Digital Commons Network^™

Prmt5 As A Key Driver Of Stemness And Metastatic Potential In Triple-Negative Breast Cancer, Jae Jin Jeong, Mauli Maniar, Shahrzad Ghane, Sakshi Deshpande, Claire Ellis, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Protein arginine methyltransferase 5 (PRMT5) mediates arginine methylation of a wide range of proteins and plays context-dependent oncogenic or tumor-suppressive roles. In cancer, PRMT5 represses several tumor suppressor genes, including E-cadherin, TP53BP1, ST7, PTEN, and RB (retinoblastoma). Elevated PRMT5 expression has been reported across multiple cancer types, notably triple-negative breast cancer (TNBC). In TNBC, high PRMT5 levels are associated with enhanced cancer stem cell self-renewal, increased tumor growth and metastasis, and reduced patient survival. Mechanistically, PRMT5 promotes breast cancer stem cell maintenance and proliferation through stabilization of the transcription factors KLF4 and KLF5. Disruption of the PRMT5-KLF4 axis results in …

Quality Improvement Project: Implementation Of The Patient Health Questionnaire-9 Modified For Teens, Hedy Gerber, Leah Buchko, Jennifer Van Winkle

All Faculty and Staff Scholarship

Background: Adolescent depression is a prevalent and significant public health concern, strongly linked to increased suicidality, poor health outcomes, impaired psychosocial functioning, and substantial societal costs. Although measurement‑based care using validated screening instruments is recommended by clinical practice guidelines, routine use of standardized depression screening tools remains limited in mental health settings.

Objective: The purpose of this quality improvement project was to assess the impact of implementing the Patient Health Questionnaire-9 modified for teens (PHQ-9M) in depression screening rates among adolescents aged 11-17 years at an outpatient mental health clinic in Southern Colorado.

Methods: A quantitative, quasi‑experimental pre- and post-intervention …

A Multilevel Analysis Of Hiv Care Outcomes Across Age, Race, And Housing Among United States Women Veterans, Giselle Day, Amber B Amspoker, Alan Z Sheinfil, Liang Chen, Emmanuel Guajardo, Maria E Fernandez, Cici Bauer, Irene Tamí-Maury, Jan Lindsay

Faculty, Staff and Students Publications

Background: Women veterans with HIV represent a growing, diverse population within the Veterans Health Administration (VHA). This study examined HIV care continuum outcomes among women veterans using a multilevel intersectional approach.

Methods: We conducted a retrospective analysis of 1154 women veterans with HIV in VHA care in fiscal year 2022, with outcomes assessed in fiscal year 2023. We applied Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate how combinations of social positions (age, race/ethnicity, housing status) were associated with HIV outcomes.

Results: MAIHDA models showed that younger age (< 45 years) and being unhoused were consistently associated with lower odds of care engagement and viral suppression than midlife (45-64) and older (65+) housed women veterans. Additionally, predicted probability analyses revealed distinct clustering patterns. Younger non-Hispanic White women consistently ranked among the lowest performing strata across all outcomes, while midlife and older Hispanic and non-Hispanic Black women veterans clustered among the highest. Variance Partition Coefficients from null models were modest (1.8-3.0%). Fully adjusted models showed no remaining between-stratum variance, suggesting that the included social positions explained the observed differences in our dataset.

Conclusions: These findings highlight disparities in HIV care …

Using United States Medicare Program Claims To Identify Reliable Measures Of Low Value Services Influenced By Primary Care Physician Decisions, Chris Fleming, Dmitriy Poznyak, Rhea E. Powell, Claire Erba, Eunhae Shin, Rui Wang, Claire Burkhart, Arkadipta Ghosh, Eugene C. Rich

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Low-value services (LVS) are those that “… provide little to no benefit to patients….”¹ Among an existing set of 31 LVS are invasive procedures not typically performed by primary care physicians (PCPs), and other LVS that may be commonly provided by specialists. To facilitate research on the role of primary care physicians in low-value care, we sought to identify the reliability of two subsets of LVS measures that are more directly subject to PCPs’ decisions. We refer to these as primary care adjacent (“PCA”) LVS measures.

METHODS: Retrospective observational cohort study to identify which of a 31-item LVS …

Quality Improvement Project: Impact Of Formalized Debriefing On Correctional Health Emergency Response, Angel Woody

Doctor of Nursing Practice Projects

Structured debriefing following medical emergencies has been identified as an evidence-based strategy to improve communication, reflective learning, and staff confidence within high-acuity healthcare settings. Inconsistent debriefing practices within correctional healthcare environments contributed to a gap in emergency response support and staff preparedness. The purpose of this quality improvement project was to evaluate whether implementation of a formalized debriefing protocol following medical emergencies impacted staff confidence during emergency response situations within a correctional healthcare setting. The project was guided by Bandura’s Self-Efficacy Theory and Lewin’s Change Theory. A quantitative one-group pretest-posttest quality improvement design was implemented in a county correctional healthcare …

The Transitional Liver Clinic: Study Protocol For A Stepped-Wedge Cluster Randomized Trial, Lindsay Yoder, Elliot B. Tapper, Richard S. Kalman, Mary Rinella, Nicole Bendin, Manisha Verma, Francis Pike, Naga Chalasani, Neha Nalumasu, Eric S. Orman

Einstein Health Papers

BACKGROUND: Patients with complications of advanced liver disease experience high rates of hospital readmission after discharge. Transitional care models have improved outcomes in other chronic conditions, but their efficacy in liver disease care remains uncertain. This randomized trial evaluates the effectiveness of a tailored transitional care model-the Transitional Liver Clinic (TLC)-in reducing readmissions, improving quality of life, and enhancing patient satisfaction for patients with advanced liver disease.

METHODS: This is a 45-month, stepped-wedge cluster randomized trial enrolling up to 1000 patients with advanced liver disease across 4 academic medical centers. Each site transitions from usual care to the TLC intervention …

Neddylation Maintains Oocyte Quality By Stabilizing Mitochondrial Transcription, Avery A Ahmed, Tessa E Steenwinkel, Bethany K Patton, Peixin Jiang, Matthew D Meyer, Jaspreet K Rishi, Mei Leng, Alexander B Saltzman, Elizabeth S Anaya, Momal Sharif, Laurie J Mckenzie, Laura Detti, Anna Malovannaya, Sean M Hartig, Stephanie A Pangas

Faculty, Staff and Students Publications

Age-related decline in oocyte quality increases the risk of infertility, miscarriage, and birth defects. Mitochondrial dysfunction is a key contributor to this decline. Here, we report that oocyte-specific deletion of Uba3, which encodes the catalytic subunit of the E1 NEDDylation-activating complex, causes sterility in mice. Fully grown, germinal vesicle–stage Uba3 conditional knockout oocytes exhibit mitochondrial dysfunction, including elevated reactive oxygen species, impaired oxidative phosphorylation, and depletion of mitochondrially encoded RNA transcripts. Proteomic analysis identified alterations in mitochondrial-associated proteins, including enrichment of mitochondrial matrix and respiratory chain components and reduced abundance of electron transport chain complexes. These defects were associated …

Protocol For Purifying And Sequencing Cell Subpopulations Based On Rna Fish Signal In Planaria, Mary Cathleen Mckinney, Jason A Morrison, Frederick G Mann, Dung M Vuu, Carolyn E Brewster, Kate E Hall, Blair W Benham-Pyle, Alejandro Sánchez Alvarado

Faculty, Staff and Students Publications

Isolation and characterization of rare cell types in non-model organisms present a challenge. Here, we provide a protocol to purify specific cells from planaria for downstream RNA sequencing. We employ a one-step dissociation and fixation method that avoids RNA-degrading formaldehyde. We label cells using RNA fluorescence in situ hybridization (RNA FISH) and flow sort to enrich sequencing reads from cells of interest for deeper biological insight.

For complete details on the use and execution of this protocol, please refer to Mann et al.1

Conformational Cycling Of The Wntless Transporter Drives Trafficking And Secretion Of Wnt Morphogens, Yunhui Ge, Taciani De Almeida Magalhaes, Hongjiang Wu, Dick J H Van Den Boomen, Thu Uyen Nguyen, Tongyi Dou, Gaya P Yadav, Sukyeong Lee, Zhao Wang, Andrew Lemoff, Xuemei Luo, Sumitha S Menon, Min Zhang, Jin Wang, Zhicheng Jin, Jiansen Jiang, Adrian Salic, Pengxiang Huang

Faculty, Staff and Students Publications

Wnt proteins are lipid-modified morphogens fundamental in development and disease. During Wnt biogenesis, the G-protein-coupled receptor (GPCR)-like transporter Wntless (WLS) escorts lipidated Wnts from the endoplasmic reticulum to the plasma membrane, then transfers them to extracellular carriers, forming active and soluble morphogen-carrier complexes. To dissect the mechanisms involved, we solve cryo-EM structures of Wnt-bound WLS and unliganded WLS, and perform structure-guided functional experiments. Wnts engage WLS via three conserved hairpins, which are all required for Wnt trafficking to the cell surface and carrier-mediated secretion. Wnt release from cells is driven by dramatic conformational changes in the WLS transmembrane domain, reminiscent …

3d Em Uncovers Mitochondrial Network Remodeling In Residual Triple Negative Breast Cancer After Conventional Chemotherapy Treatments, Mariah J Berner, Heather K Beasley, Benjamin Rodriguez, Audra Lane, Steven W Wall, Andrea G Marshall, Zer Vue, Larry Vang, Mokryun L Baek, Mason Killion, Faben Zeleke, Bryanna Shao, Dominique Parker, Autumn Peterson, Julie Sterling Rhoades, Lacey E Dobrolecki, Amber Crabtree, Annet Kirabo, Sepiso K Masenga, Prasanna Katti, Prasanna Venkhatesh, Chandravanu Dash, Michael T Lewis, Antentor Hinton, Gloria V Echeverria

Faculty, Staff and Students Publications

Mitochondria are hubs of metabolism and signaling. We previously demonstrated the importance of mitochondrial structure and function in chemotherapy-refractory triple-negative breast cancer (TNBC). Herein, we present the first 3D analysis of mitochondrial networks in human tumor tissues. Using serial block face scanning electron microscopy, we reconstructed 3,750 mitochondria and 800 lipid droplets (LDs) in naive and residual tumors persisting after conventional chemotherapies in two orthotopic patient-derived xenografts (PDX). Chemotherapies administered as monotherapy or in combination produced residual tumors that harbored mitochondria with significantly increased areas, volumes, and perimeters. We observed substantial reduction of mitochondrial intratumor heterogeneity following all treatments. Further, …

Targeting Arginine Metabolism Overcomes Chemotherapy Resistance In Aggressive-Variant Prostate Cancers, Elavarasan Subramani, Patrick G Pilié, Rebecca Slack-Tidwell, Paul V Viscuse, Xianghong Kuang, Thirukumaran Kandasamy, Dominik Awad, Jenny J Han, Licai Huang, Christine B Peterson, Amado J Zurita, Sumit K Subudhi, Paul G Corn, Rama Soundararajan, Peter Shepherd, Badrajee Piyarathna, Vasanta Putluri, Nagireddy Putluri, Arun Sreekumar, Yuzhuo Wang, Amina Zoubeidi, Iqbal Mahmud, Sara A Martinez, Lin Tan, Philip L Lorenzi, Sreyashi Basu, Sonali Jindal, Padmanee Sharma, Christopher J Logothetis, Timothy C Thompson, Daniel E Frigo, Ana M Aparicio

Faculty, Staff and Students Publications

Aggressive-variant prostate cancers (AVPCs) respond poorly to anti-androgen therapy but show sensitivity to taxane-platinum chemotherapy, though outcomes remain poor. We conducted a phase 2 trial testing induction cabazitaxel plus carboplatin (CabCarb) followed by olaparib maintenance versus observation in men with AVPC. The primary endpoint of improved progression-free survival (PFS) was not met, likely due to the study being underpowered after 38.5% of patients experienced early progression (ChemoPD) prior to randomization. No genomic alterations predicted ChemoPD; however, transcriptomic analysis revealed the enrichment of metabolic pathways, including arginine metabolism, in ChemoPD tumors. These findings were supported by metabolomics data from preclinical models. …

Targeted Inhibition Of Atr Kinase Promotes Antitumor Immunity In Hnscc Through Enhanced Sting Activation And T Cell Function, Fabio Hb Da Costa, Mutsuki Kawabe, Tsung-You Tsai, Kento Okamoto, Mason D Bartels, Sofia Cortes, Ratna Veeramachaneni, Roberto Rangel, Mitchell J Frederick, Vlad C Sandulache, Andrew G Sikora, Jeffrey N Myers, Abdullah A Osman

Faculty, Staff and Students Publications

Objectives: Oral cavity head and neck squamous cell carcinoma (HNSCC) represents a major global health burden, with over 40,000 new cases annually in the United States and >500,000 worldwide. Despite advances in surgery, radiation therapy, chemotherapy, and immunotherapy, overall survival rates have remained largely stagnant over the past three decades, and over half of patients ultimately die from the disease. Although immune checkpoint inhibitors (ICIs) have improved outcomes for a subset of patients with recurrent or metastatic HNSCC, the majority gain limited benefit. Thus, novel therapeutic strategies that enhance responses to immunotherapy are urgently needed. The ATR-CHK1 signaling pathway has …

Strategies For Improving The Drug Importation Control System In Thailand: A Qualitative Investigation, Neeranart Potiyanon, Suntaree Watcharadamrongkun

The Thai Journal of Pharmaceutical Sciences

Background: Drug importation plays a critical role in Thailand’s healthcare system; however, barriers affecting its regulatory control and their public health implications remain inadequately examined. This study compared international drug importation procedures and evaluated Thailand’s control system with strategies for improvement.
Methods: Conducted in Bangkok between 2020 and 2023, this two-phase study employed a qualitative design. Phase 1 involved content analysis comparing drug importation procedures across Thailand, Singapore, Australia and the United States to identify best practices and potential solutions. Phase 2 utilized semistructured, in-depth interviews with 19 key informants from government and private-sector agencies. Data collection was guided by …

Preparing Adjunct Clinical Instructors For Success: The Impact Of A Structured Orientation Program On Perceived Capabilities As Measured By The Capabilities Of Nurse Educators (Cone) Questionnaire, Amanda Stone

Doctor of Nursing Practice Projects

Adjunct clinical instructors are essential in helping nursing students connect classroom learning to real-world patient care. A needs assessment within an associate degree nursing (ADN) program identified that adjunct clinical instructors received only a brief overview of policies, contributing to role uncertainty and inconsistent preparation for clinical teaching responsibilities. Current literature supports the use of structured orientation and mentorship to better prepare nurses as they transition into clinical educator roles. The purpose of this quantitative, quasi-experimental quality improvement project was to evaluate the impact of a structured orientation program on adjunct clinical instructors’ perceived capabilities. Guided by the Plan-Do-Study-Act change …

Culturally Informed Approaches To Support Perinatal Mental Health: Perceptions And Experiences Of Perinatal Depression And Support Systems Among Postpartum African-Born Women In The United States, Joyce O. Imafidon

ETDs from 2020-2029

Perinatal mental health (PMH) of African-born women (ABW) is underrepresented in research and practice in the United States (US) despite known consequences of poor mental wellbeing on one’s overall health, relationships and productivity. Beyond their fundamental role in family support, ABW contribute significantly to the US workforce, education sector, and economy. This three-paper dissertation enhances understanding on PMH outcomes, perception and experiences of ABW in the US. Perinatal depression (PD), one of the most common mood disorders affecting 1 in 8 women, is highlighted. The overarching question is to what extent does the US health system address PMH of ABW …

Early Adoption Of Thyroid Radiofrequency Ablation In Canada: Physician Experiences, Barriers, And Facilitators To Implementation, Harrison Gao, David Liu, Ben B. Levy, Justin Shapiro, Kevin M. Higgins, Diana E. Khalil, Elizabeth E. Cottrill, Courtney Poon, Pabiththa Kamalraj, Justine Philteos, Antoine Eskander

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

IMPORTANCE: Thyroid radiofrequency ablation (RFA) is a minimally invasive alternative to surgery for thyroid nodules. Despite strong international evidence, thyroid RFA was only approved by Health Canada in April 2023. Understanding the experiences of early adopters can inform the broader adoption of RFA in Canada and other healthcare systems.

OBJECTIVE: To describe the implementation experiences of early adopters of thyroid RFA in Canada and identify barriers and facilitators to adoption.

DESIGN: Multiple methods.

SETTING: All 8 listed RFA facilities in Canada.

PARTICIPANTS: Physicians performing thyroid RFA (n = 9).

MAIN OUTCOME MEASURES: Survey and semi-structured interviews.

RESULTS: Most participants reported …

Non-Tobacco Nicotine Dependence Is Associated With Increased Complications Following Clavicle Open Reduction Internal Fixation, Akin A. Adio, Rahul K. Goyal, Abby Skiena, Mohammad Daher, John G. Horneff, Hafiz F. Kassam, Brian W. Hill, Joseph A. Abboud

Rothman Institute Papers

BACKGROUND: Tobacco dependence is well established to impair bone healing and increase postoperative complications. However, the independent effects of nicotine, separate from combustion-related factors, remain unclear. This study aimed to evaluate the impact of non-tobacco nicotine dependence (NTND) following open reduction and internal fixation (ORIF) of clavicle fractures, including midshaft and lateral fracture subtypes.

METHODS: A retrospective cohort study was performed using a large national database. Patients undergoing ORIF of clavicle fractures were identified using procedural and diagnostic codes. Patients with non-tobacco nicotine dependence (e.g., vaping, patches, or gum) were identified and propensity score matched to (1) patients without nicotine …

Isolated Polyhydramnios: Diagnosis Should Be Made Based On Both Elevated Afi And Elevated Mvp, Alessandro Petrecca, Vivian Nguyen, Lauren Bracken, Federica Bellussi, Suneet Chauhan, Tullio Ghi, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To evaluate which of the different sonographic definitions of isolated polyhydramnios (elevated amniotic fluid index [AFI] alone, elevated maximum vertical pocket [MVP] alone, or both elevated AFI and MVP) is best associated with adverse perinatal outcomes.

STUDY DESIGN: This retrospective case-control study included singleton pregnancies undergoing sonographic surveillance at a tertiary referral center between February 2021 and January 2026. Cases of isolated polyhydramnios identified during this time-period were compared with pregnancies with normal amniotic fluid volume from 2024. Polyhydramnios was categorized as elevated AFI only (AFI ≥24 cm), elevated MVP only (MVP ≥8 cm), or both elevated AFI and …

Fibulin-4 Expressed In Metastatic Breast Cancer Is A Target Of Peptide-Based Imaging Probes And Experimental Therapeutics, Alexes C Daquinag, Sukhen C Ghosh, Solmaz Aghaamiri, Stephen M Farmer, Sheng Zhang, Servando Hernandez Vargas, Ashwin K Ramesh, Zhiqiang An, Ali Azhdarinia, Mikhail G Kolonin

The Brown Foundation: Institute of Molecular Medicine

There is a lack of approaches to detect and kill metastatic cells. As an agent for metastasis targeting, a cyclic peptide BLMP6 has been previously characterized. As a step toward translation, we designed AZDye555-labeled BLMP6 and demonstrated its homing to metastases of human MDA-MB-231 cells in mice. We show that 68Ga-radiolabeled BLMP6 can be used for the detection of MDA-MB-231 metastases. We designed a peptide-drug conjugate consisting of monomethyl auristatin E (MMAE) and BLMP6. We show that MMAE-BLMP6 kills MDA-MB-231 cells in cell culture and in vivo. In mouse models of lung metastases, treatment with MMAE-BLMP6 suppressed metastasis growth …

Intrathecal (G4c2)149 Delivery In C9orf72-Deficient Mice Yields Mild Motor Dysfunction And Als/Ftd Pathological Hallmarks, Katelyn Russell, Amelia Shahrabi, Suleyman Akerman, Matthew D. Byrne, Jeffrey Rothstein, Davide Trotti, Brigid Jensen, Aaron Haeusler

Farber Institute for Neuroscience Faculty Papers

A repeat expansion in C9ORF72 is the most common genetic cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), yet existing mouse models incompletely engage spinal regions implicated in disease. Here, an adeno-associated virus encoding (G4C2)149 repeats was delivered via neonatal intrathecal injection, achieving widespread CNS expression with robust spinal cord targeting. This approach was applied to mice with graded loss of endogenous C9orf72 to interrogate both gain- and loss-of-function mechanisms. Longitudinal motor, behavioral, and pathological analyses revealed that repeat expression primarily drives mild, progressive muscle weakness, whereas coordination deficits were largely genotype dependent. Subtle gait abnormalities and hyperactivity …

A Multimodal Artificial Intelligence Model To Guide Use Of Whole-Pelvic Radiation Therapy In Patients With Localized Prostate Cancer: Exploratory Analysis Of Rtog 9413, Mutlay Sayan, Huei-Chung Huang, Erin L. Stewart, Timothy N. Showalter, Adam P. Dicker, George Daniel Grass, Elizabeth M. Gore, Andrew Michael Mcdonald, J. Daniel Pennington, Mark A. Hallman, Igor J. Barani, I-Chow Hsu, Michael Rooney, Stephanie L. Pugh, Paul L. Nguyen, Phuoc T. Tran, Mack Roach Iii

Department of Radiation Oncology Faculty Papers

Background/Objectives: This study explored whether a multimodal artificial intelligence (MMAI) model integrating digitized histopathology and clinical features can identify prostate cancer patients who may benefit from neoadjuvant hormonal therapy (NHT) and whole-pelvic radiotherapy (WPRT). Methods: This secondary analysis of NRG/RTOG 9413 included NHT-treated patients with digitized biopsy slides and clinical data who were not part of the MMAI model optimization. A previously validated MMAI model estimated long-term risk, and Fine-Gray models evaluated interactions between MMAI-derived scores and the radiation field (WPRT vs. prostate-only RT [PORT]) for biochemical failure (BF), chosen over progression-free survival because of extended follow-up and distant metastasis …

Qeith: Quantifies Tumor Ecosystem Heterogeneity To Predict Cancer Progression And Treatment Benefit, Qiqi Liu, Jiangti Luo, Jiawei Wang, Bangqi Zhao, Xiaosheng Wang, Linjun You

Faculty, Staff and Student Publications

Intratumor heterogeneity (ITH) is a fundamental driver of therapeutic failure and disease progression. However, the complexity of the tumor ecosystem is a critical yet underexplored aspect, making its precise quantification essential for fully deciphering ITH and its clinical implications. To address this, we developed Quantifying Ecosystem Intratumor Heterogeneity (QeITH), a computational framework that applies Shannon entropy to quantify ecosystem heterogeneity by measuring the diversity and distributional entropy of cellular compositions and functional states across single-cell, bulk, and spatial transcriptomics. At the single-cell resolution, QeITH identifies elevated ITH as intrinsic markers of malignant transformation, yet enhanced sensitivity to therapy. Pan-cancer bulk …

Macrophages As Gatekeepers Of Glioma Progression, Cliona M Rooney, Jasia Mahdi

Faculty, Staff and Students Publications

No abstract provided.

When “Mild” Isn’T Minor: Return-To-Work Challenges In Post-Stroke Mild Aphasia, Maya Berro

USF Tampa Graduate Theses and Dissertations

Return-to-work (RTW) is an important aspect of social participation and quality of life following stroke. However, limited research has explored the experiences of individuals with mild aphasia in the RTW process. This purpose of this qualitative study was to explore how individuals with post-stroke mild aphasia perceive their ability to RTW and identify factors that influence this process. Ten adults with mild or very mild aphasia participated in individual semi- structured interviews conducted via Microsoft Teams. Interview transcripts were analyzed using inductive thematic analysis. Three major themes emerged: (1) Barriers to RTW, (2) Facilitators to RTW, and (3) Perceptions of …

Staff Education To Enhance Knowledge Of Blood Culture Collection Technique To Reduce Blood Culture Contamination Rates, Whitney Ducharme

Walden Dissertations and Doctoral Studies

No abstract provided.

Antimicrobial Resistance In Pediatric Infections: Current Status, Challenges, And Future Directions, Clare Dinh, Keykavous Parang

Pharmacy Faculty Articles and Research

Background/Objectives: Antimicrobial resistance in pediatric infections presents a worsening global public health challenge, with antimicrobial resistance (AMR) accounting for more than one million deaths annually and disproportionately affecting children younger than 5 years of age. Neonates and critically ill children face heightened risk owing to immature immunity, frequent healthcare exposures, and limited therapeutic options. This review synthesizes evidence on the epidemiology, mechanisms of resistance, clinical outcomes, and management of AMR across the full pediatric age range. Methods: PubMed/MEDLINE and Google Scholar were searched for literature from 2014 to 2026 using terms covering antibiotic resistance, pediatric populations, and key …

Sputum Lautropia Is Decreased In Rheumatoid Arthritis-Associated Pulmonary Fibrosis, Timothy M. Wilson, Brendan Allen, J. Kirk Harris, Kristine A. Kuhn, Kevin D. Deane, Stephen M. Humphries, Joyce S. Lee, Joshua J. Solomon, M. Kristen Demoruelle

Division of Rheumatology Faculty Papers

OBJECTIVE: To investigate whether lung microbial composition differs between individuals with rheumatoid arthritis and pulmonary fibrosis (RA-PF) compared to those without fibrosis (RA-no-PF).

METHODS: We enrolled 54 RA patients (22 RA-PF, 32 RA-no-PF) from rheumatology and pulmonary clinics. PF was defined by high-resolution computed tomography (HRCT) findings. Induced sputum was analyzed using 16 S rRNA sequencing to identify the relative abundance of sputum bacteria. Taxonomic differences between groups were evaluated using three independent analytic approaches: Mann-Whitney U, DESeq2, and EdgeR, with false discovery rate correction. Logistic regression examined associations between Lautropia abundance and clinical variables.

RESULTS: Individuals with RA-PF were …

Management Algorithm For Vasoplegic Shock After Cardiac Surgery: An Interdisciplinary Collaboration, Subhasis Chatterjee, Jamel Ortoleva, Rakesh C Arora, Kelci R Dalton, Daniel T Engelman, Natalia Ivascu Girardi, Michael C Grant, Travis J Miles, Marc R Moon, Orlando R Suero, Erica Wittwer, Patrick M Wieruszewski

Faculty, Staff and Students Publications

Background: Vasoplegic shock is distributive shock that follows cardiopulmonary bypass, characterized by hypotension, low systemic vascular resistance, and catecholamine resistance despite preserved or elevated cardiac output. Reported incidence ranges from 5% to 50%. Associated adverse outcomes include acute kidney injury, prolonged intensive care unit stay, and mortality. A single, universally accepted consensus definition is lacking, and few evidence-based best-practice management strategies exist.

Methods: A panel of 12 clinicians-cardiac surgeons, anesthesiologists, intensivists, and pharmacists-from 6 institutions conducted a structured expert review. PubMed and Embase were searched for research studies, including clinical trials, retrospective analyses, and mechanistic studies covering epidemiology, risk factors, …

Detection, Persistence, And Rising Prevalence Of Oncogenic Viruses Revealed By Wastewater Metagenomics, Harihara Prakash, Ryan K Perez, Matt Ross, Michael Tisza, Sara J Javornik Cregeen, Jennifer Deegan, Joseph F Petrosino, Eric Boerwinkle, Justin R Clark, Anthony W Maresso

Faculty, Staff and Students Publications

Oncogenic viruses cause high-risk cancers in humans and are responsible for nearly 20% of all cancer cases worldwide. Currently, very limited data exist in the realm of wastewater-based viral epidemiology (WBE) for cancer-causing viruses, with existing studies using targeted approaches (i.e., PCR-based approaches) that lack genomic resolution. In this study, we used a hybrid-capture approach to detect, filter, and sequence all known oncogenic virus signals from wastewater samples collected over 3 years (May 2022-May 2025) in 16 Texas cities, covering nearly 25% of the state's population. Once sequenced, we used custom computational tools designed for wastewater metagenomics to assign reads …

Oral Cancer Numerical Index (Ocni): Development And Validation Of A Cytology-Based Risk Assessment For Oral Lesions, Michael P Mcrae, Nadarajah Vigneswaran, Alexander Ross Kerr, Spencer W Redding, Martin H Thornhill, Craig Murdoch, Paul M Speight, Rachelle Wolk, Kritika S Rajsri, Pooja Gaikwad, Nancy Ruel, Nicolaos J Christodoulides, John T Mcdevitt

Faculty, Staff and Student Publications

Background/Objectives: Oral potentially malignant disorders (OPMDs) require accurate risk stratification to identify patients at the highest risk for severe oral epithelial dysplasia (OED) or oral squamous cell carcinoma (OSCC). We developed and internally validated the oral cancer numerical index (OCNI), a quantitative risk score derived from clinical features and deep learning-based brush cytology measurements.

Methods: This retrospective model development and internal validation study was conducted using data from the multicenter Grand Opportunity study. Prospectively recruited subjects with OPMD with complete data were divided at the subject level into a training set (n = 384) and a holdout test set …