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Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre Jun 2026

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …


Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps Jun 2026

Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps

School of Medicine Publications

Background: Alzheimer disease and related dementias (ADRD) are more prevalent in Black and Hispanic older adults and are also more likely to be undetected and misdiagnosed. The purpose of this study was to engage with Black and Hispanic communities about interest in and support needed for memory screening.

Methods: Participants were recruited from established community partners of the South Texas Alzheimer's Disease Research Center to engagein a 90-minute listening session. The session was recorded with participants' permission, and a thematic analysis was conducted by 2 independent coders.

Results: Sixteen individuals (81% female, 88% Hispanic or Black) from various perspectives participated …


Understanding And Overcoming Innate And Acquired Mapk Inhibition Resistance In Anaplastic Thyroid Cancer, Peter Y F Zeng, Jalna Meens, Amir Hossein Karimi, Harrison Pan, Matthew J. Cecchini, Laura Jarycki, Sarah B. Ryan, Alice E. Dawson, Mushfiq H. Shaikh, David A. Palma Jun 2026

Understanding And Overcoming Innate And Acquired Mapk Inhibition Resistance In Anaplastic Thyroid Cancer, Peter Y F Zeng, Jalna Meens, Amir Hossein Karimi, Harrison Pan, Matthew J. Cecchini, Laura Jarycki, Sarah B. Ryan, Alice E. Dawson, Mushfiq H. Shaikh, David A. Palma

School of Medicine Publications

Anaplastic thyroid cancer (ATC) is highly lethal. Although patients with the BRAFV600E alteration respond to the type I RAF inhibitor (RAFi) dabrafenib with trametinib, most rapidly develop adaptive or acquired resistance. Here, multi-region whole-genome, high-coverage whole-exome, and single-nuclei RNA sequencing of tumors from ATC patients undergoing type I RAFi and MEKi therapy reveals that reactivation of the mitogen-activated protein kinase (MAPK) pathway, along with immunosuppressive macrophage proliferation, may underlie the development of acquired resistance. Screening of several RAFi reveals that ATC cell lines are exquisitely sensitive to the type II RAFi naporafenib, which inhibits EphA2-mediated MAPK signaling. Further, naporafenib and …


An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux Jun 2026

An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux

Dissertations

Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …


Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar Jun 2026

Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar

Dissertations

Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …


Activation Of The Human Β3 Gabaa Receptor By Combinations Of Receptor Protonation With Chemical Agonists And Gain-Of-Function Mutations, Allison L Germann, Spencer R Pierce, Joe Henry Steinbach, Gustav Akk Jun 2026

Activation Of The Human Β3 Gabaa Receptor By Combinations Of Receptor Protonation With Chemical Agonists And Gain-Of-Function Mutations, Allison L Germann, Spencer R Pierce, Joe Henry Steinbach, Gustav Akk

2020-Current year OA Pubs

Native GABA


Early Neurodevelopmental Outcomes In Children With Congenital Heart Disease, Mike Seed, Cynthia Ortinau, Caroline Lee, Et Al. Jun 2026

Early Neurodevelopmental Outcomes In Children With Congenital Heart Disease, Mike Seed, Cynthia Ortinau, Caroline Lee, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Neurodevelopmental impairments are common in children with congenital heart disease.

OBJECTIVES: To compare neurodevelopmental outcomes by cardiac diagnosis and identify associations between medical and social factors and early neurodevelopmental outcomes among children with congenital heart disease.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis used neurodevelopmental follow-up data obtained between May 1, 2019, and June 30, 2022, and entered into the Cardiac Neurodevelopmental Outcome Collaborative (CNOC) registry, with linkage to the Pediatric Cardiac Critical Care Consortium registry. Children younger than 30 months from 25 CNOC sites were studied. Data analysis was performed between January 2023 and December 2024.

EXPOSURES: Patients …


Noninvasive Enrichment Of Circulating Tumor Biomarkers In A Mouse Model Of Diffuse Midline Glioma Using Focused Ultrasound, Dingyue Zhang, Yimei Yue, Yan Gong, Leqi Yang, Kevin Xu, Jinyun Yuan, Hong Chen Jun 2026

Noninvasive Enrichment Of Circulating Tumor Biomarkers In A Mouse Model Of Diffuse Midline Glioma Using Focused Ultrasound, Dingyue Zhang, Yimei Yue, Yan Gong, Leqi Yang, Kevin Xu, Jinyun Yuan, Hong Chen

2020-Current year OA Pubs

BACKGROUND: Diagnosing diffuse midline glioma (DMG) through invasive tissue biopsies is challenging due to the tumor's eloquent location at the pons. Liquid biopsies offer a promising noninvasive alternative; however, their limited detection sensitivity and lack of information on the source of biomarkers pose great challenges. This study aimed to evaluate the feasibility and safety of using focused ultrasound (FUS) with microbubbles to enrich circulating DMG tumor biomarkers in blood and cerebrospinal fluid (CSF) using a mouse model.

METHODS: Murine DMG cells, transfected with enhanced green fluorescent protein (EGFP) and firefly luciferase (Fluc) genes, were orthotopically injected into the mouse brain. …


Natural History Of Limb Girdle Muscular Dystrophy R1 (Lgmdr1): A Grasp Consortium Study, Stephanie M Hunn, Andrew R Findlay, Amanda Clause, Conrad C Weihl, Et Al. Jun 2026

Natural History Of Limb Girdle Muscular Dystrophy R1 (Lgmdr1): A Grasp Consortium Study, Stephanie M Hunn, Andrew R Findlay, Amanda Clause, Conrad C Weihl, Et Al.

2020-Current year OA Pubs

Identifying clinical outcome assessments (COAs) that are able to detect change in functional abilities over time in the limb girdle muscular dystrophy (LGMD) population is critical for managing disease progression in addition to determining drug efficacy in the context of anticipated therapeutic trials. Through the Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) Consortium, 42 participants with LGMDR1 were enrolled in a 12-month natural history study across 11 international sites. Each participant completed a battery of COAs, including the North Star Assessment for Limb Girdle-Type Muscular Dystrophies (NSAD), 100-meter timed test (100 m), Performance of the Upper Limb (PUL), …


Viscoelastic And Morphologic Changes In The Lumbar Intervertebral Discs Of The 5xfad Mouse Model Of Alzheimer's Disease, C E Gonzalez, C A Schurman, K A Wilson, B Schilling, L M Ellerby, S Y Tang Jun 2026

Viscoelastic And Morphologic Changes In The Lumbar Intervertebral Discs Of The 5xfad Mouse Model Of Alzheimer's Disease, C E Gonzalez, C A Schurman, K A Wilson, B Schilling, L M Ellerby, S Y Tang

2020-Current year OA Pubs

BACKGROUND: Chronic low back pain, commonly associated with intervertebral disc (IVD) degeneration, is highly prevalent in patients with Alzheimer's disease (AD), and the severity of the pain is correlated with the severity of the dementia. While incidences of both afflictions increase dramatically in the elderly population, it is unknown whether AD exacerbates the health of the IVD.

AIMS: The aim of this study is to examine how AD-related mutations affect the structure and mechanics of the IVD.

MATERIALS AND METHODS: Utilizing one-year-old male and female 5xFAD mice that constitutively express human APP and PSEN1 transgenes with five AD-linked mutations, we …


Early Results Of Sotatercept Treatment In Patients With Severe Pulmonary Hypertension And A Potts Shunt, Manish A Aggarwal, Kelly Merrill, Delphine Yung, R Mark Grady Jun 2026

Early Results Of Sotatercept Treatment In Patients With Severe Pulmonary Hypertension And A Potts Shunt, Manish A Aggarwal, Kelly Merrill, Delphine Yung, R Mark Grady

2020-Current year OA Pubs

Twelve patients with severe pulmonary hypertension (PH) who had a pulmonary artery-to-descending aorta (Potts) shunt were treated with the novel PH drug sotatercept for an average of 12 months. Overall, the group showed significant improvement in a number of clinical parameters with no serious complications. Thus, a trial of sotatercept could be considered prior to an invasive intervention in patients with severe PH. Similarly, it may also be useful in patients with Eisenmenger-like physiology.


Technical Trends In Management Of Acl Reconstructions In 2025: A Major League Soccer Team Physicians Survey, Matthew Varano, Henry Eilen, Catherine Hand, Camden Bohn, Yining Lu, Rachel Frank, Danyal Nawabi, Robert Brophy, Bert Mandelbaum, Brian Forsythe Jun 2026

Technical Trends In Management Of Acl Reconstructions In 2025: A Major League Soccer Team Physicians Survey, Matthew Varano, Henry Eilen, Catherine Hand, Camden Bohn, Yining Lu, Rachel Frank, Danyal Nawabi, Robert Brophy, Bert Mandelbaum, Brian Forsythe

2020-Current year OA Pubs

BACKGROUND: The optimal graft choice for anterior cruciate ligament reconstruction (ACLR) remains a subject of ongoing debate. In practice, graft selection in ACLR is multifactorial, with patient characteristics, activity level, and surgeon preference/training background all playing a crucial role in the clinical decision-making process. While graft trends have been reported across select professional sports leagues, none have focused specifically on professional soccer.

PURPOSE: To report current trends in graft preference for ACLR among Major League Soccer (MLS) surgeons.

STUDY DESIGN: Cross-sectional study.

METHODS: A 39-question survey was distributed to 27 orthopaedic surgeons affiliated with MLS teams in January 2025. The …


Quantitative Assessment Of Cardiac Phosphocreatine Metabolism Under Physiological And Pharmacological Stress Using Chemical Exchange Saturation Transfer Magnetic Resonance Imaging, Qi Huang, Caleb Berberet, Ryan Wahidi, Todd Pavek, Cihat Eldeniz, Liya Dai, Rong Guo, Yang Yang, Scott Bugenhagen, Linda R Peterson, Thomas H Schindler, Pamela K Woodard, Jie Zheng Jun 2026

Quantitative Assessment Of Cardiac Phosphocreatine Metabolism Under Physiological And Pharmacological Stress Using Chemical Exchange Saturation Transfer Magnetic Resonance Imaging, Qi Huang, Caleb Berberet, Ryan Wahidi, Todd Pavek, Cihat Eldeniz, Liya Dai, Rong Guo, Yang Yang, Scott Bugenhagen, Linda R Peterson, Thomas H Schindler, Pamela K Woodard, Jie Zheng

2020-Current year OA Pubs

BACKGROUND: Phosphocreatine (PCr) exhibits a distinct chemical exchange saturation transfer (CEST) resonance at ∼2.5 ppm with slower exchange kinetics and lower pH sensitivity than creatine. This pilot study evaluated the feasibility of quantifying myocardial PCr-dominated concentration ([PCr]

METHODS: Phantoms with varied concentrations of PCr and Cr were scanned to characterize PCr CEST signals under physiological conditions. Experiments were conducted at both room temperature and 37 °C with full Z-spectra acquisition. For the study in vivo, CEST imaging was performed in normal canines (n = 13), at rest and after regadenoson vasodilation, and during dobutamine stress (n = 5). In addition, …


Synergistic Effects Of Diabetic Neuropathy And Kidney Function Decline On Second Metatarsal Skeletal Health And Foot Function: A Pilot Study, Victor A Cheuy, Saghi Sadoughi, Hasung Moon, Jalen Ellis, Rodney Gross, David R Sinacore, Mary K Hastings, Richard B Souza, Galateia J Kazakia Jun 2026

Synergistic Effects Of Diabetic Neuropathy And Kidney Function Decline On Second Metatarsal Skeletal Health And Foot Function: A Pilot Study, Victor A Cheuy, Saghi Sadoughi, Hasung Moon, Jalen Ellis, Rodney Gross, David R Sinacore, Mary K Hastings, Richard B Souza, Galateia J Kazakia

2020-Current year OA Pubs

A discouraging increase in diabetes-related nontraumatic lower-extremity amputations (NLEA) has occurred over the last decade. Individuals with diabetic neuropathy (DMPN) and CKD are at the highest risk for NLEA. Despite the critical implications, little is known about the factors that initiate the cascade of events leading to NLEA, limiting early and effective interventions. We aimed to develop and implement a technique for quantifying metatarsal bone density and microstructure using HR-pQCT. Twelve participants were enrolled:


Toward Better Response Assessment Of Cutaneous Chronic Graft-Versus-Host Disease: A Report From The National Institutes Of Health Consensus Project Task Force, Alina Markova, Iskra Pusic, Et Al. Jun 2026

Toward Better Response Assessment Of Cutaneous Chronic Graft-Versus-Host Disease: A Report From The National Institutes Of Health Consensus Project Task Force, Alina Markova, Iskra Pusic, Et Al.

2020-Current year OA Pubs

The National Institutes of Health (NIH) chronic graft-versus-host disease (cGVHD) Consensus Project established response criteria that enabled clinical trials and facilitated regulatory approval of multiple therapies. Nonetheless, organ-specific assessments have limitations, particularly for severe sclerotic skin involvement. Cutaneous manifestations occur in approximately half of patients with chronic GVHD but are difficult to evaluate due to heterogeneous clinical features. To address these challenges, the NIH Consensus Skin Task Force convened from 2024 to 2025 to refine skin response measures for use in clinical trials. This report (1) summarizes current diagnosis and scoring of skin chronic GVHD, (2) reviews existing response assessments, …


Initial Injury Type And Violent Reinjury, Nicholas Szoko, Daphne Lew, Taylor Kaser, Zoe M Miller, Matt Vogel, Michael A Mancini, Lindsay M Kranker, Christopher Behr, Vicki Moran, Rachel Ancona, Kristen Mueller Jun 2026

Initial Injury Type And Violent Reinjury, Nicholas Szoko, Daphne Lew, Taylor Kaser, Zoe M Miller, Matt Vogel, Michael A Mancini, Lindsay M Kranker, Christopher Behr, Vicki Moran, Rachel Ancona, Kristen Mueller

2020-Current year OA Pubs

IMPORTANCE: Violent injuries are the leading cause of death among children and young adults in the United States. Violent injury may increase the risk of subsequent injury (ie, violent reinjury), but it is unclear how this risk varies across different injury types (eg, blunt assault, stabbing, firearm).

OBJECTIVE: To describe patterns of violent reinjury across different injury types to inform tailored prevention strategies.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter cohort study included patients who presented with violent injuries to 2 adult and 2 pediatric level I trauma centers in St Louis, Missouri, from January 2016 to December 2023.

EXPOSURES: Violent …


Chronic Conditions And Mortality In Medicare Beneficiaries Before And After The Covid-19 Pandemic, R J Waken, Fengxian Wang, Jose F Figueroa, Rishi K Wadhera, Khavya Avula, E John Orav, Anne Mobley Butler, Karen E Joynt Maddox Jun 2026

Chronic Conditions And Mortality In Medicare Beneficiaries Before And After The Covid-19 Pandemic, R J Waken, Fengxian Wang, Jose F Figueroa, Rishi K Wadhera, Khavya Avula, E John Orav, Anne Mobley Butler, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: There were well-documented changes in health care use during the COVID-19 pandemic. Little is known about whether there were any associated decreases in claims-based comorbidity ascertainment that might have relevance to health services and policy research.

OBJECTIVE: To quantify differences in claims-based comorbidity assessment in Medicare beneficiaries pre- vs post-COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed data from the 30 Chronic Conditions Warehouse 1- or 2-year lookback claims algorithms to ascertain each comorbidity with exact date ranges for all fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries. Data were analyzed from April 2025 to April 2026.

EXPOSURES: The …


Trastuzumab Deruxtecan In Hormone Receptor-Positive, Her2-Low/-Ultralow Metastatic Breast Cancer (Destiny-Breast06): Outcome Analyses By Time To Progression On Prior First-Line Endocrine Therapy With Cdk4/6 Inhibitor And Baseline Burden Of Disease, G Curigliano, N A Bagegni, Et Al. Jun 2026

Trastuzumab Deruxtecan In Hormone Receptor-Positive, Her2-Low/-Ultralow Metastatic Breast Cancer (Destiny-Breast06): Outcome Analyses By Time To Progression On Prior First-Line Endocrine Therapy With Cdk4/6 Inhibitor And Baseline Burden Of Disease, G Curigliano, N A Bagegni, Et Al.

2020-Current year OA Pubs

BACKGROUND: In DESTINY-Breast06, trastuzumab deruxtecan (T-DXd) improved progression-free survival (PFS) versus physician's choice of chemotherapy (TPC) for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-low/-ultralow metastatic breast cancer (mBC), without new safety signals. We report additional analyses exploring outcomes for patients with characteristics that affect prognosis.

PATIENTS AND METHODS: Patients were randomly assigned 1 : 1 to receive T-DXd (5.4 mg/kg) once every 3 weeks or TPC. Subgroups were specified post hoc from the intent-to-treat population (N = 866). Outcomes were PFS, objective response rate (ORR), and duration of response (DOR) by blinded independent central review …


Cabozantinib Plus Nivolumab And Ipilimumab In Previously Untreated, Advanced Renal Cell Carcinoma: Final Results And Biomarker Analyses From The Phase Iii Cosmic-313 Study, R J Motzer, M A Reimers, Et Al. Jun 2026

Cabozantinib Plus Nivolumab And Ipilimumab In Previously Untreated, Advanced Renal Cell Carcinoma: Final Results And Biomarker Analyses From The Phase Iii Cosmic-313 Study, R J Motzer, M A Reimers, Et Al.

2020-Current year OA Pubs

BACKGROUND: Primary results from COSMIC-313 demonstrated significantly longer progression-free survival (PFS) with first-line cabozantinib plus nivolumab and ipilimumab versus placebo plus nivolumab and ipilimumab in patients with advanced renal cell carcinoma. Final efficacy and safety results, as well as data from exploratory biomarker analyses, are reported here.

PATIENTS AND METHODS: The design, participants, and primary-endpoint PFS outcomes have been reported previously for this phase III, double-blind, randomized (1 : 1) study of cabozantinib or placebo plus nivolumab and ipilimumab in adults with previously untreated, advanced clear cell renal cell carcinoma. The secondary endpoint was overall survival (OS) in the intention-to-treat …


Biomedgraphica: An All-In-One Platform For Joint Textual Biomedical Prior Knowledge And Numeric Graph Generation, Heming Zhang, Shunning Liang, Tim Xu, Wenyu Li, Di Huang, Yuhan Dong, Philip Miller, Peter Goedegebuure, Marco Sardiello, Jonathan Cooper, William Buchser, Patricia Dickson, Ryan C Fields, Carlos Cruchaga, Yixin Chen, Michael Province, Philip Payne, Fuhai Li, Et Al. Jun 2026

Biomedgraphica: An All-In-One Platform For Joint Textual Biomedical Prior Knowledge And Numeric Graph Generation, Heming Zhang, Shunning Liang, Tim Xu, Wenyu Li, Di Huang, Yuhan Dong, Philip Miller, Peter Goedegebuure, Marco Sardiello, Jonathan Cooper, William Buchser, Patricia Dickson, Ryan C Fields, Carlos Cruchaga, Yixin Chen, Michael Province, Philip Payne, Fuhai Li, Et Al.

2020-Current year OA Pubs

MOTIVATION: Multiomics data analysis is essential for scientific discovery in precision medicine. However, translating analysis results of omics data analysis into novel scientific hypotheses remains a significant challenge. Human experts must manually review analysis results and generate new hypotheses based on extensive and interconnected biomedical prior knowledge, which is subjective and not scalable. While large language models can accelerate the discovery, their reasoning improves when grounded in structured, auditable, and comprehensive biomedical prior knowledge. However, biomedical knowledge is scattered across heterogeneous databases that use diverse and inconsistent nomenclature systems, making it difficult to integrate resources into a unified format for …


Adverse Pregnancy Outcomes And Prevalent Cardiovascular Disease Among An Urban Cohort In Haiti, Wheytnie Alexandre, Anju Ogyu, Rodney Sufra, Kelly Celestin, Reichling St Sauveur, Catherine Bennett, Lily D Yan, Vanessa Rouzier, Zainab Mahmoud, Laura C Alonso, Monika M Safford, Margaret L Mcnairy Jun 2026

Adverse Pregnancy Outcomes And Prevalent Cardiovascular Disease Among An Urban Cohort In Haiti, Wheytnie Alexandre, Anju Ogyu, Rodney Sufra, Kelly Celestin, Reichling St Sauveur, Catherine Bennett, Lily D Yan, Vanessa Rouzier, Zainab Mahmoud, Laura C Alonso, Monika M Safford, Margaret L Mcnairy

2020-Current year OA Pubs

BACKGROUND: Adverse pregnancy outcomes (APOs) have been linked with cardiovascular diseases (CVDs) in high-income countries, but evidence from low-income countries like Haiti is limited.

OBJECTIVES: The authors investigated the cross-sectional association between APO and prevalent CVD using the Haiti CVD Cohort.

METHODS: This analysis included all female participants who completed a reproductive health questionnaire at their annual visit, which captured detailed pregnancy history. We analyzed the relationship between APO and prevalent CVD (defined as heart failure, myocardial infarction, or stroke, as a composite outcome and separately) on enrollment using Poisson regression models, adjusted for traditional risk factors.

RESULTS: This analysis …


Neural Plasticity Across Hormonal States In Females: From Modulator To Dynamic Regulator, Takahiro Sasaki, Christine Nwaigwe, Sayaka Inoue Jun 2026

Neural Plasticity Across Hormonal States In Females: From Modulator To Dynamic Regulator, Takahiro Sasaki, Christine Nwaigwe, Sayaka Inoue

2020-Current year OA Pubs

Ovarian sex steroid hormones play a critical role in regulating fertility. In addition, these hormones influence behavior and mood across the lifespan in females. Converging evidence from rodent studies and human neuroimaging shows that ovarian hormones dynamically regulate neuronal excitability, synaptic efficacy, and structural remodeling across menstrual/estrous cycles, puberty, and reproductive aging. Estrogen and progesterone reorganize network dynamics and gate plasticity eligibility rather than uniformly scaling synaptic strength, with additional contributions from glia, the extracellular matrix, and neurosteroid signaling. Here we synthesize recent cross-scale advances that link structural and functional changes to cellular and circuit mechanisms, and relate these dynamics …


Use Of Wearable Sensors To Measure Improvements In Real World Upper Extremity Activity After Brachial Plexus Reconstruction, Arakua N Welbeck, Catherine E Lang, David M Brogan, Christopher J Dy Jun 2026

Use Of Wearable Sensors To Measure Improvements In Real World Upper Extremity Activity After Brachial Plexus Reconstruction, Arakua N Welbeck, Catherine E Lang, David M Brogan, Christopher J Dy

2020-Current year OA Pubs

PURPOSE: Current functional assessments after brachial plexus (BP) reconstruction, including surgeon-graded active range of motion and strength scores, and patient-reported outcomes (PROs), have limitations. This study evaluated the feasibility of wearable sensors to quantify recovery and functional outcomes following BP reconstruction. We hypothesized that sensor-derived measures of daily upper-extremity use would correlate with PROs and that real-world upper-extremity use would improve.

METHODS: Traumatic BP injury patients wore bilateral wrist accelerometers for 7-day periods at 3- to 6-month intervals. Data were grouped relative to timing of reconstruction. Duration and magnitude of upper-extremity activity were expressed as ratios of injured to uninjured …


Rapid Antidepressant Potential Of Nitrous Oxide: Current State And Major Questions, Charles F Zorumski, Joseph Cichon, Yukitoshi Izumi, Thomas Zeffiro, Steven Mennerick, Peter Nagele, Charles R Conway Jun 2026

Rapid Antidepressant Potential Of Nitrous Oxide: Current State And Major Questions, Charles F Zorumski, Joseph Cichon, Yukitoshi Izumi, Thomas Zeffiro, Steven Mennerick, Peter Nagele, Charles R Conway

2020-Current year OA Pubs

The success of ketamine, a dissociative anesthetic and non-competitive N-methyl-D-aspartate receptor (NMDAR) antagonist, as a rapidly acting antidepressant has ignited efforts to identify other novel depression treatments. In recent years, several clinical trials indicated that nitrous oxide (N


Remote Hr-Guided High-Intensity Interval Training With Weekly Health Monitoring In Breast Cancer Patients During Chemotherapy: A Moderation Analysis Of Physiological Predictors, Madara Ketlīna Štarka-Rantiņa, Rudolfs Ceseiko, Martins Campa, Maksims Zolovs, Greta Franceska Jermolenko, Kristaps Eglitis, Alicia Llorente, Aija Linē, Aija Klavina May 2026

Remote Hr-Guided High-Intensity Interval Training With Weekly Health Monitoring In Breast Cancer Patients During Chemotherapy: A Moderation Analysis Of Physiological Predictors, Madara Ketlīna Štarka-Rantiņa, Rudolfs Ceseiko, Martins Campa, Maksims Zolovs, Greta Franceska Jermolenko, Kristaps Eglitis, Alicia Llorente, Aija Linē, Aija Klavina

Baltic Journal of Health and Physical Activity

Background: The study aimed to investigate the effects of a six-month remotely monitored heart rate – guided high-intensity interval training (HIIT) program on aerobic capacity, functional performance, and weekly self-reported health outcomes in women with stage II–III breast cancer undergoing neoadjuvant chemotherapy. Materials and methods: Fifty-six women (mean age 47 ± 8 years) were randomly assigned (1:1) to a HIIT group or a control group (CG). Thirty-five participants were included in analyses (HIIT group = 17; CG = 18). HIIT group performed 4 × 4-minute HIIT sessions at the intensity of 85–95% of the peak heart rate, two to three …


Effects Of Garden Exposure On Physician Assistant Students, Richard Gilbert Jr., Anne Schempp, Daniel Martin May 2026

Effects Of Garden Exposure On Physician Assistant Students, Richard Gilbert Jr., Anne Schempp, Daniel Martin

Inquiry: The Journal of the Virginia Community Colleges

Introduction: Stress and burnout within the physician assistant student population has been an evolving topic in physician assistant education. Greenspaces have been utilized for the reduction of stress and improvement of overall well-being.

Methods: Using a mixed methods survey methodology, participating physician assistant students were evaluated on their perceived stress levels both pre and post-exposure to a garden area. Both quantitative and thematic qualitative data was synthesized to evaluate the garden’s effect on the physician assistant student stress levels.

Results: A linear mixed effects model revealed that participants significantly improved stress outcomes from pre-test to post-test (ꞵ = 3.83, CI95% …


Supporting Nurse Practitioner Autonomy: A Policy Proposal To Advance Hospice Np Scope, Lauren Hochart May 2026

Supporting Nurse Practitioner Autonomy: A Policy Proposal To Advance Hospice Np Scope, Lauren Hochart

Doctor of Nursing Practice Final Manuscripts

The Nurse Practitioner (NP) profession has achieved many advancements in its autonomy and scope of practice in the last 61 years since becoming a recognized advanced practice registered nursing role. However, some areas of healthcare still limit the NPs ability to practice autonomously even though it is within their scope of practice. This is notable in the subspecialty of hospice care with regards to certifying a terminal diagnosis as part of eligibility determination for a Medicare beneficiary to be able to receive covered hospice services. This health policy paper reviews current hospice regulations and provides evidence to support the benefits …


Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall May 2026

Exercise Prescription For Adults With Prediabetes In The Primary Care Clinic, Katherine W. Hall

Doctor of Nursing Practice Final Manuscripts

Prediabetes affects approximately one in three adults in the United States, with an estimated 10% progressing to Type 2 Diabetes Mellitus (T2DM) annually. Despite strong evidence supporting exercise as a first-line intervention to prevent disease progression, most patients in primary care settings do not receive structured physical activity counseling. This evidence-based project (EBP) aims to address this gap by implementing a standardized protocol to assess baseline physical activity levels and deliver individualized exercise prescriptions to adults with prediabetes in the primary care clinic.

Eligible participants, defined by HbA1c values between 5.70% and 6.49%, were identified during routine primary care visits …


Evaluating The Role Of Ultrasound As A Tool For Airway Assessment And Management For Anesthesia Providers, Alexyss Capestany May 2026

Evaluating The Role Of Ultrasound As A Tool For Airway Assessment And Management For Anesthesia Providers, Alexyss Capestany

Doctor of Nursing Practice Final Manuscripts

Introduction: The ability to predict and manage difficult intubations is a critical component of airway management in clinical practice.

Background: Ultrasound airway assessment has emerged as a valuable tool in predicting difficult intubation, yet its integration into routine clinical practice remains limited. This Doctor of Nursing Practice (DNP) project aimed to educate healthcare providers, specifically nurse anesthetists, on the use of ultrasound to assess airway anatomy and enhance prediction of difficult airways.

Methods: An evidence-based airway assessment, the Difficult Airway Evaluation with Sonography (DARES), was implemented during a single-day skills fair. Participants received both didactic instruction and hands-on training focused …


Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak May 2026

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …