Digital Commons Network^™

What Factors Do Patients Consider When Choosing A Hand Surgeon?, Monik Debkowska, Jeremy Ruskin, Brian Lynch, Samuel Caradonna, David Komatsu, Edward Wang, Samantha Muhlrad

Introduction: Many patients find themselves frustrated wasting time and money when searching for the right hand specialist, only to be referred to a different one. There has been little research evaluating patient decision making when choosing a hand surgeon. Specialists would benefit from learning how to optimize their practice to reach their appropriate patient population for maximum benefit and minimum resource waste, both for the patients and physicians. We therefore conducted a survey study to evaluate which factors patients consider important when choosing a hand surgeon, and if these factors differ based on patient demographics. Our hypothesis is that patients …

Candida Albicans Purulent Pericarditis Complicated By Cardiac Tamponade In A Critically Ill Burn Patient: A Case Report, Mutaz Althobaiti, Abdulrahman Alqahtani, Faisal Alanazi, Mohammad S. Alotaibi, Ibrahim Bahabri, Shikah Alsuwaid, Turki Almutairi, Fawaz Almutairi

Journal of the Saudi Heart Association

Candida pericarditis is a rare, life-threatening complication of invasive candidiasis, associated with high mortality.

We report this case of a young woman with 60% body surface area burn, multidrug-resistant polymicrobial sepsis, and multiorgan failure who developed Candida albicans pericarditis complicated by cardiac tamponade. Despite urgent pericardiocentesis and escalation of antifungal therapy, she ultimately progressed to refractory shock and multiorgan failure.

This case illustrates the diagnostic challenge and therapeutic limitations of fungal pericarditis in critically ill host, and underscores the importance of maintaining a high index of suspicion in burn patients with multisite Candida colonization and prolonged antibiotic exposure.

Exploring Caregiving Choice In The Adult Cancer Population, Jennifer L. Huggins

MUSC Theses and Dissertations

ABSTRACT Purpose Although extensive research examines family caregivers (FCs) across populations, less attention has been paid to how lack of choice in assuming the role affects quality of life (QOL) among FCs of adults with cancer. Understanding choice could guide interventions protecting this invaluable, often invisible workforce. Aims (1) Synthesize what is known about perceived choice among informal caregivers of adults with serious illness; (2) assess relationships between caregiving choice and caregiver QOL, burden, sleep, depression, stress, and social determinants of health; (3) describe experiences of FCs of adults with cancer providing care with no, little, or some choice. Design …

Neural-Immune-Cardiovascular Axis: From Mechanistic Crosstalk To Therapeutic Targets In Cardiovascular Disease, Junkang Cheng, Shuang Gao, Haowei Zhang, Wei Gao, Zeyuan Mei, Xiaoling Liu, Jocelyn Gao, Chenghu Guo, Guipeng An

Student Papers, Posters & Projects

The neural-immune-cardiovascular axis represents an emerging and highly integrated physiological and pathophysiological concept, describing a complex bidirectional communication network between the nervous, immune, and vascular systems. This review systematically examines the pivotal role of this axis in maintaining cardiovascular homeostasis and in the pathogenesis of cardiovascular diseases. We first provide an overview of the fundamental signaling pathways between the components of this axis. Subsequently, we delve into the specific crosstalk mechanisms within the axis in the context of major cardiovascular conditions, including atherosclerosis, hypertension, and heart failure. A central focus is placed on critically evaluating the potential therapeutic targets and …

Barriers To Recommendation Of Integrative Oncology Modalities In Supportive Care: A Mascc/Sio Survey, Alexandre Chan, Dalia Kagramanov, Reem Nasr, Chioma Asuzu, Ting Bao, Yin Ting Cheung, Jung Hye Kwon, Judith Lacey, Richard T. Lee, Maryam Lustberg, Beatrice M. Ohaeri, Santosh Rao, Enrique Soto-Perez-De-Celis, Claudia M. Witt, Ana M. Lopez

Kimmel Cancer Center Faculty Papers

PURPOSE: Integrative oncology (IO) modalities aim to improve the quality of life of persons with cancer, including strategies to manage treatment and disease-related symptoms. As evidence increases to include IO in supportive care, interest grows globally. Understanding barriers to IO recommendation is key to facilitating its uptake.

METHODS: Members of the Multinational Association of Supportive Care in Cancer (MASCC) and the Society for Integrative Oncology (SIO) were invited to complete an online survey in Fall 2023 assessing barriers to IO recommendation on a 5-point scale. Descriptive statistics assessed demographic data and general counts of scaled agreement, while logistic regression analysis …

Wellness Literature Review – 2025, Martin Huecker, Brian A. Ferguson

Journal of Wellness

Introduction: Clinician well-being remains a persistent challenge, with ongoing burnout and psychological distress despite efforts by systems and individuals. This Journal of Wellness annual review covers studies published in 2025.

Methods: The Editors searched PubMed and Google Scholar for prospective and interventional studies / clinical trials in humans, with focus on well-being. Authors utilized artificial intelligence (AI)–based large language model (LLM) (ChatGPT, OpenAI^TM) to assist with preliminary identification of relevant studies, however authors noted significant AI-associated errors and outright misrepresentations requiring hand curated product generation and manual PubMed searches.

Literature in Review: We continue to appreciate a shift …

Rsv Can Infect The Human Nasal Epithelium Via The Basolateral Route And Shows Distinct Subgroup Infectivity And Basal Cell Tropism, Ashley Murray, Divya Nagaraj, Emily M Schultz, Gina Aloisio, Erin Nicholson, Sarah E Blutt, Vasanthi Avadhanula, Pedro A Piedra

Faculty, Staff and Students Publications

Respiratory syncytial virus (RSV) causes millions of lower respiratory tract infections (LRTIs) in young children, older adults, and immunocompromised populations every year. RSV infection initiates in the upper respiratory tract and can progress to the lower airways, resulting in bronchiolitis, pneumonia, and even death. RSV primarily infects epithelial cells apically, but we hypothesized that basolateral exposure of the respiratory epithelium could provide an alternative mechanism of infection that contributes to LRTI development. Using a human nose organoid-air-liquid interface (HNO-ALI) model, we performed apical and basolateral inoculations with contemporaneous RSV strains (RSV/A/Ontario [RSV/A/ON] and RSV/B/Buenos Aires [RSV/B/BA]) representing the two RSV …

Position Statement By The Saudi Heart Failure Working Group Of The Saudi Heart Association On The Management Of Advanced Heart Failure In Saudi Arabia, Ibrahim Jelaidan, Abeer Bakhsh, Ammar G. Chaudhary, Ebtisam Alkhattaby, Fahmi Alkaf, Feras Khaliel, Ismail Raslan, Mohammed Alreshidan, Mosaad Alhussein, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Heart failure (HF) is a leading cause of morbidity and mortality in Saudi Arabia. Despite remarkable progress in guideline-directed medical therapy, a significant proportion of patients progress to advanced HF and require evaluation for heart transplantation or mechanical circulatory support (MCS). In response to this growing burden, the Saudi Heart Association (SHA) developed recommendations to guide identification, timely referral, and optimal management of candidates for advanced HF therapies in Saudi Arabia.

Methods: A multidisciplinary panel of 10 HF experts from Saudi Arabia convened for a series of structured virtual meetings to review local and international evidence. The panel integrated …

Left Atrial Appendage Mimicking Coronary Aneurysm And Thrombus On Echocardiography In A Child With Kawasaki Disease, Anhar Ali Baeshen, Riad Abouzahr, Jameel Alata

Journal of the Saudi Heart Association

Background: The left atrial appendage (LAA) is an embryologically distinct structure with anatomical features that may mimic pathological findings on echocardiography. In Kawasaki disease, this resemblance can cause diagnostic confusion with coronary artery aneurysm or thrombus.

Clinical presentation: A 7-year-old boy presented with fever lasting more than five days and cervical lymphadenopathy following a viral illness. Kawasaki disease was suspected. Transthoracic echocardiography suggested an abnormality of the left coronary artery with possible thrombus, and the patient was started on aspirin, clopidogrel, and apixaban. Coronary computed tomography angiography demonstrated normal coronary origins, course, and caliber, confirming the suspected lesion to be …

Full Issue: Volume 4, Issue 1 - 2026

Bone Bulletin

i - Editors’ Note by Elijah Hoffman and Liam Gibbons

ii - Foreword by Dr. Alan Hilibrand

7 - Clinical Uncertainty in Digital Monitoring After Shoulder Arthroplasty by Abhi Pandey

10 - The Changing Value of Joint Arthroplasty Under the RVU System by Kiley Hamou

13 - SCALPEL TO ROBOT TO ALGORITHM: Robotics, Artificial Intelligence, and the Evolution of Spine Surgery by Mateja Stefanovic

18 - Suture-Free Nerve Repair in Upper-Extremity Surgery by Adam Gaughan

20 - The Impact of Wide-Awake Local Anesthesia No Tourniquet Surgery on Distal Radius Fracture Plating by Michael Carey

23 - Unicompartmental Versus Total Knee …

Biologic Adjuncts In Hand Surgery: Current Evidence, Limitations, And Clinical Implications, Joseph Kelly

Bone Bulletin

Introduction Biologic therapies such as platelet-rich plasma (PRP) and mesenchymal stem cell (MSC) based treatments, have gained substantial attention across orthopaedics as agents that may enhance tissue healing and modulate inflammation.^1,4 Their use has expanded in the management of degenerative joint disease, tendinopathies, and fracture nonunion across multiple subspecialties within the field.^1,3,6 Despite the developing research base, prior hand-focused reviews have noted that orthobiologics in hand surgery remains an underdeveloped area, leaving limited guidance available to inform clinical decision making.^1-2

Hazards For The Female Athlete: Disparities In Acl Injury Risk And The Evolving Research Base, Abby Skiena

Bone Bulletin

Introduction

Sex plays a significant role in sports medicine risk factors, but historically, there has been a lack of research involving female participants and investigating physiologic factors unique to female athletes.^1–4 Male athletes face a 2.26 times higher risk of hip and groin injuries, a 2.4 times higher risk of hamstring injuries, and a 1.8-2.8 times higher risk of acute fractures, especially in competitive situations.² Alternatively, female athletes experience a 2-8 times higher rate of anterior cruciate ligament (ACL) injuries, a 3.4 times higher risk of bone stress injuries, a 1.25 times higher rate of foot and ankle …

Outcomes In Robotic Knee Surgery, Tyler West

Bone Bulletin

Introduction

Total knee arthroplasty (TKA) is one of the most common orthopedic surgeries worldwide and is the mainstay for treating severe knee arthritis. In the United States, surgeons perform over 700,000 TKAs each year, and that number is expected to climb as osteoarthritis becomes more common in an aging population.^1,2 Roughly, two TKAs are completed for every one total hip arthroplasty (THA) and yet patient satisfaction after TKA has always lagged behind the THA.³ Hip replacements routinely see satisfaction rates above 90 percent.^2,3 For knees, however, satisfaction rates historically have fallen between 80 and 89 percent.^{4 …}

Conceptual Frameworks, Evolving Technology, And Common Misconceptions: How Orthopedic Hand Surgeons Choose Fracture Fixation Technique, Sudesh Jaisi

Bone Bulletin

Fracture fixation is often taught as a binary decision between operative and nonoperative management, which fails to reflect the complexity of real-world clinical decision-making. This article analyzes fracture fixation through a conceptual, fracture personality-based framework incorporating biomechanics, fracture characteristics, patient-specific factors, and evolving implant technology. Clinical decision-making is best understood as a spectrum of interventions, where multiple fixation strategies may be technically appropriate but differ in invasiveness, stability, complication risk, and functional recovery. Across representative fracture types, including distal radius and olecranon injuries, management is driven by fracture stability, anticipated behavior under physiologic load, and patient functional demands rather than …

The Impact Of Wide-Awake Local Anesthesia No Tourniquet Surgery On Distal Radius Fracture Plating, Michael Carey

Bone Bulletin

Introduction

The surgical technique known as wideawake local anesthesia no tourniquet (WALANT) has been widely used in soft tissue hand procedures since 2005.1 A local surgical field block using lidocaine with epinephrine provides local anesthesia and hemostasis via alpha-1 adrenergic agonism without the need for general anesthesia with a tourniquet. In addition to reducing costs related to general anesthesia (GA), WALANT procedures are suitable for American Society of Anesthesiologists Physical Status Classification 4 (ASA 4) high-risk patients, specifically by eliminating anesthesia risks such as nausea, aspiration, pneumonia, and thromboembolism, all while maintaining or improving clinical outcomes compared with the current …

Suture-Free Nerve Repair In Upper-Extremity Surgery, Adam Gaughan

Bone Bulletin

Introduction

Peripheral nerves have a limited capacity to regenerate.¹ Treating peripheral nerve injuries and the ensuing recovery of sensory and/or motor function are challenging for surgeons due to a number of variables that impact nerve recovery; including, the mechanism of nerve transection, the level or distance of injury relative to the target organ, patient age and comorbidities, and the repair technique employed. Most factors are not modifiable, but repair techniques are modifiable and can have a meaningful impact on outcomes. Nerve repair opt ions inc lude di r e ct end- to- end r epai r (neurorrhaphy), conduit-assisted repair, …

Clinical Uncertainty In Digital Monitoring After Shoulder Arthroplasty, Abhimaneu Pandey

Bone Bulletin

Introduction

Wearable sensor technology and smartphone based care platforms have been identified as promising technologies for postoperative care after joint arthroplasties.^1,2 In fact, in lower extremity arthroplasty, these technologies have already demonstrated their effectiveness in a multitude of randomized trials.^1,2 One recent multicenter RCT with 401 patients undergoing primary total knee arthroplasty (TKA) showed that self-directed rehabilitation using a smartwatch and mobile application (mymobility with Apple Watch, Zimmer Biomet) achieved comparable range of motion and patient-reported outcomes measures (PROMs) to standard post-operative rehab without increasing adverse events.¹ Related evidence also indicates that “episode of care” smartphone applications …

Editors' Note, Elijah Hoffman, Liam Gibbons

Bone Bulletin

It is our pleasure to present the fourth edition of the Bone Bulletin, DePalma Orthopaedic Society’s student-run journal for Sidney Kimmel Medical College (SKMC) students. The journal provides a unique opportunity for medical students to be involved with scholarly work in orthopaedics, often representing their first experience with orthopedic scholarship and academic writing. Through the journal, students gain valuable experience in orthopedic research and scientific writing with close mentorship from the renowned physicians of Rothman Orthopaedics.

Each year, the journal has grown in scope and impact, addressing new topics in orthopaedics. We are thrilled to introduce our new contributors …

Adult-Onset Iga Vasculitis Initially Attributed To A Cutaneous Drug Reaction And Diverticulitis, Leila C. Tou, Catherine Grace P. Hobayan, Shane Devine, Sarah Koraym

Journal of Community Hospital Internal Medicine Perspectives

Immunoglobulin A vasculitis (IgAV), formerly Henoch–Schönlein purpura, is a small-vessel vasculitis characterized by palpable purpura, arthralgias, gastrointestinal involvement, and renal disease. Although IgAV is common in children, adult-onset disease is rare and may be associated with more severe manifestations, particularly renal involvement. In adults, IgAV may be difficult to recognize because of overlap with more common gastrointestinal, infectious, or medication-related conditions. We present a case of adult-onset IgAV initially attributed to presumed diverticulitis and later to a drug eruption following antibiotic exposure. This case highlights diagnostic pitfalls and the importance of early recognition and renal surveillance.

From Villi To Alveoli: Lung Involvement In Celiac Disease – A Narrative Review, Mateusz Marzec, Patrycja Cecha

Journal of Community Hospital Internal Medicine Perspectives

Background:

Celiac disease (CD) is a chronic, immune-mediated enteropathy triggered by gluten that affects about 1% of the population and may present with extraintestinal manifestations. Pulmonary complications are considered rare and are poorly characterized. Lane-Hamilton syndrome is the best described lung manifestation, but data suggests a broader spectrum of respiratory involvement.

Methods:

We performed a narrative review with structured search strategy of PubMed and Embase (January 1, 1970 – December 1, 2025) using the terms celiac/coeliac and lung, pulmonary, respiratory, hemoptysis, hemosiderosis, alveolar hemorrhage, interstitial lung disease, alveolitis, bronchiectasis …

Correlation Between Aortic Valve Area Measured By Cardiac Computed Tomography And Transthoracic Echocardiography In Patients With Aortic Stenosis, Shehroz Sultan, Neeraj Joshi, Ali Haider Awan, Shabana Kauser, Hafsa Malik Aulakh, Bilal Ghafoor, Muhammad Ammar Ajmal, Abida Perveen, Jahanzeb Malik

Journal of Community Hospital Internal Medicine Perspectives

Background: Accurate assessment of aortic valve area (AVA) is essential for determining the severity of aortic stenosis (AS) and guiding clinical management. Transthoracic echocardiography (TTE) is the standard first-line imaging modality, while cardiac computed tomography (CT) provides direct anatomical planimetry and may offer complementary information in selected patients.

Objective: To evaluate the correlation and agreement between CT-derived and TTE-derived AVA measurements and to examine their association with clinical outcomes in patients with AS.

Methods: This single-center retrospective cohort study included 1,857 consecutive adults with moderate to severe AS who underwent both TTE and cardiac CT at the Rawalpindi Institute of …

Comparison Of Methods For Defatted Human Milk And Nutrient Composition: An Experimental Study, Kristin Cheng, Gina O'Toole, Stephanie Chang, Richard Chang, John Miklavcic

Food Science Faculty Articles and Research

Background

Human milk is considered the gold standard for infant nutrition; however, it is often discontinued in chylothorax and severe very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. As an alternative to complete human milk restriction, defatted human milk may be fed, though it may not fully support optimal infant growth and development. This study aimed to assess the micronutrient profile of defatted human milk.

Methods

Human milk was obtained from UCSD Human Milk Research Biorepository (San Diego, CA). Thirty samples representing 10 independent expressions in the morning, afternoon, and evening were pooled for analysis. Fat removal was performed by centrifugation at …

Less Frequent Versus More Frequent Cervical Examinations In Labor: A Systematic Review And Meta-Analysis, Alessandro Petrecca, Benedetta Bina, Chiara Tersigni, Tullio Ghi, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Digital cervical examinations are central to intrapartum care, yet their optimal frequency remains uncertain and is largely based on consensus rather than high-quality evidence.

OBJECTIVES: To compare less frequent versus more frequent cervical examinations during labor in terms of obstetrical, maternal and neonatal outcomes.

SEARCH STRATEGY: We searched Medline, Cochrane Library, EMBASE, PubMed Central, Scopus and ClinicalTrials.gov from inception to August 2025, without language or geographic restrictions. The review was registered in PROSPERO (CRD420251033729).

SELECTION CRITERIA: Randomized controlled trials comparing different frequencies of cervical examinations in term singleton pregnancies during labor were included.

DATA COLLECTION AND ANALYSIS: Two reviewers …

Assessing Current Non-Pharmacologic Pain Management Practices For Sickle Cell Disease In Adults, Shreya Kolipaka, Michelle Axe, Charmaine Wright, Stephanie Guarino

Student Papers, Posters & Projects

OBJECTIVES: Both acute and chronic pain caused by sickle cell disease (SCD) is often managed with opioid therapy despite limited evidence for long-term efficacy. Adequately managing SCD pain requires a comprehensive approach, incorporating both pharmacologic and non-pharmacologic interventions. In other conditions, peer-mentored group programs are effective in managing chronic pain; however, their role in SCD is not yet described. Our objective is to understand patients' current pharmacologic and non-pharmacologic SCD management practices as well as further exploring perspectives of pain related to SCD.

METHODS: Participants were interviewed using semi-structured format. Audio-recorded interviews were transcribed. Descriptive statistics and pain management modality …

Epilepsy-Associated Digenic Variants Affecting An Actin-Mitochondria-Glutamate Pathway Promote Seizure Susceptibility, Shenzhao Lu, Mengqi Ma, Shabab B Hannan, Mingxi Deng, Hu Chen, Zhijian Yu, Lindsey D Goodman, Haein Kim, Yun Zhao, Sandeep Kumar Dubey, Wen-Wen Lin, Xueyang Pan, Debdeep Dutta, Vishnu Anand Cuddapah, Jill A Rosenfeld, Xi Luo, Zhandong Liu, Joshua M Shulman, Hugo J Bellen

Faculty, Staff and Students Publications

Epilepsy affects approximately 50 million people worldwide, yet more than half of individuals with a presumed genetic cause still lack a molecular diagnosis despite the identification of over 1,000 monogenic epilepsy genes. This diagnostic gap is unlikely to be resolved by improved variant detection alone, suggesting that variants affecting the same biological pathway may combine to cause disease. By studying epilepsy-associated actin regulatory genes, we identified a conserved "actin-mitochondria-glutamate (AMG) pathway". We demonstrate that reduced actin polymerization promotes DRP1-mediated mitochondrial fission, increases reactive oxygen species (ROS) levels, and enhances glutamatergic transmission, leading to seizures. The glial innate immune pathway, a …

Clinical Characteristics, Microbiology, And In-Hospital Outcomes Of Infective Endocarditis At A Tertiary Cardiac Center In Saudi Arabia: A Retrospective Cohort Study, Hussain M. Alhassan, Zainab A. Al Hubail, Zahra Maruf Alshakhs, Sireen Omar Takrouni, Fatimah Alawi Al Hussain, Hussain Abdullah Alqahtani, Ammar Ahmed Binammar, Beenish Mukhtar, Muhammad Azam Shah

Journal of the Saudi Heart Association

Background: Infective endocarditis (IE) carries high morbidity and mortality, and its epidemiology in Saudi Arabia reflects a transition in which rheumatic and prosthetic valve disease coexist. Contemporary single-center data describing the clinical profile, microbiology, and in-hospital outcomes of IE in this setting remain limited.

Methods: We conducted a retrospective cohort study at a tertiary cardiac center in Riyadh, Saudi Arabia, including 102 patients with IE diagnosed between October 2020 and December 2024, classified using the modified Duke criteria. Variables were analyzed descriptively. Proportions are reported with 95% confidence intervals (CI; Wilson method) against the number of patients with available data, …

Aberrant Stat Signaling And T Cell Dysregulation Define A Targetable Pediatric Sepsis Endotype, Robert B. Lindell, Samir U. Sayed, Jose S. Campos Duran, Sydney A. Sheetz, Apoorva Babu, Montana S. Knight, Andrea A. Mauracher, Ceire A. Hay, Peyton E. Conrey, Julie C. Fitzgerald, Nadir Yehya, Stephen T. Famularo, Teresa Arroyo, Richard Tustin, Hossein Fazelinia, Edward M. Behrens, David T. Teachey, Lisa R. Forbes Satter, Alexandra F. Freeman, Jenna Re Bergerson, Steven M. Holland, Jennifer W. Leiding, Scott L. Weiss, Mark W. Hall, Deanne M. Taylor, Rui Feng, E. John Wherry, Nuala J. Meyer, Sarah E. Henrickson

Department of Pediatrics Faculty Papers

BACKGROUNDSepsis is a leading cause of morbidity and mortality in critically ill children, yet heterogeneous immune responses complicate the development of targeted therapies and the host immune factors driving sepsis pathobiology remain unclear.METHODSWe integrated deep immune phenotyping, plasma proteomics, single-cell transcriptomics, and phosphoflow cytometry in a prospective cohort of 88 critically ill children to elucidate the mechanisms underlying immune heterogeneity.RESULTSUnsupervised clustering of plasma cytokines identified 3 immunologic subgroups, including a high-severity group ("Group C") characterized by hypercytokinemia driven by IL-6 and IFN-γ. Group C exhibited distinct alterations in immune cell frequency and activation, with a strong association between hyperinflammatory cytokine …

Impact Of Non-Selective Beta-Blockers On Acute Kidney Injury Outcomes In Patients With Decompensated Cirrhosis, Simone Incicco, Kavish R Patidar, Adrià Juanola, Ann T Ma, Anna Barone, Anand V Kulkarni, José Luis Pérez Hernández, Sumeet K Asrani, Brian Wentworth, Carlo Alessandria, Nadia Abdelaaty Abdelkader, Yu Jun Wong, Qing Xie, Nikolaos T Pyrsopoulos, Sung-Eun Kim, Yasser Fouad, Aldo Torre, Eira Cerda Reyes, Javier Díaz-Ferrer, Rakhi Maiwall, Douglas A Simonetto, Maria Papp, Eric S Orman, Giovanni Perricone, Cristina Solé, Christian M Lange, Alberto Queiroz Farias, Gustavo Pereira, Sebastian Marciano, Paolo Caraceni, Thierry Thévenot, Nipun Verma, Jeong Han Kim, Julio D Vorobioff, Jacqueline Cordova-Gallardo, Vasilisa R Grechishnikova, Raoel Maan, Juan Pablo Roblero, Claudio Toledo, Stefania Gioia, Eduardo Fassio, Mónica Marino, Puria Nabilou, Victor Vargas, Manuela Merli, Luciana Lofego Goncalves, Liane Rabinowich, Aleksander Krag, Lorenz Balcar, Adrian Gadano, Francois Durand, Shiv K Sarin, Pere Ginès, Paolo Angeli, Elsa Solà, Salvatore Piano, International Club Of Ascites Global Aki Team

Faculty, Staff and Students Publications

Background & aims: Non-selective beta-blockers (NSBBs) are widely used to prevent decompensation in cirrhosis. Guidelines recommend discontinuing NSBBs in patients with cirrhosis and acute kidney injury (AKI), although this recommendation is based largely on expert opinion and limited evidence. We evaluated the impact of NSBB use on AKI outcomes in patients with cirrhosis.

Methods: This multicenter study enrolled patients hospitalized for decompensated cirrhosis and AKI. Data on NSBB treatment, including type, dose, and continuation, discontinuation, or tapering, were collected. Outcomes were compared between patients receiving and not receiving NSBBs and between those who discontinued/tapered and those who did not. Inverse …

A Systematic Literature Review Of Cvid Reveals Pervasive Detrimental Noninfectious Manifestations, Robert B Lindell, Samir U Sayed, Jose S Campos Duran, Sydney A Sheetz, Apoorva Babu, Montana S Knight, Andrea A Mauracher, Ceire A Hay, Peyton E Conrey, Julie C Fitzgerald, Nadir Yehya, Stephen T Famularo, Teresa Arroyo, Richard Tustin, Hossein Fazelinia, Edward M Behrens, David T Teachey, Lisa R Forbes Satter, Alexandra F Freeman, Jenna Re Bergerson, Steven M Holland, Jennifer W Leiding, Scott L Weiss, Mark W Hall, Deanne M Taylor, Rui Feng, E John Wherry, Nuala J Meyer, Sarah E Henrickson

Faculty, Staff and Students Publications

BACKGROUND

Sepsis is a leading cause of morbidity and mortality in critically ill children, yet heterogeneous immune responses complicate the development of targeted therapies and the host immune factors driving sepsis pathobiology remain unclear.

METHODS

We integrated deep immune phenotyping, plasma proteomics, single-cell transcriptomics, and phosphoflow cytometry in a prospective cohort of 88 critically ill children to elucidate the mechanisms underlying immune heterogeneity.

RESULTS

Unsupervised clustering of plasma cytokines identified 3 immunologic subgroups, including a high-severity group (“Group C”) characterized by hypercytokinemia driven by IL-6 and IFN-γ. Group C exhibited distinct alterations in immune cell frequency and activation, with a …

Strategies To Increase Attendance In Substance Use Disorder Group Treatment: Results From A Randomized Controlled Trial, Liliane Cambraia Windsor, Heather A Jones, Carla Ellis, Kennya Hooper, Andrea Rucker, Salma Musaad, Moses Okumu

Faculty, Staff and Students Publications

Background: Attendance in substance-use-disorder group-treatment is challenging with only 32% of patients attending at least one session (Substance Abuse and Mental Health Services Administration and Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2023 admissions to and discharges from substance use treatment services reported by single state agencies, Bethesda, 2025). The present study tested a set of strategies to increase group session attendance in Community Wise, an innovative evidence-based group-intervention delivered in harm-reduction-community-based agencies and designed to reduce alcohol and substance use among people with substance-use-disorders living in predominantly Black and disinvested communities. We examined: (1) …