Digital Commons Network^™

Divergent Humoral Immune Signatures In Response To Klebsiella Pneumoniae Bacteremia, Paeton L Wantuch, Nadia Wattad, David A Rosen

2020-Current year OA Pubs

OBJECTIVES: Klebsiella pneumoniae is an increasingly threatening global pathogen with high rates of antibiotic resistance and no licensed vaccines available. Despite its worldwide importance, little is known about the human adaptive immune response to K. pneumoniae infection.

METHODS: Herein we observed the longitudinal antibody responses of three immunocompetent patients hospitalized with K. pneumoniae bacteremia. We analyzed the human serum for antibody titers and in vitro functionality. Further, serum function was evaluated via an in vivo mouse model.

RESULTS: We found that in each case, anti-K. pneumoniae antibodies against the infecting strain were still detectable a year after the initial infection. …

Kawasaki Disease, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Ischemic Stroke As The Initial Presentation Of Advanced Pancreatic Adenocarcinoma: A Case Of Marantic Endocarditis., Micah Harris

Ambulatory and Primary Care Articles

Nonbacterial thrombotic endocarditis (NBTE), formerly known as marantic endocarditis, is a rare condition characterized by sterile vegetations on cardiac valves and is often associated with hypercoagulable states such as adenocarcinoma. We describe a patient who presented with multiple embolic cerebrovascular accidents, ultimately found to be secondary to NBTE, which served as the initial manifestation of previously undiagnosed advanced pancreatic adenocarcinoma. This case underscores the importance of considering NBTE in patients with multifocal embolic infarcts, particularly when blood cultures are negative, echocardiography reveals valvular abnormalities without evidence of infection, and clinical suspicion for an underlying malignancy is present.

Glomerular Disease In Patients With Acute Kidney Injury After Vancomycin Treatment-Need For Kidney Biopsy., Mineaki Kitamura, Pooya Zardoost, Anjali A Satoskar

Ambulatory and Primary Care Articles

No abstract provided.

Design And Implementation Of An Aapm Volunteer Database For Advancing Global Medical Physics Initiatives., Teh Lin, Minsun Kim, Courtney Morrison, Jiahan Zhang, Kevin Little, Yan-Hong Xin, Michael Woodward, Peter Sandwall, Eun Young Han

Oncology Articles

PURPOSE: The purpose of this study is to assess American Association of Physicists in Medicine (AAPM) members' availability to volunteer, share their expertise, and promote global collaboration in medical physics by partnering with international colleagues who seek support in strengthening their medical physics practice.

METHODS: The questionnaire was administered to AAPM members to assess their willingness to volunteer, preferred engagement modalities, and availability for different types of volunteer activities. The questionnaire was integrated into the AAPM member profile and covered therapy, diagnostic, and nuclear medicine disciplines, capturing participants' visiting preferences and expertise in teaching and training. Respondents were categorized based …

Cardiometabolic Parameter Change By Weight Regain On Tirzepatide Withdrawal In Adults With Obesity: A Post Hoc Analysis Of The Surmount-4 Trial, Deborah B Horn, Bruno Linetzky, Melanie J Davies, Luke J Laffin, Hui Wang, Madhumita A Murphy, Sarah Zimner-Rapuch, Eva Lau, Avigdor D Arad, Clare J Lee

Faculty, Staff and Student Publications

Importance: In the SURMOUNT-4 trial, most adults with obesity who had tirzepatide withdrawn following a 36-week treatment regained weight. The association between the degree of weight regain and cardiometabolic parameters after tirzepatide withdrawal is unknown.

Objective: To assess changes in cardiometabolic parameters by degree of weight regain after withdrawal of tirzepatide.

Design, setting, and participants: This post hoc analysis of the SURMOUNT-4 trial included tirzepatide-treated participants with 10% or greater weight reduction at week 36 initially randomized to placebo. Data were collected from March 2021 to May 2023, and data were analyzed from February 2024 to March 2025.

Interventions: After …

Role Of Childhood Trauma In Interoception And Alexithymia In Schizophrenia, Samantha Narvaez, Krista Wisner, Alina Siatka, L Elliot Hong, Joshua Chiappelli

Faculty, Staff and Student Publications

Childhood trauma (CT) is a notable risk factor for schizophrenia. Separately, CT has been associated with alexithymia, referring to difficulties in identifying and describing one's own feelings, as well as disturbed interoception, referring to difficulties sensing and responding to signals that originate from within the body. Both self-perception impairments have been observed in schizophrenia; however, the role of CT in these observations in schizophrenia is unclear. To address this gap, interoception was assessed using the Multidimensional Assessment of Interoceptive Awareness (MAIA), alexithymia was assessed using the Toronto Alexithymia Scale (TAS-20), and CT was measured using the Childhood Trauma Questionnaire (CTQ) …

Dopamine Agonist Therapy Induced Fatal Pneumocephalus In Giant Prolactinoma, Archana M H, Anurag Ranjan Lila, Manjiri Karlekar, Saba Samad Memon, Rohit Barnabas, Tushar Bandgar

Faculty, Staff and Student Publications

We report a man in the fifth decade of his life with an invasive giant prolactinoma (size: 7.3 cm; serum prolactin 56820 ng/mL [SI: 2470.4 nmol/L], reference range, 5-25 ng/mL [SI: 0.22-1.09 nmol/L]) who presented with hypogonadism and headache. Dopamine agonist (DA) cabergoline (0.25 mg twice weekly) was initiated, and serum prolactin levels reached 3941 ng/mL (SI: 171.3 nmol/L) after 2 doses. Two weeks later, he developed acute symptoms of headache, vomiting, and drowsiness associated with cerebrospinal fluid rhinorrhea. He presented to the casualty after 48 hours of the onset of these acute symptoms in an altered state. Neuroimaging demonstrated …

Cultural Influences On Camouflaging And Autistic Burnout: Examining The Experiences Of Latino Autistic Young Adults, Antonio F Pagán, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

The present study explored the relationship between camouflaging, autistic burnout, and cultural factors in Latino young adults with autism spectrum disorder (ASD). While autistic burnout and camouflaging have been widely studied in general ASD populations, limited research has focused on Latino individuals, who may experience unique pressures due to cultural values such as collectivism, familism, and traditional gender roles. Participants (N = 56) from the ¡Iniciando! la Adultez therapy program completed measures assessing burnout, camouflaging, acculturation, and cultural values. Results indicate that participants reported moderate to high levels of autistic burnout, with the highest levels observed in heightened self-awareness …

Monosaccharide Binding To Synthetic Carbohydrate Receptor Microarrays, Milan A. Shlain

Dissertations, Theses, and Capstone Projects

Chapter 1: A glycan detection platform comprised of synthetic carbohydrate receptors (SCRs) immobilized onto polymer brushes was prepared. SCR043, an alkene-containing SCR, was incorporated into grafted-from polymer brushes using hypersurface photolithography, resulting in microarrays of SCR043-functionalized polymer brushes, where brush height (h) and SCR grafting density (Γ) is controlled precisely at each feature in the array. The influence of h and Γ on the binding to five fluorescently labelled monosaccharides – α-glucose (α-Gluc-FL), α-galactose (α-Gal-FL), α-mannose (α-Man-FL), β-glucose (β-Gluc-FL), and β-galactose (β-Gal-FL) – in aqueous buffer …

Comment On ‘Muscle-Specific Strength Better Predicts Physical Performance Decline Than Conventional Metrics: The I-Lan Longitudinal Aging Study’ By Chien Et Al., Ricardo M. Lima, Anthony J. Blazevich

Research outputs 2022 to 2026

No abstract provided.

Demographic And Other Correlates Of Non-Prescription Drug Use Among College Students During The Covid-19 Pandemic, Subi Gandhi, Sidketa Fofana, Md Rafiul Islam, Tamer Oraby

School of Mathematical & Statistical Sciences Faculty Publications

Background and objectives: Substance use among college students in the U.S. remains a pressing concern and may have intensified during the COVID-19 pandemic due to increased stress, uncertainty, and academic disruptions. This study investigates the relationship between non-prescription drug use and various demographic, mental health, and behavioral factors among college students during the pandemic's early stages.

Methods: Data were collected through online and in-person surveys in the summer semester of 2021. Behavioral health was assessed using validated instruments: the Patient Health Questionnaire-9 (PHQ-9) for depression and the Drug Abuse Screening Test-20 (DAST-20) for substance use. Demographic and behavioral variables were …

Acute Otitis Media: Antibiotic Length, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Elevated Serum Lipopolysaccharides And Intrinsic Factor Autoantibodies Correlate With Macrocytic Anemia Among People With Hiv, Daniel Amakye, Samuel Hammond, Osbourne Quaye, Upal Roy, Peter Puplampu, Vincent Ganu, Emmanuel Ayitey Tagoe

Health & Biomedical Sciences Faculty Publications

Introduction: Human immunodeficiency virus (HIV) infection is associated with various comorbidities, including macrocytic anemia, though the role of the infection is unclear. HIV has been implicated in microbial translocation and altered immune responses. This study aimed to establish the relationship between gut microbial translocation and immune response, and macrocytic anemia among people with HIV (PWH).

Materials and methods: Fifty-five PWH on combination antiretroviral therapy (cART) were age-matched with 55 HIV-negative individuals. Demographic data and blood samples were collected from February to July 2023. Hematological indices, including red blood cell (RBC) count, hemoglobin concentration, and mean corpuscular volume (MCV), were measured. …

Intrapartum Experiences Of Gestational Surrogates And Intended Parents In Australia: A Qualitative Study, Jutharat Attawet, Leo Ng, Evie Kendal, Yunjing Qiu, Myles Ojabo, Sarah Jefford, Micah D.J. Peters

Research outputs 2022 to 2026

Background Gestational surrogacy is an increasingly visible, though tightly regulated, pathway to parenthood in Australia, yet intrapartum care remains under-examined. Existing maternity models are grounded in woman-centred care and offer limited guidance for births involving surrogates and intended parents within a triadic care relationship. Objectives To describe the intrapartum experiences of gestational surrogates and intended parents in Australia and to identify care processes that support or hinder respectful, inclusive practice. Methods A descriptive qualitative study was conducted with purposive sampling. Seventeen participants took part between December 2024 and May 2025, comprising nine gestational surrogates and eight intended parents who had …

Pediatric Pqct-Derived Tibial Bone Mineral Density Estimates: A Systematic Review And Meta-Regression, Anna Maria Markarian, Dennis R. Taaffe, Daniel A. Galvão, Jodie Cochrane Wilkie, Carolyn J. Peddle-Mcintyre, Mark Markarian, Daniel J. Schiferl, Robert U. Newton

Research outputs 2022 to 2026

Background: Assessing bone mineral density (BMD) in children and adolescents is essential for detecting skeletal deficits and fracture risk. Peripheral quantitative computed tomography (pQCT) has gained increasing attention as a valuable imaging tool due to its ability to assess bone quality. Unlike dual-energy x-ray absorptiometry, pQCT provides volumetric BMD measurements and distinguishes between cortical and trabecular compartments. Despite these advantages, its clinical adoption remains limited due to the lack of reference data and standardized protocols. Methods: A systematic search was conducted in CINAHL, Embase, PubMed, SPORTDiscus, and Web of Science from inception to November 2024. Studies reporting pQCT-derived tibial BMD …

Feasibility And Implementation Of Interval-Gap4: A Global Randomised Controlled Trial Of Intense Hybrid-Supervised/Self-Managed Versus Self-Directed Exercise For Metastatic Prostate Cancer, Stacey A. Kenfield, Nicolas H. Hart, Kerry S. Courneya, Rosemary Greenwood, June M. Chan, Jennette Sison, Li Zhang, Sarah Rudman, Leah Ung, Moritz Schumann, Erin L. Van Blarigan, Sam Mckeown, Charles J. Ryan, James Catto, Daniel A. Galvão, Robert U. Newton, Fred Saad

Research outputs 2022 to 2026

Background and objective: Physical activity is associated with a lower risk of mortality in men with prostate cancer (PC); yet, randomised controlled trials with survival endpoints are nonexistent. INTense ExeRcise for surviVAL-Global Action Plan 4 (INTERVAL-GAP4) was a global phase 3 trial designed to test whether structured, hybrid-supervised/self-managed exercise improves survival in men with metastatic PC. The trial was stopped early due to poor accrual. This paper reports feasibility and implementation outcomes. Methods: Men with metastatic PC were randomised (1:1) to a supervised/self-managed moderate- to high-intensity resistance and aerobic programme (three sessions per week for 2 yr) or to self-directed …

Making It Up As We Go: Midwives’ Perceptions Of Preparedness And Role Clarity In Surrogacy Birth Care, Jutharat Attawet, Leo Ng, Yunjing Qiu, Evie Kendal, Myles Ojabo, Sarah Jefford, Micah D.J. Peters

Research outputs 2022 to 2026

Background Surrogacy poses unique clinical, psychosocial, and organisational challenges. Midwives, often with limited experience, education, and guidance, may feel uncertain about providing appropriate care, potentially affecting the quality of care and experiences of surrogates, intended parents, and newborns. Objective This study explored how midwives navigate surrogacy birth care, with a focus on role clarity, involvement of intended parents, and preparedness across the intrapartum and postnatal continuum. Method An interpretative phenomenological design was adopted. Five midwives with experience in surrogacy births were recruited through professional networks and the Australian College of Midwives newsletter. In-depth interviews were conducted and analysed using reflexive …

Missed Care Prevalence And Associated Factors In Acute Care Settings: A Systematic Review And Meta-Analysis, Afia Achiaa Sarpong, Lucy Gent, Amanda Towell-Barnard, Diana Arabiat

Research outputs 2022 to 2026

Aim: The aim of the study was to comprehensively analyse the prevalence and factors associated with missed nursing care in acute care settings. Methods: A systematic review was conducted to estimate the prevalence of missed nursing care, types of activities missed and associated factors in acute care hospital settings. Five electronic databases (CINAHL, Embase, Medline, PubMed and Scopus) were searched from inception to 14th December 2022. Type of missed care and associated factors were classified based on missed care concepts, definition and measurement. Random effects meta-analysis was performed to estimate proportions and levels of types of nursing activities missed. Results: …

Peak Lower Limb Joint Angles Are Weak Predictors Of Hamstring Length Change During Sprinting, Shayne Vial, Jodie Cochrane Wilkie, Anthony J. Blazevich, Daniel Kadlec

Research outputs 2022 to 2026

Non-contact hamstring injuries (HSIs) commonly occur during the late swing phase of sprinting, when muscle–tendon units (MTUs) approach maximum length. Although sagittal-plane pelvis, hip and knee angles are often used as surrogate measures of overall hamstring lengthening, their predictive validity remains uncertain. This study investigated whether peak three-dimensional lower limb joint angles predict length change in the biarticular hamstring MTUs from peak hip flexion through to toe off (0–100 %) in fourteen intermediate-level male soccer players sprinting at maximal speed (8.56 ± 0.47 m·s−1). Participant-specific musculoskeletal models were used to compute MTU lengths for the biceps femoris long head (BFlh), …

Back-On-Track: Protocol For Randomised Controlled Feasibility Trial Of Behavioural Activation In Farmers With Mood Problems, Alison Kennedy, Richard Gray, Martin Jones, Anna Greene, Lauren Mitchell, Meera Senthuren, Suzy Malseed, Feby Savira, Kelly Barnes, Kate Gunn, Susan Brumby

Research outputs 2022 to 2026

The mental health of people living in farming communities has been identified as an important public health issue. Cumulative exposure to a range of situational factors contributes to heightened risk of poor mental health and suicide. Access to evidence-based psychological treatments is limited by the availability of skilled mental health professionals. The aim of this trial—co-designed by members of the farming community—is to establish the feasibility of conducting randomised controlled, trial-testing, peer-worker-delivered Behavioural Activation in the farming community. We will undertake a single-blind, parallel group, randomised controlled feasibility trial in rural Australia. People living in farming communities aged over 15 …

Carbohydrate Restriction Drives Greater Perturbations In Circulating Metabolites Than Low Energy Availability In Elite Male Athletes, Kyle A. Dunlop, Nathan G. Lawler, Jamie Whitfield, Alannah K.A. Mckay, Nicolin Tee, Megan L. Ross, Stacey N. Reinke, John A. Hawley, David Broadhurst, Louise M. Burke

Research outputs 2022 to 2026

Periods of low energy availability (LEA) are common in elite athletes and typically arise from reduced energy intake, often involving some degree of carbohydrate (CHO) restriction. Whether the metabolic profile created by energy restriction per se is distinct compared to that driven by CHO restriction is unknown. Using untargeted metabolomics, we examined metabolic perturbations linked to CHO restriction and energy restriction in plasma from elite male endurance athletes. In a semi-randomized controlled trial, athletes (n = 20) completed one of three 5-day dietary interventions: high energy-high CHO (HCHO); LEA (energy-restricted, CHO-reduced); or low-CHO, high-fat (LCHF; energy-matched, CHO-restricted). Plasma samples were …

A Systemic Selective Modified Mrna Delivery Platform For Preventing Chemotherapy-Induced Cardiotoxicity, Jimeen Yoo, Mengcheng Shen, Et Al.

2020-Current year OA Pubs

Doxorubicin (Dox) is a widely employed chemotherapeutic agent, but its use is clinically limited by dose-accumulative cardiotoxicity. More specifically, Dox induces oxidative stress and causes pro-apoptotic ceramide accumulation in cardiomyocytes (CMs). Acid ceramidase (AC) modified mRNA (modRNA) has been shown to reduce ceramide levels and protect the heart following ischemic injury; however, therapeutic modRNA applications have been hindered by the need for invasive delivery. Here, we present a platform for minimally intrusive transmission of modRNA to the heart. This CM-selective modRNA translational system (cmSMRTs) is encapsulated in lipid nanoparticles for intravenous (IV) delivery to enable systemic administration with high cardiac …

Neural Cells Are Susceptible To Historic And Recently Emerged Oropouche Virus Strains, Kaleigh A. Connors, Maris R. Pedlow, Zachary D. Frey, Marjorie Cornejo Pontelli, Sean P. J. Whelan, W. Paul Duprex, Leonardo D'Aiuto, Zachary P. Wills, Amy L. Hartman

2020-Current year OA Pubs

Oropouche fever is a re-emerging global viral threat caused by infection with Oropouche virus (OROV). While disease is generally self-limiting, historical and recent reports of neurologic involvement highlight the importance of understanding the neuropathogenesis of OROV. In this study, we characterize viral replication kinetics in neurons, microglia, and astrocytes derived from immortalized, primary, and induced pluripotent stem cell-derived cells, which are all permissive to infection with the prototypic OROV BeAn19991. We demonstrate cell-type dependent replication kinetics with both historic and recently emerged viral strains. Further, we show that ex vivo rat brain slice cultures can be infected by all OROV …

Serine/Threonine Protein Kinase Phosphorylation Of Dosr Alters Target Gene Transcription Mechanics And Regulates Mycobacterium Tuberculosis Response To Nitric Oxide Stress, Natalie R. Sontag, Ana Ruiz Manzano, Alwyn M. V. Ecker, Eric A. Galburt, Shumin Tan

2020-Current year OA Pubs

Successful host colonization by bacterial pathogens requires appropriate response and adaptation to environmental signals encountered during infection, with two-component systems (TCSs) and serine/threonine protein kinases (STPKs) being two important signal transduction mechanisms. Mycobacterium tuberculosis (Mtb) possesses similar numbers of STPKs (11) and TCSs (12), but if and how these two regulatory systems coordinate to enable Mtb adaptation in response to key environmental cues remains poorly understood. Here, we identify extensive interactions between STPKs and TCSs, with a subset of STPKs demonstrating interactions with multiple TCS response regulators. STPK phosphorylation of purified DosR, the response regulator of the key nitric oxide …

Plasma Ceramides Levels In Severe Covid-19 Disease: Correlations With Survival, Tri Pham, Andrea M Heredia Castillo, Andrew Atkinson, Linda R Peterson, M Cristina Vazquez Guillamet

2020-Current year OA Pubs

BACKGROUND: Dysregulated inflammatory processes have been associated with severe COVID-19 disease. Ceramides, bioactive lipids involved in inflammatory signaling, have been utilized to predict outcomes in chronic cardiometabolic diseases and pancreatic cancer, but their role in COVID-19 remains unknown.

METHODS: This observational study prospectively enrolled patients with COVID-19 disease who required intubation and mechanical ventilation at a Midwestern academic hospital between August 2020 and March 2021. Plasma ceramides 16:0 (C16), 22:0 (C22), and 24:0 (C24) and inflammatory markers (CRP, ESR, D-Dimer, and ferritin) were collected and organized weekly from symptom onset for up to 6 weeks. Patients were grouped by in-hospital …

Nested Ecosystems Theory For Conceptualizing Brain Tumors, Lori A Forster, David H Gutmann

2020-Current year OA Pubs

The application of advanced multi-omic methodologies to studying brain tumors has culminated in the appreciation that these cancers function as ecosystems that depend on the interactions of a diverse collection of cell types and signals. This connectivity operates not only at the level of the cancer cell, in which variants create new growth dependencies, but also between tumor cells and the immediate tumor microenvironment, between tumor cells and cell populations residing elsewhere in the brain tissue or body, and in response to extracorporeal factors. The cellular and molecular relationships within these four interrelated strata (intracellular, extracellular, intracorporeal and extracorporeal) act …

Palbociclib With Adjuvant Endocrine Therapy In Early Breast Cancer: 5-Year Follow-Up Analysis Of The Global Multicenter, Open-Label, Randomized Phase Iii Pallas Trial (Abcsg-42/Aft-05/Pre0109/Big-14-13), E L Mayer, K Clifton, Et Al.

2020-Current year OA Pubs

BACKGROUND: In the phase III PALLAS trial, the addition of 2 years of palbociclib to adjuvant endocrine therapy (ET) did not improve short-term invasive disease-free survival (iDFS) compared with ET alone in high-risk early-stage hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. In this article, we report 5-year efficacy outcomes, including updated iDFS and overall survival (OS).

PATIENTS AND METHODS: PALLAS is an international, open-label, randomized phase III trial evaluating the addition of 2 years of palbociclib to adjuvant ET in patients with stage II-III HR-positive/HER2-negative breast cancer. The primary endpoint was iDFS.

RESULTS: The trial enrolled …

Ultrasound Applications In The Treatment Of Major Depressive Disorder: A Systematic Review Of Techniques And Therapeutic Potentials In Clinical Trials And Animal Model Studies, Gansheng Tan, Hong Chen, Eric C Leuthardt

2020-Current year OA Pubs

OBJECTIVE: Major depressive disorder (MDD) is a debilitating condition that inflicts significant personal and economic burdens and affects approximately 8% of the US population. Approximately 30% of patients with MDD do not respond to conventional antidepressant and psychotherapeutic treatments. Current treatment options for refractory MDD include transcranial magnetic stimulation (TMS) and invasive surgical procedures such as surgical ablation, vagus nerve stimulation, and deep brain stimulation. In this context, therapeutic ultrasound emerges as a promising alternative for treating refractory MDD, which has the unique advantage of combining noninvasiveness with selective targeting. Over the past ten years, there has been growth in …

Sequence And Chemical Specificity Define The Functional Landscape Of Intrinsically Disordered Regions, Iris Langstein-Skora, Ryan J Emenecker, Alex S Holehouse, Et Al.

2020-Current year OA Pubs

Intrinsically disordered regions (IDRs) pervasively engage in essential molecular functions, yet they are often poorly conserved as assessed by sequence alignment. To explore the seeming paradox of how sequence variability is compatible with persistent function, we examined the functional determinants for a poorly conserved but essential IDR. We show that IDR function depends on two distinct but related properties: sequence and chemical specificity. Whereas sequence specificity operates via binding motifs and depends on the precise order and identity of residues, chemical specificity reflects the sequence-encoded chemistry of multivalent interactions across an IDR and depends on local and global chemical properties. …