Digital Commons Network^™

Greater Weekly Exercise Volume Is Associated With Lower Prevalence Of Metabolic Comorbidities, Psychiatric Conditions, And Exertional Symptoms In Youth Athletes Undergoing Pre-Participation Screening: An Observational Study, Grace Qiu, Seong Kyu Kim, Douglas Corsi, Alexander G. Hajduczok, Imran Masood, Daniel Underberg, Brian Osler, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

INTRODUCTION: Physical activity has been associated with improved cardiovascular health outcomes in adults. However, the specific associations between physical activity volume and cardiovascular outcomes in youth athletes are less defined.

METHODS: This study analyzed data from the HeartBytes National Youth Database, compiled from Simon's Heart. Simon's Heart is a nonprofit organization that includes information from sports pre-participation examinations for adolescents. The dataset encompasses demographics, electrocardiogram (ECG) findings, and exercise-related symptoms. Youth athletes' self-reported weekly physical activity volume was classified into four levels: < 2 h, 2-5 h, 5-10 h, and >10 h, with less than 2 h taken as the reference group. Given the physical diMerences among athletes …

Ct-Derived Epicardial Adipose Tissue Density And Its Association With Systemic Inflammation And Functional Impairment In Heart Failure With Preserved Ejection Fraction: A Prospective Cross-Sectional Study From Oman, Arif Albulushi, Ahmed Tawfek, Ahmed Basuoni

Journal of the Saudi Heart Association

Background: Heart failure with preserved ejection fraction (HFpEF) is strongly influenced by cardiometabolic comorbidity and systemic inflammation. Epicardial adipose tissue (EAT) is a biologically active visceral fat depot in direct contact with the myocardium, and CT-derived EAT density (attenuation) may reflect inflammatory adipose remodeling beyond adipose quantity alone. However, the clinical relevance of EAT density in HFpEF remains uncertain.

Objectives: To evaluate the association of CT-derived EAT density with systemic inflammatory biomarkers, functional capacity, health status, and echocardiographic indices of HFpEF severity in a prospective cross-sectional cohort.

Methods: In a prospective cross-sectional study conducted between January and July 2024 at …

Clinical Outcomes After Ulnar Collateral Ligament Reconstruction With Palmaris Longus Versus Gracilis Autograft In Baseball Players: A Cohort Analysis, Michael C. Ciccotti, Brooks Martino, Frank Cautela, Nathaniel Tchangou, Daniel Kwak, Eric Didomenico, Harrison S. Fellheimer, Christopher C. Dodson, Steven B. Cohen, Michael G. Ciccotti

Rothman Institute Papers

BACKGROUND: Ulnar collateral ligament (UCL) reconstruction (UCLR) is a common procedure for overhead athletes, particularly baseball players sustaining partial or full UCL tears. Palmaris longus (PL) and gracilis (GR) autografts are the most frequently used graft sources, yet limited data compare clinical outcomes in baseball athletes.

PURPOSE: To compare patient-reported outcomes after UCLR with PL versus GR autografts in baseball players.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent isolated UCLR with either PL or GR autograft and a minimum of 2 years of follow-up were identified. All reconstructions were performed using the Modified Jobe or …

Perspective On Lessons Not Learned: From Coley’S Toxins To Microbial Drug Delivery, Guidance For Institutional Review Boards (Irbs), Brian P. Hanley, Alejandro J. Betancourt, Gustavo Gross, Wilbur (Bo) Bowne

School of Medicine Publications

The bacterial and toxin methods of cancer treatment date back 130 years. This paradigm rests on nonspecific bacterial-toxin-generated immunotherapy. This high-risk oncology research is experiencing a renaissance of methods that are among the most effective yet. Glioblastomas and other resistant cancers are the modern touchpoint, because of remission history following sepsis. Spurred by recent research deaths, we discuss protocols IRBs should consider in live bacterial or synthetic immuno-stimulatory trials. Human systemic inflammatory response syndrome immunology is unique due to non-functioning SIGLEC-13 and 17, which control excessive Toll-like receptor 4 (TLR-4) signaling. This is not a technicality like human CD8+/CD4+ T …

Bi-Allelic Loss-Of-Function Variants In Tmem63b Cause Syndromic Surfactant Dysfunction Disorder, Sock Hoai Chan, Audra N Iness, Jill A Rosenfeld, Mir Reza Bekheirnia, Lindsay C Burrage, Matthew Hoi Kin Chau, Chaerish Eint Myet Chae Htoo, Eric C Kao, Shamika Ketkar, Wan Wan Lim, Xi Luo, Rifhan Mazlan, Elizabeth Mizerik, Kein Seong Mun, Kalyani R Patel, Lorraine Potocki, Christina K Rapp, Xavier Roca, Ana Saianda, Ignacio Iglesias-Serrano, Everlyn C Siew, Donald Yuhui Sim, David R Spielberg, Sok-Kun Tae, Jing Xian Teo, Julian Warfsmann, Fan Xia, Child-Eu Registry, Saumya S Jamuar, Ee Shien Tan, Matthias Griese, Weng Khong Lim, Meow-Keong Thong, Keren Machol

Faculty, Staff and Students Publications

Transmembrane protein 63B gene (TMEM63B) encodes a mechanosensitive ion channel expressed in alveolar type II epithelial cells, where it mediates stretch-induced surfactant secretion. While heterozygous gain-of-function variants in TMEM63B have been associated with developmental and epileptic encephalopathy, no human disorder has previously been linked to bi-allelic loss-of-function variants. Here, we report five individuals from four unrelated families with childhood interstitial lung disease and bi-allelic predicted loss-of-function variants in TMEM63B. Affected individuals presented with early-onset respiratory distress, chronic hypoxemia, and diffuse parenchymal lung abnormalities on chest imaging. One individual died in infancy, two underwent bilateral lung transplantation, and two require oxygen …

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

Holding Hands, Alexis Notarianni, Md

The Medicine Forum

My patient had already received the medications we reach for when patients are in pain and afraid — antiemetics, analgesics, and anxiolytics. The nasogastric tube was in place. What remained was not another intervention, but the simple act of being there.

My patient had been healthy until just months earlier, when his life changed abruptly. In the two hundred days since, illness had altered nearly every part of his body. Now he lay in bed in pain, breathing through a tracheostomy, receiving nutrition from a feeding tube. Tears streamed down his cheeks as he reached out and took my hand. …

The Intersection Of Ventilator Support And Hospice In Late Als Diagnosis, J. Marco Cipriaso, Md, Kenna Hawes, Md, Margot Noyelle, Md, Megan Cecchine, Md

The Medicine Forum

Amyotrophic lateral sclerosis (ALS) often leads to respiratory failure that can be treated with respiratory support in the form of tracheostomy plus invasive mechanical ventilation. It typically occurs late in the disease course, often allowing patients to adequately prepare by discussing their goals of care. We describe a case of a patient whose ALS was diagnosed after he had TMV initiated. As a result, the patient and family faced a daily decision on when to withdraw ventilator support, and he was unable to achieve his ultimate wish to die at home. We highlight this to recognize that serious illnesses with …

The Back Burn: A Case Report Of Mollaret’S Meningitis In A Young Male, Muneeba Ali, Md, Lubaba Mukhtar, Md, Warda Naqvi, Md, Joseph Hassey, Md, Muhammad Ayub, Md

The Medicine Forum

Mollaret’s syndrome, or benign recurrent aseptic meningitis, is a rare condition characterized by recurrent, self-limited episodes of aseptic meningitis. We present the case of a 49-year-old male with a past medical history of herpes meningitis as a teenager, who presented to the emergency department (ED) with a headache, and whose initial lumbar puncture results were consistent with viral meningitis. HSV-2 was detectable in cerebrospinal fluid (CSF) DNA by PCR but not detected on quantitative PCR. He was diagnosed with Mollaret’s meningitis, and all intravenous antiviral therapy was discontinued, with the patient making a full recovery. This case highlights the important …

Fever, Cytopenias, And Splenomegaly: A Hematologic Approach To Suspected Hlh In Autoimmune Liver Disease, Reed Firestone, Md, Ms

The Medicine Forum

Fever with cytopenias and splenomegaly raises concern for hematologic malignancy and hyperinflammatory syndromes such as hemophagocytic lymphohistiocytosis (HLH). Distinguishing these entities is critical, as management strategies differ significantly. In this report, we describe a 19-year-old male with autoimmune hepatitis–primary sclerosing cholangitis overlap who presented with one year of recurrent fevers, cytopenias, and splenomegaly. Extensive infectious and malignant workup, including PET imaging and bone marrow biopsy, were negative. HLH was considered; however, laboratory findings were inconsistent, including ferritin of 191 ng/mL and fibrinogen of 683 mg/dL. His course remained chronic and stable. The presentation was attributed to autoimmune liver disease with …

Delayed Immune-Related Ophthalmoplegia After Pembrolizumab Therapy: A Case Report, Mohammed Shah, Md, Smriti Nair, Md, Sarah Sulkowski, Md, Maheen Imran, Bs

The Medicine Forum

We present a case of Pembrolizumab-associated ophthalmoplegia in a patient with HNSCC who previously developed an immune checkpoint inhibitor associated hepatitis. Immune checkpoint inhibitor– associated ocular toxicities are rare, occurring in approximately <1% to 1.1% of treated patients.^1,2 This case highlights the diagnostic challenges of neuroophthalmic immune-related adverse events and the importance of prompt evaluation and immunosuppressive therapy.

Radiographic Imaging Of Power Injectable Medical Access Ports As A Supplemental Identification Tool, Nikhil Goyal, Md, Huy M. Do, Md, Alexandra P. Toscano, Bs, Lillian G. Spear, Bs Georgetown University, Lindsey A. Hazen, Rn, Les R. Folio, Do

The Medicine Forum

Medical access ports (MAPs) are implanted devices often used for intravenous administration of chemotherapeutic agents or contrast agents for CT or MR imaging. Improper MAP usage poses risk of catheter rupture; hence, proper identification and usage are essential. We demonstrate an approach for MAP identification based on their unique radiographic imaging features.

When It’S Not Gastroparesis: Isolated Idiopathic Acth Deficiency Presenting With Recurrent Gastrointestinal Symptoms, Navya Pendyala, Md, Ramya Pendyala, Md, Anna Mathew, Md, Beatriz Torre, Md, Christopher Henry, Md

The Medicine Forum

Adrenal insufficiency is an uncommon but important cause of nonspecific gastrointestinal symptoms. We present a 33-year-old male with recurrent nausea, vomiting, and presumed gastroparesis who was ultimately found to have isolated idiopathic ACTH deficiency after discordant diagnostic findings prompted further evaluation. His symptoms resolved rapidly with glucocorticoid replacement. This case highlights the importance of considering adrenal insufficiency in patients with unexplained gastrointestinal symptoms and systemic features despite negative structural work up and underscores the role of diagnostic anchoring in delayed diagnosis.

Occupational Hydrocarbon Exposure Presenting As Acute Hepatocellular Injury With Atypical Mitotic Figures On Liver Histopathology In An Oil Rig Worker: A Case Report, Hamzah Shariff, Md, Maria Averbuch, Do, Leanna Rucker, Md, Madison Force, Md, Dina Halegoua-De Marzio, Md

The Medicine Forum

Occupational exposure to hydrocarbons and aromatic solvents in the petroleum industry has been somewhat associated with hepatotoxicity, though the clinical manifestations and histologic features remain incompletely characterized. We present the case of a 33-year-old oil rig worker with prolonged occupational exposure to benzene and hydrocarbon compounds who presented with acute hepatocellular liver injury and concurrent biliary pathology. The patient presented with right upper quadrant pain, jaundice, and pale stools. Laboratory evaluation demonstrated marked hepatocellular injury with alanine aminotransferase (ALT) elevation to 1183 U/L and total bilirubin of 6 mg/dL. Extensive infectious, metabolic, and autoimmune evaluation was unrevealing. ANA and ASMA …

Lvad Patient With Delayed Family Involvement Due To Incarceration, J. Marco Cipriaso, Md, Kathleen Mechler, Md

The Medicine Forum

Left ventricular assist device (LVAD) placement requires an extensive support system for success. Patients who are incarcerated face unique challenges in achieving this due to prison rules. We describe a case in which an LVAD patient suffered a massive intracranial hemorrhage, leaving him unable to make his own decisions. Medical teams did not involve his family in admissions for his slow chronic decline, but family were asked to make decisions for him at this acute change causing them significant distress. We advocate that families of incarcerated patients be more routinely involved in provider communications and education related to their chronic …

Isolated Left Ventricle Apical Non-Compaction- A Diagnostic Conundrum, Trisha Sindhu, Md, Ranjita Sengupta, Md

The Medicine Forum

Left ventricular non-compaction (LVNC) cardiomyopathy is a rare myocardial disorder characterized by abnormal morphogenesis of the left ventricle (LV). It is typically associated with additional cardiac abnormalities and is most often diagnosed in childhood.¹ We present a unique case of isolated LVNC in a 42-year-old, physically active African American police officer. This case highlights an uncommon presentation of LVNC and underscores the variable specificity of current diagnostic criteria across diverse patient populations.³

The Medicine Forum: Volume 27

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 27, 2025-2026

TABLE OF CONTENTS

• Case Reports
• Letter to the Editor
• Research Studies
• Humanities & Reflections

Reducing Stress Through Low-Carbohydrate Nutrition Education In Emergency Department Staff – A Quality Improvement Project, Hassan Oman Gomar

Loma Linda University Electronic Theses, Dissertations & Projects

Introduction and Background

Emergency department staff often face job-related stress, which can lead to burnout, reduced compassion satisfaction, and adverse effects on patient care. Loma Linda University Health (LLUH) offers support programs, including Care for the Caregiver (C4C) and the Living Whole Employee Wellness program, that provide emotional and general wellness resources. While these programs are helpful, they do not offer practical solutions for everyday stress. There is a need for simple, lasting, and food-based ways to help staff manage stress and perform better. Recent research shows that eating patterns, especially high intake of processed carbohydrates, can alter energy and …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …

Comprehensive Assessment Of Direct And Passive Smoking Across The Pancreatitis Spectrum, Samuel Han, Dhiraj Yadav, Jun Xu, Melena D Bellin, William E Fisher, Evan L Fogel, Chris Forsmark, Phil A Hart, Liang Li, Stephen J Pandol, Walter G Park, Guru Trikudanathan, Stephen K Van Den Eeden, Santhi Swaroop Vege, Darwin L Conwell, Christie Y Jeon, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Students Publications

Objectives: Smoking is a key risk factor for pancreatitis, contributing to pathogenesis and disease progression. Data regarding second-hand smoking, or passive smoking (PS) exposure, are lacking. We therefore aimed to assess the impact of PS exposure across the pancreatitis spectrum.

Methods: We analyzed baseline data from the PROCEED study, a multicenter study in the United States including patients with acute (AP), recurrent acute (RAP), and chronic (CP) pancreatitis. Participants detailed their individual smoking history and PS exposure, which was compared between AP, RAP, and CP subgroups. Participant factors and clinical characteristics were compared by level of individual and PS exposure. …

Muscle–Tumor Crosstalk In Exercise Oncology: Exercise-Induced Myokines And Cancer Cachexia, Amirhossein Ahmadi Hekmatikar, Francesco Bettariga, Álvaro López Llorente, Diego Fernández-Lázaro, Katsuhiko Suzuki, D. Maryama Awang Daud

Research outputs 2022 to 2026

Exercise-induced myokines, such as IL-6, irisin, and myostatin, play crucial roles in mediating systemic adaptations and modulating tumor progression. This narrative review synthesizes evidence on how regular moderate-intensity exercise affects the myokine network within the tumor microenvironment (TME) of solid tumors. Results from the 86 included studies indicate that structured training (aerobic: 45–65% VO2 max; resistance: 45–70% 1RM) enhances the expression of beneficial myokines that support immune surveillance, reduce inflammation, and improve muscle–tumor cross-talk. IL-6 demonstrates a dual modulatory effect on inflammation and immunity; irisin contributes to tumor apoptosis, while myostatin downregulation supports muscle integrity and metabolic balance. Evidence suggests …

Healthcare Professionals’ Experiences And Perspectives On Self-Management Education For Breast Cancer Survivors In Australian Primary Care: A Qualitative Study, Meng Yuan Li, Tao Wang, Daniel Terry, Haiying Wang, Isabella Zhao, Jing Yu Tan

Research outputs 2022 to 2026

Purpose: Breast cancer has been recognised as a chronic condition, with survivors experiencing long-term physical and psychosocial effects following treatment. Supporting breast cancer survivors to self-manage their health can optimise health-related quality of life and reduce symptom burden. Self-management education (SME) has been advocated at the policy and programme level in Australian primary care, but its uptake is often limited. This study explores healthcare professionals’ (HCPs) experiences and perceptions of SME in primary care, aiming to identify factors influencing its implementation and to support survivorship care for breast cancer survivors in Australia.

Methods: A qualitative descriptive approach was adopted involving …

Myelomalacia Severity On Preoperative Magnetic Resonance Imaging Does Not Predict Patient-Reported Outcomes After Anterior Cervical Discectomy And Fusion, Mitchell K. Ng, Joshua Mathew, Robert J. Oris, Yulia Lee, Jonathan Dalton, Gregorio Baek, Ashley Thommana, William A. Green, Yasmine Eichbaum, Morgan Hitchner, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Paul Gunter, Vinay Bijoor, Andrew Vanchikorn, John J. Mangan, David I. Kaye, Mark F. Kurd, Thomas Cha, Jose A Canseco, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN/SETTING: Retrospective cohort study.

BACKGROUND: Signal changes within the spinal cord on magnetic resonance imaging (MRI) or myelomalacia, are frequently seen in patients with cervical myelopathy. While often assumed to predict the outcomes, their prognostic value remains uncertain. Therefore, this study aimed to: (1) describe the clinical characteristics of patients with myelomalacia undergoing Anterior cervical discectomy and fusion (ACDF); (2) evaluate whether MRI findings correlate with patient-reported outcomes (PROMs); and (3) determine whether morphology predict recovery.

METHODS: A retrospective review at a single tertiary care center was performed (2014-2021). Patients were included if they underwent a primary elective ACDF …

Not Just A Pediatric Condition: Down Syndrome Across The Lifespan., Emily Haury, Jacqueline Kitchen, Brenda Rogers

Manuscripts, Articles, Book Chapters and Other Papers

With increasing life expectancy for individuals with Down Syndrome (DS), there are growing numbers of adult DS patients needing care from primary care physicians who are knowledgeable regarding their health needs and risks. The Global Down Syndrome Foundation (GDSF) Medical Care Guidelines for Adults with Down Syndrome identify important areas of focus: mental health, dementia, diabetes, cardiovascular disease, obesity, osteoporosis, atlantoaxial instability, hypothyroidism and celiac disease. Additionally, there are unique considerations regarding cancer risk and screenings, as well as vaccination. Young adults with DS should have a structured transition from pediatric to adult care like any patient with chronic illness …

How To Tell A True Food Allergy From An Intolerance, Sarah Gubara, Aarti Pandya

Pediatrics in Practice: A CME Podcast

This episode explains the key history elements and symptom timeline that differentiate an IgE-mediated food allergy from an intolerance or sensitivity, so clinicians and parents can make safer, evidence-based decisions. Aarti Pandya, MD, Medical Director of the Food Allergy Center at Children’s Mercy, reviews symptom patterns, timing and red flags for anaphylaxis. Learn about food allergy testing, IgE-mediated food allergy, anaphylaxis action plan, epinephrine auto-injector, food intolerance and when testing is truly warranted.

Click here to stream the podcast episode.

Antibiotic Administration After Previable Preterm Prelabor Rupture Of Membranes Is Associated With Prolonged Latency, Alexandra L Hammerquist, Alexander M Saucedo, Selina L Bowler, Mohan Pammi, Catherine Eppes, Ignatia Van Den Veyver, Michael D Jochum, Enrico R Barrozo

Duncan NRI Faculty and Staff Publications

Introduction: While antibiotics have been shown to increase the interval to delivery between rupture of membranes and delivery (latency) and improve neonatal outcomes after viable preterm prelabor rupture of membranes (PPROM), this has not been well investigated in the previable PPROM population. We aimed to investigate the association between antenatal antibiotics and latency following previable PPROM. Secondarily, we examined various maternal and neonatal outcomes. We hypothesized that the administration of antibiotics would prolong latency in pregnancies with previable PPROM.

Methods: Single-center retrospective cohort study that included pregnancies diagnosed with previable PPROM between 140/7 and 216/7 and delivered between 2012 and …

Biphasic Sleep Is A Feature Of Sleep Disturbance In Syngap1-Rd, Aida Doucoure, Het Patel, Mark A Abboud, Alice Sperry, Sarah K Wanigatunga, Deana Crocetti, Heather Volk, Adam P Spira, Stewart H Mostofsky, Vaishnav Krishnan, Constance Smith-Hicks

Faculty, Staff and Students Publications

Study objectives: Sleep problems are common in children with SYNGAP1-Related Disorder (SYNGAP1-RD). The use of devices that objectively estimate sleep are complicated by co-occurring sensory disorders in this population. We examined the feasibility and validity of wrist actigraphy to examine sleep and rest-activity rhythms (RAR).

Methods: Data from five children with SYNGAP1-RD and 42 typically developing children were analyzed. All children were asked to wear the Actiwatch-2 for 14 continuous days and caregivers were asked to complete a sleep diary and the Children Sleep Health Questionnaire (CSHQ). Parametric (alpha, beta, acrophase, amplitude, up/down mesor, mesor), nonparametric (intradaily variability, interdaily stability, …

Longitudinal And Cross-Sectional Evidence That Daily Resting And Activity Energy Expenditures Are Independent In Humans, Andrew K Yegian, Elizabeth Pachus, Leanne M Redman, Steven B Heymsfield, K Falkenhain, Alexandra R Harris, Shaji K Chacko, William W Wong, Daniel E Lieberman

Faculty, Staff and Students Publications

Total energy expenditure (TEE) is commonly modelled as the sum of resting energy expenditure (REE), activity energy expenditure (AEE), and diet-induced thermogenesis (DIT). This additive model has recently been challenged by the constrained energy balance model, which proposes that reductions in mass-adjusted REE compensate to some extent for increases in AEE, rendering mass-adjusted TEE effectively invariant. We tested these competing models using two complementary approaches. First, we conducted a short-term longitudinal, repeated-measures experiment in 12 adults who completed 10-day periods of high and low physical activity separated by a washout period. TEE was measured with doubly labelled water, AEE with …

Na-Gst-1 Adsorbed On Alhydrogel Co-Administered With Different Toll-Like Receptor Agonists In Hookworm-Naive Adults Using A Controlled Human Infection Model In The Usa: A Phase 2, Double-Blind, Randomised Controlled Trial, Caroline K Dirosato, Elissa M Malkin, Sean M Lee, Guacyara Erwin, Lara Hoeweler, Larissa Scholte, Maria Elena Bottazzi, David I Pritchard, Peter J Hotez, Jeffrey M Bethony, David J Diemert

Faculty, Staff and Students Publications

Background: Necator americanus glutathione S-transferase-1 (Na-GST-1) performs a crucial enzymatic step in hookworm blood feeding and is a leading target for vaccine development. Phase 1 trials in Brazil, Gabon, and the USA of recombinant Na-GST-1 adsorbed on Alhydrogel (Na-GST-1/Al), co-administered with or without AP 10-701 (Toll-like receptor [TLR] 4 agonist) or CpG 10104 (TLR9 agonist), showed the vaccine was well tolerated, safe, and immunogenic. A controlled human hookworm infection (CHHI) model was previously developed to evaluate the effect of candidate hookworm vaccines on infection. We aimed to assess the effect of vaccination with three different Na-GST-1 vaccine formulations on subsequent …

A Nationwide Central Diagnosis For Pediatric Cns Tumors In Japan: The Jccg Brain Tumor And Pathology Committees, Yoshiko Nakano, Junko Hirato, Takako Yoshioka, Tetsuya Takimoto, Sumihito Nobusawa, Kaishi Satomi, Ran Tomomasa, Seiji Yamada, Taku Homma, Shoh Sasaki, Ayako Yamazaki, Maki Sakaguchi, Yasuhide Takeuchi, Nei Fukazawa, Kai Yamasaki, Kohei Fukuoka, Yui Shinohara Kimura, Yuki Nagayama, Yohei Inoue, Akira Miyahira, Ema Yoshioka, Asako Katsuma, Hayato Fukusumi, Tomoko Shofuda, Yuko Hibiya, Yuko Matsushita, Mai Honda Kitahara, Yuki Yomoda, Miho Kato, Michael D Taylor, Yasuhito Arai, Tatsuhiro Shibata, Hiroaki Sakamoto, Keita Terashima, Yoshiki Arakawa, Toshihiro Kumabe, Ryo Nishikawa, Junichi Hara, Yonehiro Kanemura, Koichi Ichimura

Faculty, Staff and Students Publications

In 2016, the Japan Children's Cancer Group launched a nationwide research initiative to provide central diagnosis incorporating pathology review and molecular profiling for pediatric central nervous system (CNS) tumors. Over the first eight years, 2224 cases were registered. Non-next-generation sequencing analyzes, such as pyrosequencing and NanoString, were routinely performed, mainly for glioma, medulloblastoma, and ependymoma. Additional analyzes, including methylation profiling and RNA sequencing, were conducted for selected diagnostically challenging cases. The most common diagnoses were low-grade glioma (26%), medulloblastoma (18%), germ cell tumor (16%), high-grade glioma (12%), and ependymoma (11%). Diagnostic or targetable alterations were detected in nearly half of …