Digital Commons Network^™

The Impact Of Genetic Testing On Physician Practice In Specialized Cardiovascular Clinics, Arsalan Hamid, Tyler Sewell, Sucheta Bhatt, Scott Spencer, Damon Hostin, Ginger A Metcalf, Richard A Gibbs, Vijay Nambi, Layla A Abushamat, Christie M Ballantyne

Faculty, Staff and Students Publications

Background: Although familial hypercholesterolemia (FH) is a US Centers for Disease Control and Prevention tier 1 condition for genetic testing, the impact of testing on clinical outcomes is unclear.

Objective: We aimed to assess whether genetic testing alters lipid management in HeartCare participants.

Methods: For participants with pathogenic/likely pathogenic variants for FH observed at Baylor College of Medicine cardiology clinics, data on laboratory values, medication prescriptions, and diagnoses were collected and compared before and after genetic testing.

Results: In the 20 participants with APOB/LDLR variants and complete data, low-density lipoprotein cholesterol (LDL-C) was numerically lower but not significantly different before …

Toward Scientific Rigor: Setting Standards For Indirect Calorimetry Analysis And Reporting, Elizabeth L Lieu, Mark A Herman, Sean M Hartig

Faculty, Staff and Students Publications

Indirect calorimetry determines energy expenditure by measuring respiratory gas exchange. The approach is based on the principle that nutrient metabolism consumes O2 and produces CO2 and water in predictable ratios that can be compared with heat production. Due to the impracticality and high cost of direct calorimetry, indirect calorimetry is the major approach for modern metabolic studies in preclinical models. Despite the broad adoption of this method in rodent phenotyping, the field has lacked standardized methods for analyzing, representing, and sharing these data, limiting scientific progress. The recent review in Nature Metabolism by the International Indirect Calorimetry Consensus Committee (IICCC) …

Comparing Observed With Self-Reported Hand Hygiene Adherence Among Bedside Nurses And Physicians At Two Hospitals In The United States, Prathit A Kulkarni, M Todd Greene, Sanjay Saint, Karen E Fowler, Serene Jacob, Laura Dillon, Michelle Espiritu, Nathan Houchens, Huberta T Cozart, Barbara W Trautner

Faculty, Staff and Students Publications

Background: Hand hygiene is a core component of infection prevention in healthcare settings. One potential reason for lack of adherence to recommended hand hygiene practices is erroneous self-perception. We aimed to compare perceptions about hand hygiene compliance with objective data.

Methods: Direct observations of hand hygiene performance by nurses and physicians during typical workflow in inpatient general medicine wards were conducted from 12 September 2022 to 27 October 2022 at two academic Veterans Affairs medical centers. Participants were surveyed regarding perceptions about their hand hygiene performance relative to recommended practices.

Results: Among nurses, hand hygiene was performed in 1,397/3,690 (37.9%) …

Distributed Battery-Free Bioelectronic Implants With Improved Network Power Transfer Efficiency Via Magnetoelectrics, Joshua E Woods, Fatima Alrashdan, Ellie C Chen, Wendy Tan, Mathews John, Lukas Jaworski, Drew Bernard, Allison Post, Angel Moctezuma-Ramirez, Abdelmotagaly Elgalad, Alexander G Steele, Sean M Barber, Philip J Horner, Amir H Faraji, Dimitry G Sayenko, Mehdi Razavi, Jacob T Robinson

Faculty, Staff and Students Publications

Networks of miniature implants could enable simultaneous sensing and stimulation at different locations in the body, such as the heart and central or peripheral nervous system. This capability would support precise disease tracking and treatment or enable prosthetic technologies with many degrees of freedom. However, wireless power and data transfer are often inefficient through biological tissues, particularly as the number of implanted devices increases. Here we show that magnetoelectric wireless data and power transfer supports a network of millimetre-sized bioelectronic implants in which system efficiency improves with additional devices. We demonstrate wireless, battery-free networks ranging from one to six implants, …

Nasopharyngeal Microbiome-Epigenome-Wide Association Analysis In Infants With Severe Bronchiolitis, Ryohei Shibata, Yijun Li, Anat Yaskolka Meir, Sara Javornik Cregeen, Matthew Clayton Ross, Janice A Espinola, Ashley F Sullivan, Liming Liang, Kohei Hasegawa, Carlos A Camargo, Zhaozhong Zhu

Faculty, Staff and Students Publications

Background: Bronchiolitis exposes infants to both acute burdens (e.g., hospitalization in cases of severe bronchiolitis) and increased risks for chronic respiratory sequelae (e.g., asthma). In severe bronchiolitis, recent evidence suggests distinct pathobiological roles of microbiota (e.g., viruses, bacteria) and host responses influenced by genetic and epigenetic factors. However, the relationship of airway microbiota with host DNA methylation (DNAm) in infants with severe bronchiolitis remains unknown.

Methods: In a multi-center prospective cohort of 504 multi-ethnic infants with severe bronchiolitis (age < 1 year), using nasopharyngeal microbiome (exposure) and blood DNAm (outcome, Infinium MethylationEPIC BeadChip, Illumina) data within 24 h of the hospitalization, we conducted microbiome-epigenome-wide association studies (mbEWAS). We examined microbiota-associated differentially methylated CpGs (mbDMCs, false discovery rate [FDR] < 0.05), regions (mbDMRs, FDR < 0.05), and DNAm age acceleration. We also determined the associations of DNAm age acceleration with asthma development by age 6 years. Furthermore, we focused on asthma-related pathogenic bacteria-Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae-for functional analyses by examining serum mbDMR-related proteins (Proseek Multiplex, Olink) and their enriched pathways (FDR < 0.10).

Results: Across 23 common taxa-observed at least in 25% of the infants, we identified 1 mbDMC (S. pneumoniae, cg16594639, chr20: 39528675) …

Linkage Disequilibrium Score Regression Identifies Genetic Correlations Between Hepatocellular Carcinoma And Clinically Relevant Traits, Younghun Han, Vikram R Shaw, Jinyoung Byun, Aaron P Thrift, Catherine Zhu, Donghui Li, Rikita I Hatia, Robin Kate Kelley, Sean P Cleary, Anna S Lok, Paige M Bracci, Jennifer B Permuth, Roxana Bucur, Jennifer Knox, Jian-Min Yuan, Amit G Singal, Prasun K Jalal, R Mark Ghobrial, Yuko Kono, Dimpy P Shah, Mindie H Nguyen, Neehar D Parikh, Richard Kim, Hui-Chen Wu, Hashem El-Serag, Ping Chang, Yun Shin Chun, Jian Gu, Chad Huff, Asif Rashid, Lu-Yu Hwang, Alison P Klein, Saira A Khaderi, Ahmed O Kaseb, Kathrine A Mcglynn, Lewis R Roberts, Manal M Hassan, Christopher I Amos

Faculty, Staff and Students Publications

Hepatocellular carcinoma (HCC) mortality is increasing globally, partly due to the growing prevalence of nonviral liver diseases. Genome-wide association studies (GWAS) have identified genetic variants associated with HCC development. Leveraging GWAS summary statistics and linkage disequilibrium score regression (LDSR), we investigated disease co-development with hepatitis C virus-negative (HCV-negative) HCC to provide unique insights into HCC etiology and prioritize relationships for further causal inquiry. We utilized the LDSR statistical framework to estimate the genetic correlation and heritability between HCV-negative HCC with 901 epidemiologic, behavioral, and clinical traits from the United Kingdom Biobank (UKBB). First, we set the threshold for observed scale …

Clinical Insights Into The Management Of Sleep Disturbances Within Cancer Care: A Qualitative Analysis, Sam Adams, Timothy D. Clay, Mitchell Turner, Christopher Kueh, Kelly Moes, Travis Cruickshank

Research outputs 2022 to 2026

Purpose: The present study aimed to gain a deeper understanding of how oncology healthcare professionals’ (HCPs) manage sleep disturbances. Methods: Semi-structured interviews were conducted with 10 oncology HCPs (medical oncologists, oncology nurse practitioners, clinical nurse consultants) working in metropolitan Perth, Western Australia. Reflexive thematic analysis was used to understand oncology HCPs’ perspectives on treating sleep disturbances, explore challenges and barriers to their management, as well as opportunities for improvement. Results: Four main themes were developed: (1) sleep disturbances are underreported and underassessed, (2) poor sleep can be difficult to manage, (3) limited capacity to address sleep issues, and (4) opportunities …

Vibostolimab Coformulated With Pembrolizumab Versus Pembrolizumab Alone As Adjuvant Therapy For High-Risk Stage Iib–Iv Melanoma (Keyvibe-010): A Randomised, Double-Blind, Phase 3 Study, Reinhard Dummer, Jun Guo, Jason J. Luke, Matteo S. Carlino, Dirk Schadendorf, Muhammad A. Khattak, Axel Hauschild, Paolo A. Ascierto, Yu Chen, Sang Joon Shin, Piotr Rutkowski, Zhiguo Luo, Jing Chen, Gareth Rivalland, Corlia Coetzee, Antoni Ribas, Karmele Mujika, Gal Markel, Rodrigo U. Villarroel, Omer Dizdar, Christian Caglevic, Dmitri Grebennik, Kevin Donovan, Clemens Krepler, Georgina V. Long

Research outputs 2022 to 2026

Background Combination therapy with vibostolimab plus pembrolizumab has previously shown promising antitumor activity in melanoma. We aimed to evaluate the efficacy and safety of vibostolimab coformulated with pembrolizumab as adjuvant therapy for high-risk resected melanoma. Methods This randomised, double-blind, phase 3 study was done at 205 global sites (hospitals and cancer centres). Participants aged 12 years or older with surgically resected, stage IIB–IV cutaneous melanoma per the American Joint Committee on Cancer Cancer Staging Manual 2017 (8th edition), with no evidence of metastatic disease after resection, were randomly assigned (1:1) to receive vibostolimab 200 mg coformulated with pembrolizumab 200 mg …

The Emerging Role Of Tertiary Lymphoid Structures As Predictive And Prognostic Biomarkers Of Immunotherapy In Cancer, Lidia B. Medhin, Rodas Amanuel, Lydia Warburton, Leslie Calapre, Benhur Amanuel, Elin S. Gray

Research outputs 2022 to 2026

Background: Immune checkpoint inhibitors (ICIs) have improved outcomes across several cancers, yet many patients do not respond, highlighting the need for robust predictive biomarkers. Tertiary lymphoid structures (TLS), ectopic lymphoid aggregates that support local antigen presentation and adaptive immune activation, have emerged as potential indicators of favourable prognosis and immunotherapy responsiveness. Methods: This review summarises current clinical and translational evidence examining the prognostic and predictive value of TLS in solid malignancies. Studies assessing TLS presence, organisation, and biological function were identified through searches of major scientific databases and evaluated with respect to their association with patient outcomes and responses to …

Reply To The Letter-To-Editor On Article "Evaluation Of Left Ventricular Function In Coronary Artery Ectasia: The Added Value Of 2d Speckle-Tracking Echocardiography", Osama Elshaer

Journal of the Saudi Heart Association

No abstract provided.

Aav Gene Therapy For Mps Iva With Induction Of Immune Tolerance Via Oral Administration Of Epitope Peptides Of N-Acetylgalactosamine-6-Sulfate Sulfatase, Sampurna Saikia, Yasuhiko Ago, Fnu Nidhi, Shaukat Khan, Zhengyu Ma, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is caused by the accumulation of undegraded glycosaminoglycans due to the deficiency of the N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme. MPS IVA manifests as progressive systemic skeletal dysplasia. Gene therapy (GT) is potentially a one-time treatment in which the enzyme is continuously produced, circulated, and delivered to target tissues. However, immune responses to gene products can diminish therapeutic efficacy. We hypothesized that oral delivery of tolerogenic peptides induces immune tolerance to human GALNS (hGALNS) in MPS IVA mice, enhancing therapeutic efficacy. Neonatal mice deficient in mouse GALNS (mGALNS) were treated orally with three T-cell/B-cell epitope peptides or hGALNS …

In Vitro Studies Of The Effects Of Antithrombotic Zn-Dipicolylamine-Harboring Liposomes (Dpals) On Serum Albumin And Human Umbilical Vein Endothelial Cells, Michelle Tanujaya, Gianna Cai, Jia Patel, Zana Moldavsky, Yumna Ejaz, Malia Mahazabin Ahmed, Sangsang Duong, Lawrence E. Goldfinger, Koon Y. Pak, Brian D. Gray, Parkson Lee-Gau Chong

Cardeza Foundation for Hematologic Research

Thrombosis remains a leading cause of cardiovascular morbidity and mortality. During thrombosis, activated platelets and endothelial cells expose phosphatidylserine (PS) on their outer membranes, creating a surface that accelerates clot formation. Current antithrombotic therapies, such as heparin and warfarin, carry significant bleeding risks, highlighting the need for safer alternatives. In response, we developed a PS-targeting liposomal formulation composed of Zn-dipicolylamine (DPA)-cyanine-3[22,22] and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (molar ratio 3:97). This DPA-harboring liposome (DPAL) binds selectively to PS-rich surfaces such as activated platelets and has demonstrated efficacy in reducing thrombosis in mouse models, with minimal bleeding. In the present study, we examined the interaction …

Aggregation Of Gene Regulatory Information And Knowledge On Fair Principles Enables Discovery Of Pathogenic Gene Regulatory Variants, Keyang Yu, Haoquan Zhao, Andrea S Wilderman, Tierra R Farris, Jessie E Arce, David Chen, Andrew R Jackson, Yiran Guo, Qi Li, Bosko Jevtic, Dubravka Jevtic, Vuk Milinovic, Yuankun Zhu, Jeremy Costanza, Eric D Wenger, Christopher Nemarich, Lisa Anderson, Aleksandar Mihajlović, Kristin Ardlie, Shaine A Morris, Matthew E Roth, Deanne M Taylor, Adam C Resnick, Lilei Zhang, Aleksandar Milosavljevic

Faculty, Staff and Students Publications

Motivation: Methods for sharing gene regulatory information and knowledge on FAIR principles, particularly in the context of tissue-specific gene regulation, remain poorly defined and implemented, hampering discovery and clinical genetic diagnosis.

Results: We specified FAIR principles for tissue-specific gene regulatory information and knowledge; implemented them by developing a registry of regulatory elements and aggregating FAIR gene regulatory information from several major sources; developed computational tools that utilize these FAIR resources; and demonstrated their utility by associating gene regulatory variants with major subtypes of congenital heart disease.

Benign Transient Hyperphosphatasemia In Adults: Case Report And Literature Review, Jose L. Rodriguez Castro, Grettel Gonzalez Garcia, Daniel Heller, Bernardo J. Reyes

HCA Healthcare Journal of Medicine

Background

Benign transient hyperphosphatasemia (BTH) in children is characterized by temporary highly elevated serum alkaline phosphatase (ALP) activity in the absence of liver or bone disease and a return to normal within 3 to 4 months. Since its first description in the 1950s, several cases of BTH in infants and children have been reported. Although there is no known etiology for this illness, it has been associated with viral infections. This condition has rarely been seen in the adult population, and there is scarce available information. The sialylation of the ALP isoenzymes decreases their renal clearance from the circulation; however, …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Braden Van Alfen, Navya Peddireddy, Marshall Hall, Henry Lim, Christian Scheufele, Garrett Furth, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Tinea corporis is a common superficial fungal infection caused by dermatophytes. It typically presents as well-defined, pruritic, annular papules and plaques with central hypopigmentation. The differential diagnosis includes pityriasis rosea, nummular dermatitis, plaque psoriasis, tinea versicolor, granuloma annulare, and discoid lupus. This article compares different presentations of tinea corporis in various skin types as classified by the Fitzpatrick scale. Recognizing varying presentations of tinea in patients of different skin tones will aid in early and appropriate diagnosis and treatment.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …

Impact Of Palliative Care Consultation On Clinical Interventions And Outcomes In A Medical-Surgical Community-Based Intensive Care Unit, Manjot S. Malhi, Jude Tabba, Aunie M. Danyalian, Michele Iguina, Daniel Zapata, Raiko Diaz, Dionne Morgan, Daniel Heller, Sanaz Kashan, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Integrating palliative care into intensive care unit (ICU) practice is an essential component of comprehensive patient management, ensuring that critical interventions are aligned with patient-centered care objectives. This study aims to evaluate the impact of palliative care consultation (PCC) on clinical interventions, patient outcomes, and decision-making processes in a community-based medical-surgical ICUs.

Methods

We conducted a prospective, observational, single-center cohort study of critically ill adult patients in a community-based medical-surgical ICU. Patients were grouped by the presence (PCCP) or absence (PCCA) of palliative care consultation. Primary outcomes included differences in clinical interventions (mechanical ventilation, vasoactive medications, renal replacement therapy, …

Replicability Of Highly Cited Comparative Studies In Orthopedic Journals, Cody Ashy, William E. Few, Gabriella A. Rivas, Emily Brennan, Langdon Hartsock, Kristoff R. Reid

HCA Healthcare Journal of Medicine

Introduction

Concerns are rising regarding the quality, validity, and reliability of clinical research findings in medical literature. This investigation sought to identify the most cited orthopedic clinical studies and assess the replicability of the findings reported.

Methods

Web of Science was used to identify the top ten orthopedic surgery journals by impact factor from which primary comparative studies cited at least 250 times were identified. A second literature search identified follow-up studies relevant to the respective primary studies. Studies investigating the same intervention via parallel methodology were summarized and their conclusions compared to their respective highly cited primary study.

Results …

Exploring The Effects Of Traumatic Brain Injuries On Cranial Nerve Injury, Caitlin J. Mcpartland, Michael J. Pienkos, Sarah E. Johnson, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Background

Traumatic brain injuries (TBI) are a significant and growing health issue, leading to over 200 000 hospitalizations annually in the United States. Cranial nerve (CN) injuries accompanying TBI can severely impact patients’ quality of life. This review aims to address the gap in research regarding the severity, mechanisms of injury, and associated intracranial injuries, emphasizing the importance of early detection and intervention.

Methods

A comprehensive literature search was conducted across databases such as PubMed and Ovid using key terms, including “cranial nerve injury,” “cranial nerve palsy,” “traumatic brain injury,” and “Glasgow Coma Scale.” Inclusion criteria encompassed studies reporting CN …

The Efficacy Of The Fitzpatrick Scale In Clinical Practice, Dana Olsen, Cecilia Nguyen, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Many skin diseases can manifest differently depending on the pigment of one’s skin. The Fitzpatrick scale is a classification of phototypes (I-VI) that categorizes patients' skin based on its ability to tan and burn. Even though it is a simple questionnaire, the Fitzpatrick scale has numerous criticisms due to its dependence on patients’ self-perception, variability in how questions are asked, limited range, and the underestimation of the risk of skin cancers. Alternatives to the Fitzpatrick scale include the melanin index, pigment protection factor, a visual color scale, and using artificial intelligence along with existing or new scales. Having a more …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

Comparison Of Ventilation Support During Laser Treatment Of Retinopathy Of Prematurity, Jason Peng, Raghav Taneja, Barry N. Wasserman, Krystal Hunter, Vineet Bhandari, Alla Kushnir

Wills Eye Hospital Papers

Highlights: What are the main findings? Preterm infants undergoing ROP laser surgery with routine elective intubation had significantly longer durations of post-operative mechanical ventilation. Routine intubation during this procedure did not improve short-term clinical outcomes, such as overall hospital length of stay or timing of laser intervention in the infant’s life. What are the implications of the main findings? Routine intubation strategies may unnecessarily increase exposure to mechanical ventilation without improving clinical outcomes. Standardization of perioperative intubation practices across hospitals may be needed to optimize respiratory support in this vulnerable population. Objective: To compare respiratory outcomes between infants undergoing retinopathy …

Exploring The Landscape Of Hair And Scalp Disorders In The Pediatric Skin Of Color Population: A Scoping Review, Nicole Baker, Simona A. Alomary, Jake H. Shapira, Cheryssa Hislop, Esther Zhang, Michelle Oboite, Temitayo Ogunleye

Department of Medicine Faculty Papers

No abstract provided.

Atypical High-Burden Breakthrough Varicella: A Diagnostic Pitfall In The Two-Dose Vaccine Era, Smaran Marupudi, Jared Hensley, Robert Vezzetti

School of Medicine Publications

We present the case of a seven-year-old fully immunized male who developed an intensely pruritic, generalized maculopapular rash that progressed to vesicles. The patient’s rash was initially diagnosed by his primary care provider as possible scabies and treated with topical permethrin. Our examination revealed a diffuse maculopapular and vesicular exanthem with lesions at various stages of evolution, eventually progressing to secondary cellulitis. The patient’s presentation, consistent with varicella (chickenpox), highlights the diagnostic challenges of breakthrough varicella infection and potential complications in fully vaccinated children. Thus, we highlight the importance of having a high clinical index of suspicion for varicella, even …

Endosteal Stem Cells At The Bone-Blood Interface: A Double-Edged Sword For Rapid Bone Formation: Bone Marrow Endosteal Stem Cells Provide A Robust Source Of Bone-Making Osteoblasts Both In Normal And Abnormal Bone Formation, Keita Kondo, Yuki Matsushita, Shion Orikasa, Yuta Nakai, Aiko Kuroda, Shinsuke Ohba, Wanida Ono, Noriaki Ono

Faculty, Staff and Student Publications

Endosteal stem cells are a subclass of bone marrow skeletal stem cell populations that are particularly important for rapid bone formation occurring in growth and regeneration. These stem cells are strategically located near the bone surface in a specialized microenvironment of the endosteal niche. These stem cells are abundant in young stages but eventually depleted and replaced by other stem cell types residing in a non-endosteal perisinusoidal niche. Single-cell molecular profiling and in vivo cell lineage analyses play key roles in discovering endosteal stem cells. Importantly, endosteal stem cells can transform into bone tumor-making cells when deleterious mutations occur in …

Bone Marrow Endosteum Houses Hedgehog-Susceptible Dlx5-Expressing Osteoblast Precursor Cells, Keita Kondo, Yuki Matsushita, Shion Orikasa, Yuta Nakai, Aiko Kuroda, Shinsuke Ohba, Wanida Ono, Noriaki Ono

Faculty, Staff and Student Publications

The bone marrow endosteum provides a robust source of bone-making osteoblasts by housing various types of osteoblast precursor cells, including endosteal stem cells expressing fibroblast growth factor receptor 3 (Fgfr3) and their downstream progenitor cell populations. In fetal bone development, Dlx5 marks early perichondrial cells that populate the diaphyseal bone and marrow stroma in the postnatal stages. However, the location of Dlx5-expressing cells in the postnatal bone marrow and how they contribute to osteogenesis remain undefined. Here, we show that Dlx5

A Patient-Needs Assessment In The Management Of Vestibular Schwannoma, Eric Martinez, Alexandra Jackson, Gavriel Kohlberg, Andy Saultz

Pacific Journal of Health

Background: Decision aids have evolved as a tool utilizing evidence-based information to help patients understand treatment options and are nascent in the field of neurotology. Vestibular schwannoma management consists of observation, microsurgery, and / or radiation. A decision aid has the potential to help patients understand treatment options regarding vestibular schwannomas while functioning in a patient-centered environment.

Objective: To conduct a patient needs assessment in the diagnosis and management of vestibular schwannoma to inform draft decision aid development.

Setting and Participants: Eight patients between 45 and 74 years of age who received a diagnosis of a unilateral vestibular schwannoma and …

Impella 5.5 Versus Heartmate 3 In Left Ventricular Unloading, Hannah Frederick, Douglas Tran, Erik Sorenson, H. Todd Massey, Albert Hicks, Manjula Ananthram, Bartley P. Griffith, Aakash Shah

The VAD Journal

The Impella 5.5 (Abiomed) is increasingly used as a bridge to durable left ventricular assist device (LVAD) implantation in advanced heart failure, yet most studies focus on survival and transition success rather than left ventricular (LV) unloading or valvular effects. This study addresses this gap by comparing Impella 5.5 and HeartMate 3 (HM3, Abbott) in terms of unloading and cardiac support at similar flow rates. We conducted a retrospective study of nine patients who received Impella 5.5 before HM3 implantation. The primary outcome was the degree of LV unloading, as assessed by changes in left ventricular end-diastolic diameter (LVEDD). There …

A Comparative Effectiveness Trial For Universal Psychosocial Screening With The Psychosocial Assessment Tool (Pat) Across 18 Childhood Cancer Programs In The United States: Adoption, Penetration, And Health Equity, Lamia P. Barakat, Michele A. Scialla, Nithyasri Ramaswamy, Janet A. Deatrick, Kamyar Arasteh, Eric Sandler, Shannon N. Hammer, Anne E. Kazak

Department of Pediatrics Faculty Papers

BACKGROUND: Universal, systematic psychosocial screening in childhood cancer assures care matched to need and achieves a Standard of Psychosocial Care. It is accomplished inconsistently due to barriers at the family, provider, and institution level, potentially contributing to disparities in care and outcomes. We conducted a comparative effectiveness trial of two implementation strategies of an established measure (Psychosocial Assessment Tool; PAT3.0) across 18 children's cancer programs to identify strategies that resulted in higher levels of screening in English and Spanish (penetration, health equity). We also examined uptake at the institution level (adoption).

METHODS: Sites were randomized to Strategy I (web-based training …

Frequency And Self-Reported Outcomes Of Transcranial Magnetic Stimulation For Obsessive Compulsive Disorder In The U.S. And Latin America, Hala Aziz, Guadalupe Vidal-Martinez, Ogechi C Onyeka, Jacey L Anderberg, Javier Vargas-Medrano, Diana Sotelo, Demi Kourtesi, Renee M Frederick, Josselyn S Muñoz, Dayan Berrones, Vanessa Zavala Cruz, Peter Thompson, Silvina Tonarelli, Andrew D Wiese, James J Crowley, Eric A Storch

Faculty, Staff and Students Publications

Introduction: Obsessive compulsive disorder (OCD) affects about 1-2% of the global population, with roughly 30% of patients not responding to first-line treatments. Transcranial Magnetic Stimulation (TMS) has some support for treatment-resistant OCD but global use is unclear.

Methods: This study describes the frequency with which TMS was reported to be received among a large cohort of individuals who self-identified as Latino-Hispanic in Latin America and the United States. Among 3,391 participants, 76 (2.2%) had completed TMS for OCD.

Results: Recipients who received TMS exhibited more severe current and lifetime OCD symptoms compared to non-recipients. On average, participants underwent 22.61 TMS …