Digital Commons Network^™

Associations Among Pork Intake, Weight-Loss, And Diet Quality Outcomes In A Commercial Weight-Management Program, Ana M Palacios, Grace Anderson, Beate Henschel, Alexandra M Lee, Kelli M Richardson, Chelsie Parker, Stephanie L Dickinson, Jing X Kersey, David B Allison, Gary D Foster, Michelle I Cardel

Faculty, Staff and Students Publications

Background: Pork is a common source of high-quality protein. However, it is typically recommended in moderation due to its saturated fat content, especially as its role in weight management, weight-loss (WL) programs, and overall diet quality is not well understood. This study aimed to identify associations among pork intake, WL, and diet quality among adults with overweight or obesity participating in a weight management program (WMP).

Methods: This secondary analysis used data from a 6-month randomized controlled trial (NCT05648344) evaluating the effectiveness of a WMP on diet quality. Data were collected through online surveys and the Automated Self-Administered …

Target Trial Of Glucagon-Like Peptide-1 Agonists Versus Dipeptidyl Peptidase-4 Inhibitors And Mortality In Hemodialysis, Dustin Le, Duncan Kilpatrick, Walter K. Kraft, Morgan E. Grams, Bernard G. Jaar, Jung-Im Shin

Division of Nephrology Faculty Papers

INTRODUCTION: The comparative effectiveness of glucagon-like peptide-1 (GLP-1) agonists (GLP-1s) versus dipeptidyl peptidase-4 (DPP-4) inhibitors (DPP-4s) in hemodialysis is unknown.

METHODS: Using 2011 to 2021 US Renal Data System and Medicare claims data, we emulated a target trial comparing new users of GLP-1s versus DPP-4s with patients who survived ≥ 90 days on in-center hemodialysis before medication initiation. We used inverse probability of treatment weighting (IPTW) and Cox proportional hazards models to estimate hazard ratios (HRs).

RESULTS: We identified 3671 GLP-1 and 12,039 DPP-4 users. After IPTW, mean age was 63 years, 52% male, 63% White, and mean body mass …

Development Of A Second-Generation Rarα Selective Antagonist As An Orally Bioavailable, Effective, Safe, And Reversible Male Contraceptive, Rui Shi, Kristen John, Xuan Qin, Ehfazul Haque, Taimeng Liang, Narsihmulu Cheryala, Feng Li, Henry L Wong, Gunda I Georg

Faculty, Staff and Students Publications

We report the design and SAR studies of benzopyran-, benzofuran-, and benzothiophene-derived inhibitors of the retinoic acid receptor alpha (RARα) for male contraception. SAR studies identified critical features influencing activity, such as the optimal positioning of antagonism moieties and substituents, leading to the discovery of (S)-4-(5-(2,8-dimethyl-5-(p-tolyl)-2H-chromen-3-yl)-1H-pyrrol-2-yl)­benzoic acid (compound 23). Compound 23 is a highly potent RARα inhibitor (IC50 = 0.051 nM) with excellent selectivity (>1650-fold over RARβ and >1960-fold over RARγ) and ADMET properties. Compound 23 is orally bioavailable and reduces sperm counts in mice for a full male contraceptive effect …

Pregnancy Outcomes After In Utero Exposure To Immune Checkpoint Inhibitors, Morgan Bou Zerdan, Bruna Kfoury, Eliane Aoun, Sarah Diane Hmaidan, Roni Nitecki Wilke, Jeffrey A How, Terri L Woodard, Pamela T Soliman, Laurie J Mckenzie

Faculty, Staff and Students Publications

Importance: Immune checkpoint inhibitors (ICIs) have transformed the management of cancers affecting reproductive-age patients, yet their impact on pregnancy outcomes remains incompletely understood. We describe two cases of maternal and fetal outcomes associated with ICI exposure during pregnancy and present a comprehensive literature review.

Methods: A retrospective chart review was conducted at MD Anderson Cancer Center (1 January 2015 to 31 December 2024) to identify patients exposed to ICIs during pregnancy. Clinical data including cancer type, treatment timing, pregnancy course, and maternal and neonatal outcomes were collected. A narrative literature review was also performed using PubMed to identify reported cases …

Richmond Agitation-Sedation Scoring Implementation In A Critical Access Hospital, Jasmine A. Hobbs

Doctor of Nursing Practice Scholarly Projects

Mechanically ventilated patients who are boarding in rural emergency departments face an increased risk of inconsistent sedation management due to the lack of standardized protocols and the extended transfer times to higher levels of care. The variability in sedation practices can lead to both under- and over-sedation, which negatively affects patient comfort, safety, and clinical outcomes. Research suggests that sedation protocols incorporating the Richmond Agitation-Sedation Scale (RASS) can shorten mechanical ventilation duration and improve clinical outcomes. The purpose of this project was to evaluate the effectiveness of a targeted educational intervention on improving nursing knowledge and comfort with the RASS …

Implementation Of A Provider-Focused Multimodal Educational Initiative To Address Polypharmacy And High-Risk Medication Use In A Home And Community Medicare Advantage Setting, Jennifer Butler-Rickard, Kellie Olsen, Eileen Stuart-Shor, Craig Drew

Doctor of Nursing Practice Scholarly Projects

BACKGROUND: Community-dwelling adults are at risk for adverse drug events such as falls, hospitalizations, cognitive decline, drug-to-drug interactions, and mortality related to high-risk medication use and polypharmacy, often defined as concurrent use of five or more different medications. Lack of provider knowledge of polypharmacy and high-risk medication use as well as suboptimal communication with primary care providers can lead to gaps in medication management in this vulnerable population.

LOCAL PROBLEM: Patients seen by the Comprehensive Annual Health Assessment Program advanced practice clinicians (APCs) at the project Medicare Advantage insurer organization often experience polypharmacy. Given the lack of provider knowledge of …

A Remote Intervention To Improve Medication Nonadherence Guided By A Marker Of Risk Derived From The Electronic Health Records Of Adolescent Transplant Recipients, Eyal Shemesh, Ravinder Anand, Rachel A Annunziato, Emily M Fredericks, Jennifer Garcia, Nitika Arora Gupta, Lawrence C Kleinman, Alyssa Kriegermeier, Krupa R Mysore, Vicky L Ng, Steven J Lobritto, Shreena Patel, Emily Rothbaum Perito, Elizabeth B Rand, Rene Romero, Robert S Venick, Sarah Duncan-Park, Jeffrey Mitchell, Sarah G Anderson, Margaret L Stuber, Miguel Reyes-Múgica, George V Mazariegos, Benjamin L Shneider

Faculty, Staff and Students Publications

Improving medication adherence in adolescents who had a liver transplant (iMALT), a prospective, block-randomized, single-blind, controlled multisite study in 13 pediatric transplant centers, used the medication level variability index (MLVI) to identify nonadherent adolescents. It compared a 2-year remote behavioral telemetric intervention (TI) that focused on adherence and addressed barriers to standard of care (SOC). The primary endpoint was the composite incidence of centrally determined (3 masked pathologists) rejection, death, retransplantation, or consent withdrawal. In 148 participants (TI group, n = 72 and the SOC group, n = 76), with a mean age 15.5 years, there were twice as many …

Expert Recommendations To Strengthen Chikungunya Outbreak Surveillance And Reporting For Traveler Health Protection, Daniel C. Payne, Karoun H. Bagamian, Jeffery Goad, Nathan D. Grubaugh, Michael A. Johansson, Moritz U. G. Kraemer, Eyal Leshem, Francesca F. Norman, Alfonso J. Rodríguez-Morales, Henrik Salje, Stephen Thomas, Scott C. Weaver, Lindsey A. Laytner, Rebecca Sturgis, Suzanne K. Scheele, Davidson H. Hamer

Pharmacy Faculty Articles and Research

Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because …

Molecular Classification And Association With Survival Outcomes In High-Intermediate And High-Risk Early-Stage Endometrial Cancers: Ancillary Analysis Of Gog-0249, Lindsay Kuroki, Danielle Enserro, Heather Lankes, Kyle Strickland, Rebecca Previs, Aine Clements, Matthew Powell, Ann Klopp, Elena Ratner, Paul Disilvestro, Casey Cosgrove, Guilherme Henrique Cantuaria, Nicola Spirtos, Michael Carney, Mitchell Edelson, Gottfried Konecny, Penny Anderson, Christopher Tarney, Britt Erickson, Meredith Newton, Krishnansu Tewari, Premal Thaker, David Warshal, Amy Armstrong, Xun Clare Zhou, Angeles Alvarez Secord

Abington Jefferson Health Papers

OBJECTIVE: Determine whether mismatch repair (MMR) and p53 expression predict recurrence-free survival (RFS) and overall survival (OS) in early-stage endometrial cancer (EC) patients treated with vaginal cuff brachytherapy plus chemotherapy (VCB/C) versus pelvic radiation therapy (RT).

METHODS: In the GOG-0249 trial, 601 patients with high-intermediate risk (HIR) early-stage EC were randomized to VCB/C (carboplatin/paclitaxel for 3 cycles) or pelvic RT. Molecular subgroups, deficient MMR (dMMR), p53 wildtype (p53wt), p53 abnormal (p53abn), were determined by immunohistochemistry. Five-year RFS and OS were analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusting for lymphadenectomy, planned VCB, and treatment group.

RESULTS: Among 315 …

Modulate Obesity And Related Metabolic Complications For Yielding Improvements In Ibd Outcomes (Modify-Ibd): Consensus On Obesity And Cardiometabolic Comorbidities In Inflammatory Bowel Disease Using Systematic Reviews And The Rand/Ucla Appropriateness Method, Jalpa Devi, Sami Samaan, Priya Sehgal, Mouhand Mohamed, Matthew Vincent, Shannon Coombs, Michelle Doering, Edward L. Barnes, Amanda M. Johnson, Andres J. Yarur, Parakkal Deepak

Division of Gastroenterology and Hepatology Faculty Papers

INTRODUCTION: Obesity and related cardiometabolic comorbidities, including hypertension, dyslipidaemia, diabetes, metabolic dysfunction-associated steatotic liver disease and atherosclerotic cardiovascular disease, are increasingly prevalent among individuals with inflammatory bowel disease (IBD). These conditions influence disease activity, therapeutic response, surgical outcomes and overall quality of life, yet evidence remains fragmented. The Modulate Obesity and relateD metabolic complIcations For Yielding improvements in IBD outcomes (MODIFY-IBD) initiative aims to synthesise evidence and generate consensus recommendations to guide practice and future research in this area. This study describes a protocol for a structured evidence synthesis and Research And Development/University of California, Los …

Migrainous Thoracalgia In A Patient With Chronic Migraine And Coronary Vasospasm: A Case Report, Dean Zeldich, Victor S. Wang, Cyril David, Clinton Lauritsen, Claire E.J. Ceriani

Department of Neurology Faculty Papers

Migrainous thoracalgia (MT) refers to chest pain (CP) potentially arising from a neurologic etiology, often temporally linked to migraine. We present a 57-year-old woman with chronic migraine who developed recurrent CP typically following migraine attacks. Despite multiple cardiac evaluations, including cardiac MRI and catheterizations, she was diagnosed with fibromuscular dysplasia, spontaneous coronary artery dissection, and coronary microvascular disease. Her CP partially responded to nitroglycerin and improved modestly with migraine control using ubrogepant and calcium channel blockers. During admission for refractory migraine, she received intravenous lidocaine, magnesium, ketorolac, and neuroleptics, resulting in several months of CP remission despite brief migraine relief. …

Smaller Right Ventricle Results In Poorer Exercise Performance In Young Patients With Repaired Tetralogy Of Fallot, Christiane Mhanna, Katerina Kourpas, Takeshi Tsuda

Department of Pediatrics Faculty Papers

BACKGROUND: Severe right ventricular (RV) dilatation and exercise intolerance are considered indications for pulmonary valve replacement in surgically repaired tetralogy of Fallot (rTOF).

METHODS AND RESULTS: Cardiopulmonary exercise testing (CPET) and cardiac magnetic resonance (CMR) were performed in rTOF patients with pulmonary insufficiency (PI). Oxygen pulse (OP), calculated as oxygen consumption (V̇O

CONCLUSIONS: A smaller RV was associated with worse exercise performance, indicating exercise intolerance is independent of RV dilatation in young rTOF with PI and represents a unique pathological entity responsible for reduced exercise performance.

A Disorder-Aware Computational Framework To Identify Structurally Tractable Targets In Proliferative Vitreoretinopathy, Mak B. Djulbegovic, Nedym Hadzijahic, David J. Taylor Gonzalez, Michael Antonietti, Sidra Zafar, Ajay E. Kuriyan

Wills Eye Hospital Papers

OBJECTIVE: Proliferative vitreoretinopathy (PVR) remains a major cause of failure after rhegmatogenous retinal detachment repair and lacks effective pharmacologic therapies. Although epithelial-mesenchymal transition (EMT) is central to PVR pathogenesis, the structural determinants governing the tractability of EMT regulators, particularly those involving intrinsic disorder, remain poorly defined. We developed a disorder-aware, artificial intelligence-enabled computational framework to evaluate EMT-associated proteins in PVR and prioritize structurally tractable regulators for structure-based targeting.

DESIGN: A computational, hypothesis-generating study employing an in silico screening and structural modeling pipeline.

SUBJECTS: No human subjects or biological specimens were included. The dataset comprised 25 EMT-associated proteins implicated in PVR, …

A Multi-Agent Large Language Model Framework To Automatically Assess Performance Of A Clinical Ai Triage Tool, Adam Flanders, Yifan Peng, Luciano Prevedello, Robyn Ball, Errol Colak, Prahlad Menon, George Shih, Hui-Ming Lin, Paras Lakhani

Department of Radiology Faculty Papers

Radiology reports can be used as a surrogate for performance of clinical AI tools. Radiology reports were analyzed by an ensemble of eight open-source LLM models and a internal version of GPT-4o using a single multi-shot prompt that assessed for presence of ICH. Performance of the open-source models, consensus of models and GPT-4o were compared to human report review. Three ideal consensus LLM ensembles were tested for rating the performance of the triage tool. The capability of each LLM varied. The highest AUC performance was achieved with llama3.3:70b and GPT-4o. Using MCC the ideal combination of LLMs were: Full-9 Ensemble, …

Associations Between Neighborhood Disadvantage, Cannabis Use, And Patient-Reported Outcomes Among Patients With Cancer, Brittney Greene, Shilpa Ghosh, Craig Colder, Salimah Meghani, Brooke Worster, Rebecca Ashare

Kimmel Cancer Center Faculty Papers

INTRODUCTION: Cannabis use is proliferating among oncological populations. However, research is limited on whether cannabis routes and sources are associated with neighborhood disadvantage and whether it moderates the relationship between neighborhood disadvantage and patient-reported outcomes (PROs). This analysis evaluates the relationship between neighborhood disadvantage and cannabis source and route, and their association with PROs.

METHODS: Analyses included 106 patients with cancer from varying levels of neighborhood disadvantage. Logistic regressions tested the association of neighborhood disadvantage with cannabis source (i.e., regulated vs. unregulated) and route (i.e., inhaled vs. consumed/other formulations). Multilevel regressions tested the association of neighborhood disadvantage with PROs (e.g., …

Minimally Invasive Versus Burr Hole Craniostomy For Chronic Subdural Haematoma Evacuation: A Systematic Review And Meta-Analysis, Shaan Patel, Shiva A. Nischal, Angelette Mendonca, Kush M. Kale, Santosh Guru, Pious D. Patel, Kevin Hines, Jack Jallo, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

BACKGROUND: Minimally invasive surgery (MIS) has emerged as an appealing alternative to burr hole craniostomy (BHC) for chronic subdural haematoma (cSDH), offering reduced operative trauma and anaesthetic exposure. However, whether these procedural advantages translate into comparable outcomes remains uncertain. This systematic review and meta-analysis aimed to compare the safety, effectiveness, and procedural performance of MIS versus BHC for cSDH evacuation, with attention to device-specific outcomes.

METHODS: A systematic search of PubMed, Embase, and CENTRAL (10th November 2025) identified randomised and observational studies directly comparing MIS techniques, including twist-drill craniostomy (TDC), subdural evacuating port systems (SEPS), and YL-1 devices, with BHC. …

International Multi-Center Study To Quantify The Effect Of Deep Venous Drainage After Surgical Resection Of Spetzler-Martin Grade Ii-Iii Brain Arteriovenous Malformations, Avi A. Gajjar, Rashad Jabarkheel, Mohamed M. Salem, Basel Musmar, Sandeep Kandregula, Hammam Abdalrazeq, Nimer Adeeb, Assala Aslan, Nathan Ramachandran, Stavropoula Tjoumakaris, Hamza Adel Salim, Adam A. Dmytriw, Christopher S. Ogilvy, Mustafa K. Baskaya, Douglas Kondziolka, Jason Sheehan, Howard Riina, Abdallah Abushehab, Kareem El Naamani, Najib Muhammad, Ahmed Abdelsalam, Natasha Ironside, Deepak Kumbhare, Sanjeev Gummadi, Cagdas Ataoglu, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Daniel Sconzo, Arwin Rezai, Omar Alwakaa, Pierce Davis, Salem M. Tos, Ufuk Erginoglu, Johannes Pöppe, Rajeev D. Sen, Alan S. Boulos, John C. Dalfino, Christoph J. Griessenauer, Robert M. Starke, Laligam N. Sekhar, Michael R. Levitt, David J. Altschul, Neil Haranhalli, Malia Mcavoy, Hussein A. Zeineddine, Adib A. Abla, Saman Sizdahkhani, Sravanthi Koduri, Michael R. Gooch, Robert H. Rosenwasswer Md, Christopher Stapleton, Matthew Koch, Peng R. Chen, Spiros Blackburn, Ketan Bulsara, Louis J. Kim, Omar Choudhri, Bryan Pukenas, Joshua S. Catapano, Darren Orbach, Edward Smith, Pascal J. Mosimann, Alexandra R. Paul, Pascal Jabbour, Ali Alaraj, Mohammad A. Aziz-Sultan, Aman B. Patel, Amey Savardekar, Christina Notarianni, Hugo H. Cuellar, Bharat Guthikonda, Jacques Morcos, Michael Lawton, Jan-Karl Burkhardt, Visish M. Srinivasan

Department of Neurosurgery Faculty Papers

Deep venous drainage (DVD) is considered a negative prognostic factor in AVM surgery, yet its effect on postoperative functional decline remains incompletely defined. This study evaluates whether DVD predicts worsened functional status after surgical resection of Spetzler-Martin Grade II-III AVMs. This retrospective multicenter study analyzed 129 patients with Spetzler-Martin Grade II-III AVMs across nine centers in North America and Europe who underwent primary surgical resection. We excluded cases with prior endovascular or stereotactic interventions. The primary outcome measured was poor functional status, defined as modified Rankin Scale (mRS) score 3-6 at last follow up. Among 129 patients with Spetzler-Martin Grade …

Targeted Suppression Of Spp1 Inhibits Tumor Invasion And Metastasis In Nrf2 Hyperactivated Cisplatin Resistant Hnscc, Mutsuki Kawabe, Sujuan Yang, Lorena I Gomez-Bolanos, Shiro Takamatsu, Sylvia Flores, Patricia D Castro, Tsung-You Tsai, Arisa Nishikawa Kaga, Kento Okamoto, Mitchell J Frederick, Vlad C Sandulache, Humam Kadara, Jeffrey N Myers, Abdullah A Osman

Faculty, Staff and Students Publications

Background: Cisplatin remains the standard systemic therapy for the definitive treatment of head and neck squamous cell carcinoma (HNSCC), however, resistance to cisplatin continues to be a major barrier to effective treatment, particularly in tumors with NRF2 hyperactivation. Recent studies identify secreted phosphoprotein 1 (SPP1/osteopontin) as a key NRF2 target frequently overexpressed in cancers, where it drives aggressive tumor behavior, metastasis, chemoresistance, and, in some cases, immune suppression. Our recent data highlight SPP1 as one of the top 10 NRF2-upregulated genes in cisplatin-resistant HNSCC. However, its specific role in therapy resistance and metastasis in HNSCC remains unclear. Here, we investigate …

Cd11c+ Cd8 T Cells Cause Ifn-Γ-Dependent Autoimmune Neuroinflammation That Is Restrained By Pd-1 Signaling, Daniel Hwang, Gholamreza Azizi, Larissa Lumi Watanabe Ishikawa, Maryam S. Seyedsadr, Arin Cox, Soohwa Jang, Ezgi Kasimoglu, Abdolmohamad Rostami, Guang-Xian Zhang, Bogoljub Ciric

Department of Neurology Faculty Papers

In multiple sclerosis (MS) lesions, CD8 T cells outnumber CD4 T cells, suggesting that they contribute to MS pathology. However, little is known about the role of CD8 T cells in MS, partly due to the prevalent use of experimental autoimmune encephalomyelitis (EAE) models mediated by CD4 T cells, which have limited involvement of CD8 T cells. Importantly, MS and EAE differ in both their distribution of CNS lesions and neurologic deficits, indicating differences in CNS inflammation. MS lesions are more commonly found in the brain, whereas EAE lesions are more frequent in the spinal cord. Additionally, neurologic deficits in …

Comparing Injury Incidence Between Major League Soccer And The English Premier League During The 2024/2025 Season: A Retrospective Cohort Study, William Gadbois, Youssef Salama, Kevin Reck, Scott Mohamed El-Sayed Yaekle

Medical Student Research Symposium

Background

Major League Soccer (MLS) and the English Premier League (EPL) differ substantially in geographic footprint, travel requirements, competition structure, and scheduling. These structural differences may influence player injury risk, yet no study has directly compared injury incidence between the two leagues within the same competitive season. In 2024, MLS introduced a centralized, standardized injury-reporting system that improved transparency and created a unique opportunity for direct comparison with the EPL.

Methods

This retrospective cohort study will analyze all reported time-loss injuries during the 2024 MLS and 2024–25 EPL seasons. Injury data will be collected from publicly available league reports, club …

Axitinib-Pembrolizumab And Adverse Event Management In Patients With Advanced Renal Cell Carcinoma, Neil Shah, Yaa Ababio, Anthony Eccleston, Dharanija Rao, Scott Kelly, Jane Chang, Sarah Lucht, Caleb Paydar, Bryce Van Doren, Emily Bland, William John, Sarah Giegerich, Jalyna Laney, Bruce Feinberg, Kevin Zarrabi

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Understanding approaches to managing treatment-related adverse events (AEs) in immunotherapy and tyrosine kinase inhibitor-based treatments in a clinical setting is critical for reaching optimal patient outcomes.

OBJECTIVE: To investigate the management of AEs in community practices during first-line axitinib plus pembrolizumab therapy for advanced renal cell carcinoma (aRCC).

DESIGN, SETTING, AND PARTICIPANTS: This study comprised a cross-sectional electronic physician survey and a multisite, retrospective cohort study of the medical records of US patients with aRCC who initiated first-line axitinib-pembrolizumab between April 22, 2019, and January 31, 2024. Data were analyzed from September 18 to December 20, 2024.

EXPOSURE: First-line …

In-Use Stability And Device Compatibility Define Clinically Actionable Handling Limits For A Gmp-Produced Attenuated Listeria Monocytogenes Vaccine Expressing Gucy2c, Jagmohan Singh, Taranjot Johar, Vannessa Scully, Scott A. Waldman, Babar Bashir, Adam E. Snook

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Background: Live-attenuated Listeria monocytogenes (Lm) vectors are a clinically validated cancer immunotherapy platform, but translation requires reproducible, clinically realistic workflows for dose preparation and infusion. For live bacterial products, in-use stability and device compatibility can drive dose variability through adsorption, settling, and device losses. Methods: We developed and GMP-manufactured an attenuated Lm vaccine expressing human GUCY2C (Lm-GUCY2C) and performed translational characterization, including construct verification and immunogenicity readouts, and defined the administration-focused in-use stability and device compatibility. Post-thaw stability was assessed in primary cryovials and during preparation and delivery from 250 mL saline infusion bags using standard clinical devices (syringes/needles, filter-free …

Circulating Metabolites Associated With Protection Against Mycobacterium Tuberculosis Infection And Inhibition Of Mycobacterial Growth, Todia P Setiabudiawan, Lika Apriani, Julian Avila-Pacheco, Edwin Ardiansyah, Vinod Kumar, Bachti Alisjahbana, Ayesha J Verrall, Andrew R Dinardo, Agnes R Indrati, Vera P Mourits, L Charlotte J De Bree, Simone J C F M Moorlag, Clary B Clish, Leo A B Joosten, Arjan Van Laarhoven, Krista E Van Meijgaarden, Mihai G Netea, Simone A Joosten, Valerie A C M Koeken, Philip C Hill, Reinout Van Crevel

Faculty, Staff and Students Publications

A significant proportion of individuals who are heavily exposed to infectious tuberculosis patients do not acquire Mycobacterium tuberculosis (Mtb) infection, as detected by an interferon gamma release assay (IGRA). We examined circulating metabolite profiles and metabolic genotypes in 199 heavily exposed IGRA-negative tuberculosis household contacts in Indonesia. Based on differentially abundant metabolites, activity of several pathways including arachidonic acid, arginine and proline, glutathione, and tryptophan metabolism, correlated with a negative IGRA at three months. SNPs near PRODH (involved in arginine and proline metabolism) were associated with circulating proline concentrations and persistently negative IGRA results, while SNPstudys near AFMID (involved in …

Childcare Challenges Among Surgical Trainees And Faculty: A Single-Institution Study, Emma G Burke, Sarah Peiffer, Melissa Koci, Lindsay Dean, Kristy L Rialon, Michele Loor, Alice King

Faculty, Staff and Students Publications

Background: Previous studies have demonstrated the challenges of parenthood in surgical training and careers. However, certain aspects of childrearing for surgeons remain understudied. We aim to leftacterize the complexity and costs of childcare amongst surgical trainees and faculty.

Methods: An anonymous, self-administered survey was conducted within the Department of Surgery at a large academic medical center. Both male and female trainees and faculty were included in the analysis. Chi-square or Fisher's Exact test was performed.

Results: Forty-six respondents provided information about childcare costs, with 37% of respondents being residents or fellows. Trainees worked longer workhours (p = 0.003) than their …

Exceptional Response Of Radiotherapy-Naïve Cranial Meningiomas To Dual Immune Checkpoint Blockade In Bap1 Tumor Predisposition Syndrome, Gary Gallia, Christine Hann, Calixto-Hope Lucas, Licia Pacheco Luna, David Kamson, Takami Sato

Department of Medical Oncology Faculty Papers

Meningiomas are the most common primary central nervous system tumors, and while most are benign, atypical and anaplastic variants frequently recur and have limited effective treatment options. Recent trials of PD-1 blockade in unselected meningioma cohorts have demonstrated modest activity, with low objective response rates. These findings highlight the need to identify molecular biomarkers that may predict immunotherapy sensitivity in this disease. BRCA1-associated protein 1 (BAP1) is a tumor suppressor critical for chromatin regulation and DNA repair, and germline pathogenic variants cause BAP1 tumor predisposition syndrome (BAP1-TPDS), a hereditary cancer syndrome characterized by uveal melanoma, mesothelioma, renal cell carcinoma, meningioma, …

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Associated With Tirzepatide, William Goodman, Karan Pandher, Mahaa Ayub

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Pr Interval Alternans And The Mystery Of Inverse Decremental Conduction, Alyssa Zakala, Mohammed Hussein Kamareddine, Farah Olleik, Ali Keramati, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: A 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation.

TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the …

When Qtc Shrinks After Rhythm Conversion, Mohammed Hussein Kamareddine, Alyssa Zakala, Farid Farkouh, Ibrahim Alameh, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: An 83-year-old man with a history of atrial fibrillation on amiodarone therapy was admitted for direct-current cardioversion because of recurrent atrial fibrillation with a ventricular rate of approximately 105 beats per minute. Cardioversion successfully restored sinus rhythm. Postcardioversion 12-lead electrocardiography revealed an unexpectedly short QTc of 344 ms despite chronic treatment with a QT-prolonging agent. This finding was attributed to QT hysteresis, reflecting delayed adaptation of ventricular repolarization to the abrupt reduction in heart rate after rhythm conversion.

TAKE-HOME MESSAGE: QT hysteresis can result in transient QTc shortening and has important implications for interpretation of QT intervals during …

A Review Of Robotic Vnotes Surgery: Current Applications, Advantages, And Future Directions, Daniel Y Lovell, Qiannan Yang, Xiaoming Guan

Faculty, Staff and Students Publications

Over the past 500 years, the convergence of three distinct paths - vaginal surgery, laparoscopy, and robotic technologies - has enabled the development of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES). The ongoing evolution of vaginal surgery has led to contemporary procedures such as hysterectomy, myomectomy, sacrocolpopexy, adnexal interventions, and oncologic operations, applicable to a wide range of diagnoses and pathologies. This approach offers patients significant benefits, including superior cosmetic outcomes, less pain, lower infection rates, and faster recovery of baseline quality of life. Surgeons benefit from improved ergonomics, better visualization, the ability to use multiple instruments, and enhanced …

Objective Oculomotor, Vestibular, Reaction Time, And Cognitive Signatures Of Vestibular Migraine, Claire E. J. Ceriani, Alexandr Braverman, Alexander Kiderman

Department of Neurology Faculty Papers

OBJECTIVE: To evaluate oculomotor, vestibular, reaction time, and cognitive (OVRT-C) function in patients with vestibular migraine (VM) using objective eye-tracking-based metrics and to identify patterns of dysfunction relative to healthy controls.

BACKGROUND: Vestibular migraine is a common yet underdiagnosed cause of vertigo. Diagnosis remains primarily clinical, because objective neurologic and vestibular findings are often absent or inconsistent. Quantitative methods capable of capturing the multisystem manifestations of VM may improve objective characterization of the disorder.

METHODS: Participants with a clinical diagnosis of vestibular migraine were recruited from a tertiary headache center and assessed using a battery of OVRT-C tests administered with …