). However, some patients still have poor outcomes after RT, and biomarkers are needed to stratify prognostic groups. High circulating growth hormone (GH) levels promote HCC proliferation and survival and are associated with aggressive disease. In this study, we evaluated whether pretreatment GH levels are associated with OS and progression-free survival (PFS) in patients who underwent RT for unresectable HCC.

Methods and materials: Patients undergoing RT for HCC during 2017-2023 were identified from a …

Psychotropic Medications And Their Interactions With Subcortical Brain Volume In Bipolar Disorder: An Enigma Mega-Analysis, Sinead King, John O'Connor, Emma Corley, Giulia Tronchin, Elisa Fontana, Leila Nabulsi, Melody J Y Kang, Joaquim Radua, Brian Hallahan, Christoph Abé, Martin Alda, Dag Alnæs, Silvia Alonso-Lana, Silvia Amoretti, Jochen Bauer, Francesco Benedetti, Klaus Berger, Michael Berk, Erlend Bøen, Joscha Böhnlein, Birgitte Boye, Beatrice Bravi, Erick J Canales-Rodríguez, Udo Dannlowski, Caroline Demro, Annabella Di Giorgio, Ana M Diaz-Zuluaga, Torbjørn Elvsåshagen, Pauline Favre, Tracy Erwin-Grabner, María Florencia Forte, Janice M Fullerton, Lisa S Furlong, Susan L Rossell, David C Glahn, Benjamin I Goldstein, Ian H Gotlib, Roberto Goya-Maldonado, Melissa J Green, Dominik Grotegerd, Oliver Gruber, Bartholomeus C M Haarman, Tim Hahn, Tomas Hajek, Leonie Hater, Marco Hermesdorf, Josselin Houenou, Fleur M Howells, James A Karantonis, Kody G Kennedy, Tilo Kircher, Anna Luisa Klahn, Maximilian Konowski, Bernd Krämer, Elijah Lahud, Rayus Kuplicki, Mikael Landén, Carlos López-Jaramillo, Bradley J Macintosh, Hannah Meinert, Susanne Meinert, Elisa M T Melloni, Philip B Mitchell, Benson Mwangi, Igor Nenadić, Bronwyn J Overs, Nadine Parker, Godfrey Pearlson, Edith Pomarol-Clotet, James J Prisciandaro, Yann Quidé, Gloria Roberts, Amanda Rodrigue, Elena Rodríguez-Cano, Lisa Rauer, Matthew D Sacchet, Raymond Salvador, Fabio Sambataro, Theodore D Satterthwaite, Jonathan Savitz, Freda Scheffler, Navid Schürmeyer, Chen Shen, Kang Sim, Jair C Soares, Aleix Solanes, Márcio Gerhardt Soeiro-De-Souza, Scott R Sponheim, Dan J Stein, Frederike Stein, Henk S Temmingh, Lea Teutenberg, Sophia I Thomopoulos, Snezana Urosevic, Tamsyn E Van Rheenen, Eduard Vieta, Lars T Westlye, Daniel H Wolf, Mon-Ju Wu, Lakshmi N Yatham, Giovana B Zunta-Soares, Dara M Cannon, Paul M Thompson, Ole A Andreassen, Christopher R K Ching, Colm Mcdonald

Faculty, Staff and Student Publications

MRI studies in bipolar disorder (BD) have yielded inconsistent findings, partly due to the varied use of psychotropic medications. This study utilised a mega-analysis approach, accounting for concurrent medication status (syndrome-based and Neuroscience-based Nomenclature (NbN) classifications), in order to assess the association of medication status with subcortical brain volumes in BD. Data from 2,664 BD patients and 4,065 controls (CN) were pooled from 34 research groups as part of the ENIGMA Bipolar Disorder Working Group. Standardized ENIGMA protocols were used to measure subcortical brain volumes. Linear-mixed-effects regression evaluated the association between psychotropic medications and subcortical volumes, and moderation analyses explored …

Intravenous Buprenorphine Reversed Opioid-Induced Respiratory Depression Without Precipitating Withdrawal In Emergency Department Patients, Anthony Spadaro, Nicholas Imperato, Jaclyn Scalgione, Cynthia Santos

Faculty, Staff and Student Publications

Objective: Buprenorphine is a high-affinity partial agonist that can displace full opioid agonists and could be used to reverse opioid-induced respiratory depression. There is scant evidence to support the use of buprenorphine in an acute opioid overdose to reverse respiratory depression in the era of high fentanyl prevalence in the drug supply. This is a case series of four patients with signs and symptoms of an opioid overdose who showed clinical improvement after receiving intravenous buprenorphine.

Method: A case series of adult emergency department patients treated at a single urban academic medical center was reviewed by the authors, who determined …

Structural Brain Differences Associated With Panic Disorder: An Enigma-Anxiety Working Group Mega-Analysis Of 4924 Individuals Worldwide, Laura K M Han, Willem B Bruin, Janna Marie Bas-Hoogendam, Nynke A Groenewold, Kevin Hilbert, Anderson M Winkler, Andre Zugman, Takeshi Asami, Jacques P Barber, Francesco Benedetti, Robert J R Blair, Joscha Böhnlein, Paolo Brambilla, Fabian Breuer, Randy L Buckner, Robin Bülow, Monica E Calkins, Natalia Chechko, Udo Dannlowski, Katharina Dohm, Katharina Domschke, Thomas Dresler, Angelika Erhardt-Lehmann, Gregory A Fonzo, Andreas J Forstner, Hans J Grabe, Dominik Grotegerd, Raquel E Gur, Ruben C Gur, Catherine Harmer, David Hofmann, Odile A Van Den Heuvel, Neda Jahanshad, Tilo T J Kircher, Katharina Koch, Max A Laansma, Till Langhammer, Sang-Hyuk Lee, Elisabeth J Leehr, Eleonora Maggioni, Claire E Marino, Susanne Meinert, Hannah Meinert, Barbara Milrod, Benson Mwangi, Jared A Nielsen, Patricia Ohrmann, Spiro P Pantazatos, Martin P Paulus, Brenda W J H Penninx, Sara Poletti, Andrea Reinecke, Isabelle C Ridderbusch, Pavel Rjabtsenkov, Philipp G Sämann, Theodore D Satterthwaite, Lianne Schmaal, Elisabeth Schrammen, Jair C Soares, Nili Solomonov, Murray B Stein, Benjamin Straube, Thomas Straube, Benjamin Suarez-Jimenez, Jordan W Smoller, Ardesheer Talati, Sophia I Thomopoulos, Carlos E Vazquez, Henry Völzke, Katharina Wittfeld, Mon-Ju Wu, Yunbo Yang, Giovana B Zunta Soares, Ulrike Lueken, Paul M Thompson, Daniel S Pine, Dan J Stein, Nic J A Van Der Wee, Dick J Veltman, Moji Aghajani

Faculty, Staff and Student Publications

Neuroanatomical findings on panic disorder (PD) are typically difficult to replicate, with inconsistent effects. These concerns prompted a paradigm shift towards large-scale collaborations, focused on harmonized data extraction and processing for robust examination of PD brain correlates. Hence, leveraging the largest-ever multi-site neuroimaging database on PD (Age: 10–66 years; global sites: 28), compiled by the ENIGMA-Anxiety Working Group, we report on cortical and subcortical differences in individuals with PD (N = 1146) versus healthy controls (HC: N = 3778). The analyses revealed lower thickness and smaller cortical surface area within fronto-temporo-parietal regions in PD (Cohen’s ds: −0.08–0.13), along with lower …

A Scoping Review Of The Associations Between Ascariasis, Helicobacter Pylori Infection And Gastric Pathologies, Nina L Tang, Jacob J Williams, Jennifer Stockton, Maria Elena Bottazzi, Jill E Weatherhead

Library Staff Publications

Ascaris infection-ascariasis-is the most common human parasitic worm infection worldwide and induces damage and cellular changes within the stomach. Helicobacter pylori is a bacterium of the stomach that also causes gastric pathologies globally. Importantly, Ascaris, H. pylori, and gastric diseases all disproportionately affect individuals in resource-limited settings. However, the associations between ascariasis, H. pylori infection, and gastric diseases remain relatively unexplored. We synthesized the existing research associating Ascaris infection with H. pylori infection and/or gastric pathologies. Records were identified in OVID Medline, Embase and Web of Science using search terms for ascariasis, H. pylori infection, and gastric abnormalities and additional …

Survodutide For The Treatment Of Obesity: Baseline Characteristics Of The Synchronize Cardiovascular Outcomes Trial, Elke Platz, Lee M Kaplan, Carel W Le Roux, Sean Wharton, Svenja Burger, Samina Ajaz Hussain, Martina Brueckmann, Elena Startseva, Constanze Fey, Mikhail N Kosiborod, Biykem Bozkurt

Faculty, Staff and Students Publications

No abstract provided.

Reducing Transfusions In Neuromuscular Spinal Fusion: A National Surgical Quality Improvement Program-Pediatrics Quality Improvement Project, Holden Archer, Venessa L Pinto, Farrah Russell, Valentina Briceño, Melissa Ard, Lisa Hensch, Jun Teruya, Tanisha G Daugherty, Wallis Molchen, Ryan D Coleman, Darrell Hanson, Frank T Gerow, Nicole I Montgomery

Faculty, Staff and Students Publications

Background: Pediatric spinal fusion can result in substantial blood loss, particularly in patients with scoliosis related to underlying neuromuscular (NM) disease. Transfusion is frequently required but carries risks including transfusion reactions, alloimmunization, volume overload, and infection.

Local problem: The American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-P) is a nationally validated, risk-adjusted national outcomes registry. At our institution, ACS NSQIP-P data identified our institution as a high outlier in transfusion for neuromuscular scoliosis patients.

Methods: A multidisciplinary group convened from January 2024 to June 2024 to design and implement a perioperative pathway with the primary goal of …

The "Hallett Sign" Of Functional Jerky Movement Disorder, Jon Stone, Anthony E Lang, Joseph Jankovic, Michele Tinazzi, Barbara A Dworetzky, Alan Carson, Marina A J Tijssen

Faculty, Staff and Students Publications

No abstract provided.

Maternal Fish Intake In The Year Prior To Conception And Birth Defects, National Birth Defects Prevention Study, 1997-2011, Dorothy Kim Waller, Zeyu Miao, Renata H Benjamin, Richard Finnell, Nithya Lakshmi Mohan Dass, Eirini Nestoridi, Marcia C De Oliveira Otto, Julie Peterson, Tunu Ramadhani, Mark A Canfield

Faculty, Staff and Students Publications

Background: Epidemiologic data on the association between maternal fish intake and birth defects are sparse. Our objective was to assess associations between maternal fish intake and 52 different birth defects, most of which have not been assessed previously.

Methods: Using logistic regression, data was analyzed for 29,242 mothers of infants with birth defects and 10,973 mothers of control infants who participated in the National Birth Defects Prevention Study (NBDPS) and delivered between 1997 and 2011. We focused on associations between mothers who reported high fish intake of 2 or more servings of fish per week for the year prior to …

Adhesion G Protein-Coupled Receptors, Tobias Langenhan, Garret R Anderson, Demet Araç, Gabriela Aust, Monserrat Avila-Zozaya, Sofie Morsing Bagger, Patrick Barth, Sandra Berndt, Stephen C Blacklow, Beatriz Blanco-Redondo, Antony A Boucard, James P Bridges, Lara-Sophie Brodmerkel, Kathleen M Caron, Yin Kwan Chung, Andrew N Dates, Virginea De Araujo Farias, Daniel Del Toro, Joseph G Duman, Felix B Engel, David M Favara, Caroline J Formstone, Chaoyu Fu, Alain Garcia De Las Bayonas, Anastasia Georgiadi, David E Gloriam, Randy A Hall, Jörg Hamann, Peter W Hildebrand, Cheng-Chih Hsiao, Bill X Huang, Jonathan A Javitch, Hee-Yong Kim, Robert J Kittel, Gunnar Kleinau, Richard Leduc, Ines Liebscher, Hsi-Hsien Lin, Joshua Linnert, Marie-Gabrielle Ludwig, David C Martinelli, Signe Mathiasen, Daniel Matúš, Mariam Melkumyan, Ana L Moreno-Salinas, Jan Mulder, Michael A Nash, Kasturi Pal, Daniel T Pederick, Nicole A Perry-Hauser, Xianhua Piao, Yu-Qi Ping, Dimitris G Placantonakis, Fabian Pohl, Simone Prömel, Mette M Rosenkilde, Laurent Sabbagh, Richard C Sando, Patrick Scheerer, Torsten Schöneberg, Elena Seiradake, Mareike Selcho, Florian Seufert, Abhishek K Singh, Georgios Skiniotis, Katja Spiess, Norbert Sträter, David Strutt, Thomas C Südhof, Jinpeng Sun, Gregory G Tall, Doreen Thor, Douglas G Tilley, Kimberley F Tolias, Mario Vallon, Erwin G Van Meir, Benoit Vanhollebeke, Giselle R Wiggin, Uwe Wolfrum, Jie Yan, Nathan A Zaidman, Yimin Zou, Nicole Scholz

Faculty, Staff and Students Publications

Adhesion G protein-coupled receptors (aGPCRs) constitute a structurally and functionally distinct group within the superfamily of GPCRs. In 2015, the International Union of Pharmacology invited the Adhesion GPCR Consortium to publish a comprehensive review about aGPCRs and establish a unified nomenclature. Since then, substantial progress has been made in delineating the biological roles, molecular architecture, biochemical properties, expression profiles, ligand repertoire, and activation and signaling strategies of aGPCRs. Commensurate with these advances, their relevance to human pathophysiology has become increasingly apparent. In a coordinated effort, the Adhesion GPCR Consortium has reviewed recent progress in this field and provides a comprehensive …

Antibiotics Aren’T Enough, Andrew R Dinardo, Christoph Lange

Faculty, Staff and Students Publications

No abstract provided.

Risk Factors For The Development Of Food Allergy In Infants And Children: A Systematic Review And Meta-Analysis, Nazmul Islam, Alexandro W L Chu, Falana Sheriff, Farid Foroutan, Gordon H Guyatt, Romina Brignardello-Petersen, Paul Oykhman, Alfonso Iorio, Ariel Izcovich, Katherine M Morrison, Yetiani Roldan Benitez, Rachel J Couban, Dorota Borovsky, Yiming Zhang, Leonardo Ologundudu, Keerthana Pasumarthi, Syed Fahad Farooq, Kyle Tong, Wang-Choi Tang, Haseeb Faisal, Muhammad Faran Khalid, Mohammad Saad Asif, Shannon French, Susan Waserman, R Sharon Chinthrajah, Hugh A Sampson, S Shahzad Mustafa, Jay A Lieberman, Kirsi M Järvinen, Sally Bailey, Philippe Bégin, Scott H Sicherer, Jennifer Gerdts, Melanie Carver, Lynda Mitchell, Kelly Cleary, Matthew J Greenhawt, Julie Wang, Aikaterini Anagnostou, Marcus S Shaker, Anita Chandra-Puri, Patricia C Fulkerson, Robert A Wood, Derek K Chu

Faculty, Staff and Students Publications

Importance: The incidence and risk (predictive) factors for early life food allergy development remain uncertain.

Objective: To estimate the incidence and quantify risk factors for food allergy development.

Data sources: MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025.

Study selection: Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses.

Data extraction and synthesis: Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds …

Hiding In Plain Sight: A Call To Prevent Cutaneous Leishmaniasis Transmission In The United States, Juan David Ramírez, Sarah M Gunter, Megan Coffee, Norman Beatty, Dawn M Wetzel

Faculty, Staff and Students Publications

Cutaneous leishmaniasis (CL), once considered a travel-associated tropical disease, is increasingly transmitted within the United States, particularly in southern regions. Despite mounting evidence of local transmission, public health recognition and preventive infrastructure remain limited. This Viewpoint highlights the urgent need to shift the U.S. CL response from questioning endemicity to preventing transmission. We review ecological, clinical, and surveillance data demonstrating the presence of competent vectors, animal reservoirs, and autochthonous human cases. Diagnostic delays, underreporting, and insufficient provider training contribute to missed prevention opportunities. Climate change and peri-urban rodent-human contact data further heighten future risk. A coordinated response is essential, including …

A Multi-Institutional Epid-Based 3d Dose Reconstruction Model In A Virtual Phantom For Standardized Patient Qa, Benchmarking And Auditing For Stereotactic Radiosurgery, Benjamin Zwan, Emily Searle, Cameron Stanton, Ching-Ling Teng, Seng Boh Lim, Andrew Dipuglia, Richard Popple, Michael Lovelock, Ashley Cullen, Conor K Mcgarry, Victoria Robinson, Sergei Zavgorodni, Baozhou Sun, Xiaodong Zhao, Matthew Schmidt, Juan-Francisco Calvo-Ortega, Gemma Warner, Andrew Cousins, Michael Barnes, Peter Greer

Faculty, Staff and Students Publications

Background and purpose: For single-isocentre multi-target (SIMT) stereotactic radiosurgery (SRS), benchmarking, auditing and inter-institutional standardisation of dose verification remain challenging as they require specialized equipment and expertise. This work aims to develop and validate an electronic portal imaging device (EPID)-based technique to determine 3D dose in a virtual spherical phantom which is applicable across institutions for SIMT SRS dose verification.

Materials and methods: Small-field output factors from 11 international centres were measured in-water for the TrueBeam linear accelerator, including jaw-defined and high-definition multi-leaf collimator (MLC) fields from 0.5 × 0.5 to 20 × 20 cm2 and depths from 1.5-20 cm. …

Immigration Enforcement In Protected Areas-Implications For Health And Equitable Access To Care, Eric A Russell, Carmelle Wallace

Faculty, Staff and Students Publications

No abstract provided.

Gender Disparities Among General Surgeons: A Comprehensive Review, Julie Holihan, Devi Bavishi, Kush Brahmbhatt, Rebecca Franks, Zuhair Ali, Karla Bernardi, Christine Castillo, Mike Liang, Rachel Wong, Michele Loor

Faculty, Staff and Student Publications

Background: Unlike in-house call, the Accreditation Council for Graduate Medical Education (ACGME) does not require a postcall day for "home call" shifts. Despite this, we hypothesize that on-call residents are still in the hospital for the majority of their shift despite having the luxury of home call and, thus, are not protected by ACGME postcall duty hour regulations.

Methods: A prospective single center survey study was conducted by surveying junior and senior residents who completed overnight call shifts from January 2023 to April 2023 at one of the busiest level 1 trauma centers in the United States. Data include number …

Mif-Cd74 Signaling Drives Immune Modulation In Medulloblastoma, Benjamin Draper, Zhen You, Dean Thompson, Xu Guo, Alaide Morcavallo, Diego Chillon Pino, Carlos Lorenzo Gido Nery, Sumana Shrestha, Chantelle E Bowers, Courtney Himsworth, Alberto Delaidelli, Bethany Remeniuk, Sonia Morlando, Brandon Wade, Freya Gordon, Yara Sanchez-Corrales, Bei Hopkins, Natalie Monteiro, Darren Locke, Miao Liu, Jacob Torrejon Diaz, Kevin Greenslade, Barbara Martins Da Costa, Karen Barker, Colin Kwok, Olumide Ogunbiyi, Anya Fletcher, Stacey Richardson, Carlos Custodia, Rafael Roque, Thomas Jackson, Regan Barfoot, Sergi Castellano, Rebecca M Hill, Olivier Saulnier, Thomas S Jacques, Michael D Taylor, Claudia C Faria, Olivier Ayrault, Poul H Sorensen, John Anderson, Louis Chesler, L Frank Huang, Steven C Clifford, Laura K Donovan

Faculty, Staff and Students Publications

Background: Relapsed medulloblastoma remains a significant therapeutic challenge as it is near universally fatal. The tumor microenvironment of medulloblastoma plays a critical role in tumor progression, influencing tumor growth, immune evasion, and therapeutic resistance. We hypothesized that defining tumor-immune interactions in diagnostic and relapsed medulloblastoma may uncover mechanisms of immune evasion and identify novel therapeutic targets.

Methods: We analyzed paired primary and recurrent RNA-sequencing data from 140 medulloblastoma patients to profile immune cell composition and validate spatial relationships within the TME. To identify key tumor-immune interactions, we developed a novel algorithm to detect receptor-ligand pairs using single-cell RNA-sequencing data. These …

Assessment Of Correctness, Content Omission, And Risk Of Harm In Large Language Model Responses To Ophthalmology Continuing Medical Education Questions, Jacqueline L Chen, Amanda J Lu, Rohan Verma, Li Wang, Douglas D Koch, Allison J Chen

Faculty, Staff and Students Publications

Purpose: To evaluate the accuracy and prose responses of 2 large language models (LLMs) to ophthalmology continuing medical education questions.

Design: Question prompts and multiple choice (MC) answer options were input into the 2 LLMs, and responses were analyzed for accuracy and assessed for evidence of correctness, completeness, bias, and potential harm using a previously reported standardized rubric.

Subjects: Basic and Clinical Science Course questions and MC answer options from the American Academy of Ophthalmology question bank were used as inputs into the 2 LLMs (ChatGPT-4 and Google Vertex's Gemini Pro 1.5).

Methods: The MC responses were assessed for accuracy …

Exploring Bidirectionality In Global Health Partnerships: Perspectives From U.S. Pediatric Residency Programs, Anik Patel, Pauline Kamau, Justus Simba, Ashley Combs, Adelaide Barnes, Kathy Ferrer, Heather Haq, Duncan K Hau, Lee Morris, Brittany Murray, Amy Rule, Reena P Tam, Lisa Umphrey, Megan S Mchenry

Faculty, Staff and Students Publications

Introduction Despite growing interest, little guidance exists to re-evaluate global health partnerships (GHPs) through promoting bidirectionality. This study aims to understand the perspectives of United States (U.S.) pediatric global health (GH) faculty on institutional bidirectional practices to inform future discussions with international collaborators. Methods An internally, iteratively developed REDCap-based online survey (REDCap, Vanderbilt University, Nashville, TN), by our diverse author group, collected qualitative data from January 18 to February 20, 2023. Free-text responses were reviewed and coded inductively, with findings framed to generate themes for subsequent engagement with international partners. Results Of the 88 U.S. programs that identify as having …

Novel Model To Predict Survival In Dcd Heart Transplants: Development Of A Mortality Risk Score Using Unos Data, Anh Nguyen, Abbas Rana, Alexis Shafii, Gabriel Loor, Andrew Civitello, Todd Rosengart, Kenneth Liao

Faculty, Staff and Students Publications

Background: While prior studies have compared outcomes between donation after brain death (DBD) and donation after circulatory death (DCD) heart transplants, this study focuses on donor and recipient characteristics influencing survival and develop a risk score exclusively in DCD heart transplants.

Methods: We analyzed adult DCD heart transplants in the UNOS database from January 2019 to June 2024. Mortality risk factors were assessed using multivariable Cox proportional hazards regression. The coefficients of the most significant factors were used to develop a mortality risk score.

Results: Among 18,014 adult heart transplants, 1453 (8.1%) were DCD recipients. One-, two-, and three-year survival …

Risk Factors When Considering Heart Transplants With Donors Aged 45 Or Above: Development Of A Novel Mortality Risk Score Using Unos Data, Anh Nguyen, Abbas Rana, Alexis Shafii, Gabriel Loor, Andrew Civitello, Todd Rosengart, Kenneth Liao

Faculty, Staff and Students Publications

Background: Current International Society for Heart and Lung Transplantation guidelines support the use of donor hearts aged ≥45 if significant coronary artery disease is excluded and ischemic time remains < 4 hours. This study aimed to identify additional risk factors affecting patient survival and develop a risk score for recipients of older donor hearts.

Methods: We performed a retrospective cohort study of adult heart transplants using donors aged ≥45 from January 2000 to June 2024, using United Network for Organ Sharing data. Multivariable Cox regression identified risk factors for mortality, and the most significant variables were used to construct a risk score.

Results: Of 58,859 adult heart transplants, 9,843 (16.7%) involved donors aged ≥45. Recipient median age was 58 years (interquartile range, 51-64). One-, 5-, …

Phenotypic Diversity And Outcomes In Pediatric Nmda Receptor Encephalitis: A 15-Year Retrospective Study From The Largest Children's Hospital In The United States, Alexander J Sandweiss, Timothy Erickson, Yike Jiang, Varun Kannan, Jonathan M Yarimi, Kristen S Fisher, Nikita Shukla, Tim Lotze, Eyal Muscal, Kristy O Murray

Faculty, Staff and Students Publications

Anti‐NMDAR encephalitis (NMDARE) is an autoantibody‐mediated disorder characterized by seizures, movement disorders, neurocognitive deficits, and psychosis, but the complete phenotypic heterogeneity, and outcomes are incompletely understood in children. This single‐center retrospective analysis of NMDARE at the largest pediatric hospital in the United States between 2009 and 2024 screened 115 patients diagnosed with NMDARE. 103 had sufficient clinical data available for analyses. Two‐thirds were Hispanic, disproportionate to the Houston metro area demographics, and Hispanic patients had a higher CSF white cell count and antibody titer. Approximately one‐half of the patients with idiopathic NMDARE presented with a focal cortical phenotype that localized …