Digital Commons Network^™

Benchmarking Machine Learning Models To Predict Low Birthweight Baby Outcomes And Identify Associated Risk Factors From An Extremely Unbalanced Large-Scale Dataset, Yang Ren, Dezhi Wu, Yan Tong Ph.D., Ana Lopez-De Fede Ph.D., Sarah J. Gareau

Publications

Background: Low birthweight (LBW) is one of the leading causes of neonatal mortality in the United States (US), and also is a major causative factor of short- and long-term adverse health effects in newborns. To prevent adverse birth outcomes, it is critical to precisely predict and identify which mothers are at high risk of bearing LBW babies in the early stage of their pregnancy. Previous studies proposed various LBW prediction models from different ML algorithms primarily on small datasets. However, their model performance is significantly limited by data access barriers and data quality issues with one major technical challenge of …

Activation Of A Gpcr, Orl1 Receptor: A Novel Therapy To Prevent Heart Failure Progression, Saliha S Pathan, Aarthi Pugazenthi, Beverly R E A Dixon, Theodore G Wensel, Todd K Rosengart, Megumi Mathison

Faculty, Staff and Students Publications

The number of ischemic heart failure (HF) patients is growing dramatically worldwide. However, there are at present no preventive treatments for HF. Our previous study showed that Gata4 overexpression improved cardiac function after myocardial infarction in rat hearts. We also found that Gata4 overexpression significantly increased the expression of a Pnoc gene, an endogenous ligand for the cell membrane receptor ORL1. We hypothesized that the activation of the ORL1 receptor would suppress HF in a rat ischemic heart model. Adult Sprague Dawley rats (8 weeks old, six males and six females) underwent left anterior descending coronary artery ligation. Three weeks …

Guidelines For The Prevention, Diagnosis, And Management Of Urinary Tract Infections In Pediatrics And Adults: A Wikiguidelines Group Consensus Statement, Zachary Nelson, Abdullah Tarik Aslan, Nathan P. Beahm, Michelle Blyth, Matthew Cappiello, Danielle Casaus, Fernando Dominguez, Susan Egbert, Alexandra Hanretty, Tina Khadem, Katie Olney, Ahmed Abdul-Azim, Gloria Aggrey, Daniel T. Anderson, Mariana Barosa, Michael Bosco, Elias B. Chahine, Souradeep Chowdhury, Alyssa Christensen, Daniela De Lima Corvino, Margaret Fitzpatrick, Molly Fleece, Brent Footer, Emily Fox, Bassam Ghanem, Fergus Hamilton, Justin Hayes, Boris Jegorovic, Philipp Jent, Et Al

School of Medicine Faculty Publications

IMPORTANCE: Traditional approaches to practice guidelines frequently result in dissociation between strength of recommendation and quality of evidence. OBJECTIVE: To create a clinical guideline for the diagnosis and management of urinary tract infections that addresses the gap between the evidence and recommendation strength. EVIDENCE REVIEW: This consensus statement and systematic review applied an approach previously established by the WikiGuidelines Group to construct collaborative clinical guidelines. In May 2023, new and existing members were solicited for questions on urinary tract infection prevention, diagnosis, and management. For each topic, literature searches were conducted up until early 2024 in any language. Evidence was …

Genetic Risk Factors Underlying White Matter Hyperintensities And Cortical Atrophy, Yash Patel, Jean Shin, Eeva Sliz, Ariana Tang, Aniket Mishra, Rui Xia, Edith Hofer, Hema Sekhar Reddy Rajula, Ruiqi Wang, Frauke Beyer, Katrin Horn, Max Riedl, Jing Yu, Henry Völzke, Robin Bülow, Uwe Völker, Stefan Frenzel, Katharina Wittfeld, Sandra Van Der Auwera, Thomas H Mosley, Vincent Bouteloup, Jean-Charles Lambert, Geneviève Chêne, Carole Dufouil, Christophe Tzourio, Jean-François Mangin, Rebecca F Gottesman, Myriam Fornage, Reinhold Schmidt, Qiong Yang, Veronica Witte, Markus Scholz, Markus Loeffler, Gennady V Roshchupkin, M Arfan Ikram, Hans J Grabe, Sudha Seshadri, Stephanie Debette, Tomas Paus, Zdenka Pausova

Faculty, Staff and Student Publications

White matter hyperintensities index structural abnormalities in the cerebral white matter, including axonal damage. The latter may promote atrophy of the cerebral cortex, a key feature of dementia. Here, we report a study of 51,065 individuals from 10 cohorts demonstrating that higher white matter hyperintensity volume associates with lower cortical thickness. The meta-GWAS of white matter hyperintensities-associated cortical 'atrophy' identifies 20 genome-wide significant loci, and enrichment in genes specific to vascular cell types, astrocytes, and oligodendrocytes. White matter hyperintensities-associated cortical 'atrophy' showed positive genetic correlations with vascular-risk traits and plasma biomarkers of neurodegeneration, and negative genetic correlations with cognitive functioning. …

Understanding The Demographic And Health Factors Associated With The Incidence Of Stroke In Jamaica, Zandy Elliott

Walden Dissertations and Doctoral Studies

Stroke, the leading cause of death and disability worldwide, is a significant public health issue in Jamaica, affecting individuals, families, and the healthcare system. This study identified demographic and health factors associated with stroke, enabling medical professionals to better understand high-risk factors and implement preventative care strategies in Jamaica—filling a significant gap in public health knowledge. The quantitative cross-sectional study examined Jamaican demographics, health, and stroke rates. Secondary data from the Office of the Consultant Neurologist (OCN) from 2000-2023 was integrated into the Social Ecological Model (SEM). The study included 291 stroke patients aged 18 and older, excluding those under …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M. Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S. Diaz, Kaitlyn Ann Bartholomew, Julia S. Evans, Maria R. Johnson, Jeffrey Zhou, Deeksha Ajeya

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Burnout And Employee Satisfaction Of Mental Health Clinicians In Corrections, Jeremy C. Capuyon, Lindsay Gietzen

Pacific Journal of Health

Approximately 1.9 million individuals are currently incarcerated within the United States. Rehabilitation and preparation for parole back into the community is common goal amongst correctional facilities. Mental health clinicians (social workers and psychologists) within the correctional facilities are providers who assist in the rehabilitation of inmates. Unfortunately, mental health clinicians in correctional facilities experience high rates of burnout and low levels of job satisfaction, resulting in an increase in turnover rates. This research project looks to investigate the impact burnout and employee satisfaction has on mental health clinicians who work in correctional settings. Furthermore, this research project compares burnout and …

Successful Application Of Craniosacral Therapy In A Case Of Colic In An 8-Week-Old Baby, Caro O’Neill, Angie Butterfield

Journal of Transformative Touch

This case study reports on the effectiveness of CranioSacral Therapy (CST) for an eight-week-old baby boy experiencing colic. A CST pediatric protocol was utilized during two sessions, a week apart, in May 2023. An improvement in symptoms was recorded after the first treatment. After the second treatment the baby was no longer presenting with symptoms related to infant colic. This case suggests that CST can be an effective support for babies experiencing infant colic.

Word count: 75

Association Of Chronic Malnutrition, And Not Anemia, With Cognitive Development In Ethiopian Schoolchildren: A Cross-Sectional Study, Befikadu Tariku Gutema, Muluken Bekele Sorrie, Sifray Batire, Tadiwos Hailu Zewdie, Bruno Levecke, Amina Abubakar, Stefaan De Henauw, Souheila Abbeddou

Institute for Human Development, East Africa

This study assesses the associations between nutritional statusand cognitive development of schoolchildren. A unit increase inheight-for-age Z-score was associated with 0.12 SD, 0.08 SD and0.12 SD increase in standardized digit span, Raven’s coloredprogressive metrics, and performance index of visual searchtask, respectively. A unit increase in body-mass-index-for-ageZ-score was associated with 0.11 SD increase in standardizeddigit span. Hemoglobin concentration was not associated withany of the cognitive outcomes. Chronic malnutrition was asso-ciated with cognitive development in schoolchildren while thin-ness and hemoglobin concentrations were associated withselected or no cognitive outcomes, respectively.

History Of Incarceration And Dental Care Use Among Older Adults In The United States, Alexander Testa, Dylan B Jackson, Carmen Gutierrez, Chantal Fahmy, Vahed Maroufy, Rafael Samper-Ternent, Ana C Neumann

Faculty, Staff and Student Publications

INTRODUCTION: Dental care is a critical component of healthy aging; however, emerging evidence suggests that having been previously incarcerated is a risk factor for not using dental care services. This study investigates the relationship between prior incarceration and dental care among older adults and assesses whether wealth and dental insurance explain this relationship.

METHODS: Data are from the Health and Retirement Study, a nationally representative sample of community-dwelling older adults in the United States, collected in 2012 and 2014. Multivariable logistic regression is used to assess the relationship between a history of incarceration and dental care. Mediation analyses were conducted …

Postnatal Growth Of Etiologically Characterized Preterm Newborns According To Gestational Age At Birth, Paola Roggero, Irina Ryumina, Robert Gunier, Adele Winsey, Stephen Rauch, Irma Alejandra Coronado Zarco, Shabina Ariff, Maria Albertina Rego, Constanza Soto Conti, R. Ochieng

Obstetrics and Gynaecology, East Africa

Objective: To examine the relationship between etiologically-based preterm birth sub-groups and early postnatal growth according to gestational age at birth.

Methods: Prospective, multinational, cohort study involving 15 hospitals that monitored preterm newborns to hospital discharge. Measures/exposures: maternal demographics; etiologically-based preterm birth sub-groups; very, moderate and late preterm categories, and feeding. Primary outcomes: serial anthropometric measures expressed as z-scores of the INTERGROWTH-21st preterm postnatal growth standards.

Results: We included 2320 singletons and 1180 twins: very=24.4% (n = 856, including 178 < 28 weeks’ gestation); moderate=16.9% (n = 592) and late preterm=58.6% (n = 2052). The median (interquartile range) postmenstrual age at the last measure was 37 (36–38) weeks. The ‘no main condition’ sub-group percentage increased from early to late preterm; the ‘perinatal sepsis’ sub-group percentage decreased. ‘Perinatal sepsis’, ‘suspected IUGR’ and ‘fetal distress’ very and late preterm infants had lower postnatal growth patterns than the ‘no main condition’ reference sub-group. This pattern persisted in late but not very preterm infants when postnatal growth was corrected for weight z-score at birth.

Conclusion: The proportional contribution of etiologically-based preterm sub-groups and their postnatal growth trajectories vary by preterm category. Postnatal growth is partially …

Participation Of Behavioral Health Facilities In Medicare Accountable Care Organizations, Yucheng Hou, Susan H Busch, Helen Newton

Faculty, Staff and Student Publications

This cross-sectional study examines temporal trends in behavioral health facility inclusion in accountable care organizations (ACOs) and beneficiary characteristics of such ACOs.

Genomic Analysis Of Intracranial And Subcortical Brain Volumes Yields Polygenic Scores Accounting For Variation Across Ancestries, Luis M García-Marín, Adrian I Campos, Santiago Diaz-Torres, Jill A Rabinowitz, Zuriel Ceja, Brittany L Mitchell, Katrina L Grasby, Jackson G Thorp, Ingrid Agartz, Saud Alhusaini, David Ames, Philippe Amouyel, Ole A Andreassen, Konstantinos Arfanakis, Alejandro Arias-Vasquez, Nicola J Armstrong, Lavinia Athanasiu, Mark E Bastin, Alexa S Beiser, David A Bennett, Joshua C Bis, Marco P M Boks, Dorret I Boomsma, Henry Brodaty, Rachel M Brouwer, Jan K Buitelaar, Ralph Burkhardt, Wiepke Cahn, Vince D Calhoun, Owen T Carmichael, Mallar Chakravarty, Qiang Chen, Christopher R K Ching, Sven Cichon, Benedicto Crespo-Facorro, Fabrice Crivello, Anders M Dale, George Davey Smith, Eco J C De Geus, Philip L De Jager, Greig I De Zubicaray, Stéphanie Debette, Charles Decarli, Chantal Depondt, Sylvane Desrivières, Srdjan Djurovic, Stefan Ehrlich, Susanne Erk, Thomas Espeseth, Guillén Fernández, Irina Filippi, Simon E Fisher, Debra A Fleischman, Evan Fletcher, Myriam Fornage, Andreas J Forstner, Clyde Francks, Barbara Franke, Tian Ge, Aaron L Goldman, Hans J Grabe, Robert C Green, Oliver Grimm, Nynke A Groenewold, Oliver Gruber, Vilmundur Gudnason, Asta K Håberg, Unn K Haukvik, Andreas Heinz, Derrek P Hibar, Saima Hilal, Jayandra J Himali, Beng-Choon Ho, David F Hoehn, Pieter J Hoekstra, Edith Hofer, Wolfgang Hoffmann, Avram J Holmes, Georg Homuth, Norbert Hosten, M Kamran Ikram, Jonathan C Ipser, Clifford R Jack, Neda Jahanshad, Erik G Jönsson, Rene S Kahn, Ryota Kanai, Marieke Klein, Maria J Knol, Lenore J Launer, Stephen M Lawrie, Stephanie Le Hellard, Phil H Lee, Hervé Lemaître, Shuo Li, David C M Liewald, Honghuang Lin, W T Longstreth, Oscar L Lopez, Michelle Luciano, Pauline Maillard, Andre F Marquand, Nicholas G Martin, Jean-Luc Martinot, Karen A Mather, Venkata S Mattay, Katie L Mcmahon, Patrizia Mecocci, Ingrid Melle, Andreas Meyer-Lindenberg, Nazanin Mirza-Schreiber, Yuri Milaneschi, Thomas H Mosley, Thomas W Mühleisen, Bertram Müller-Myhsok, Susana Muñoz Maniega, Matthias Nauck, Kwangsik Nho, Wiro J Niessen, Markus M Nöthen, Paul A Nyquist, Jaap Oosterlaan, Massimo Pandolfo, Tomas Paus, Zdenka Pausova, Brenda W J H Penninx, G Bruce Pike, Bruce M Psaty, Benno Pütz, Simone Reppermund, Marcella D Rietschel, Shannon L Risacher, Nina Romanczuk-Seiferth, Rafael Romero-Garcia, Gennady V Roshchupkin, Jerome I Rotter, Perminder S Sachdev, Philipp G Sämann, Arvin Saremi, Muralidharan Sargurupremraj, Andrew J Saykin, Lianne Schmaal, Helena Schmidt, Reinhold Schmidt, Peter R Schofield, Markus Scholz, Gunter Schumann, Emanuel Schwarz, Li Shen, Jean Shin, Sanjay M Sisodiya, Albert V Smith, Jordan W Smoller, Hilkka S Soininen, Vidar M Steen, Dan J Stein, Jason L Stein, Sophia I Thomopoulos, Arthur W Toga, Diana Tordesillas-Gutiérrez, Julian N Trollor, Maria C Valdes-Hernandez, Dennis Van T Ent, Hans Van Bokhoven, Dennis Van Der Meer, Nic J A Van Der Wee, Javier Vázquez-Bourgon, Dick J Veltman, Meike W Vernooij, Arno Villringer, Louis N Vinke, Henry Völzke, Henrik Walter, Joanna M Wardlaw, Daniel R Weinberger, Michael W Weiner, Wei Wen, Lars T Westlye, Eric Westman, Tonya White, A Veronica Witte, Christiane Wolf, Jingyun Yang, Marcel P Zwiers, M Arfan Ikram, Sudha Seshadri, Paul M Thompson, Claudia L Satizabal, Sarah E Medland, Miguel E Rentería

Faculty, Staff and Student Publications

Subcortical brain structures are involved in developmental, psychiatric and neurological disorders. Here we performed genome-wide association studies meta-analyses of intracranial and nine subcortical brain volumes (brainstem, caudate nucleus, putamen, hippocampus, globus pallidus, thalamus, nucleus accumbens, amygdala and the ventral diencephalon) in 74,898 participants of European ancestry. We identified 254 independent loci associated with these brain volumes, explaining up to 35% of phenotypic variance. We observed gene expression in specific neural cell types across differentiation time points, including genes involved in intracellular signaling and brain aging-related processes. Polygenic scores for brain volumes showed predictive ability when applied to individuals of diverse …

Sex Differences In Hypertension And Its Management Throughout Life, Wan-Jin Yeo, Rahul Abraham, Aditya L Surapaneni, Pascal Schlosser, Shoshana H Ballew, Bige Ozkan, Carina M Flaherty, Bing Yu, Joseph V Bonventre, Chirag R Parikh, Paul L Kimmel, Ramachandran S Vasan, Josef Coresh, Morgan E Grams

Faculty, Staff and Student Publications

Background: The prevalence of hypertension and uncontrolled hypertension may differ by age and sex.

Methods: We included participants in the Atherosclerosis Risk in Communities study at seven study visits over 33 years (visit 1: 15 636 participants; mean age, 54 years; 55% women), estimating sex differences in prevalence of hypertension (systolic blood pressure ≥130 mm Hg; diastolic blood pressure ≥80 mm Hg; or self-reported antihypertension medication use) and uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) using unadjusted and comorbidity-adjusted models.

Results: The prevalence of hypertension increased with age from 40% (ages, 43-46 …

Survival In Patients With Rheumatoid Arthritis And Early Breast Cancer Treated With Tumor Necrosis Factor Inhibitors, Juan I Ruiz, Xiudong Lei, Wu Chi-Fang, Sharon H Giordano, Hui Zhao, Suja S Rajan, Heather Lin, Maria E Suarez-Almazor

Faculty, Staff and Student Publications

Background: There have been concerns about the use of tumor necrosis factor inhibitors (TNFi) for autoimmune disease in patients with recently diagnosed cancer. We assessed the survival of patients with rheumatoid arthritis (RA) and newly diagnosed early breast cancer (BC) treated with TNFi in the first two years after BC diagnosis.

Methods: We identified patients in two datasets: (1) Optum's de-identified Clinformatics® Data Mart Database (CDM), (2) Surveillance, Epidemiology, and End Results program (SEER) and Texas Cancer Registry (TCR) Medicare-linked cohort. We grouped patients according to whether they received TNFi, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) only, or no DMARDs …

Impact Of Participation In Cardiac Rehabilitation Post Myocardial-Infarction: An Integrative Review, Zoie Maynard, Mallory Stinson

Master's Projects

As one of the most common causes of hospitalization, the prevalence of myocardial infarction is indisputable Since this condition is so ubiquitous, a treatment protocol is initiated with methods to help patients modify their lifestyle, treat their underlying disease process, educate them to prevent reoccurrence, and improve their healthcare outcomes. This protocol relies heavily on the use of cardiac rehabilitation. Despite the implementation of this treatment protocol, the concern for recurrence and rehospitalization remains. The goal of this integrative review is to determine how participation in cardiac rehabilitation post-myocardial infarction impacts healthcare outcomes including rates of rehospitalization and depression. The …

Prevalence Trends Of Foodborne Pathogens Bacillus Cereus, Non-Stec Escherichia Coli And Staphylococcus Aureus In Ready-To-Eat Foods Sourced From Restaurants, Cafés, Catering And Takeaway Food Premises, Nicole Foxcroft, Edmore Masaka, Jacques Oosthuizen

Research outputs 2022 to 2026

Foodborne pathogens of Bacillus cereus (B. cereus), non-STEC Escherichia coli (non-STEC E. coli) and Staphylococcus aureus (S. aureus) are currently non-notifiable in Australia unless attributed to a food poisoning outbreak. Due to the lack of data around individual cases and isolations in foods, any changes in prevalence may go undetected. The aim of this study was to determine any changes in the prevalence of B. cereus, non-STEC E. coli and S. aureus in ready-to-eat (RTE) foods sampled from Western Australian restaurants, cafés, catering facilities and takeaway food premises from July 2009 to June 2022. A total of 21,822 microbiological test …

Solid Tumour-Induced Systemic Immunosuppression Involves Dichotomous Myeloid-B Cell Interactions, Xiaoxin Hao, Yichao Shen, Jun Liu, Angela Alexander, Ling Wu, Zhan Xu, Liqun Yu, Yang Gao, Fengshuo Liu, Hilda L Chan, Che-Hsing Li, Yunfeng Ding, Weijie Zhang, David G Edwards, Nan Chen, Azadeh Nasrazadani, Naoto T Ueno, Bora Lim, Xiang H-F Zhang

Faculty, Staff and Students Publications

Solid tumours induce systemic immunosuppression that involves myeloid and T cells. B cell-related mechanisms remain relatively understudied. Here we discover two distinct patterns of tumour-induced B cell abnormality (TiBA; TiBA-1 and TiBA-2), both associated with abnormal myelopoiesis in the bone marrow. TiBA-1 probably results from the niche competition between pre-progenitor-B cells and myeloid progenitors, leading to a global reduction in downstream B cells. TiBA-2 is characterized by systemic accumulation of a unique early B cell population, driven by interaction with excessive neutrophils. Importantly, TiBA-2-associated early B cells foster the systemic accumulation of exhaustion-like T cells. Myeloid and B cells from …

Residential Proximity To Oil And Gas Developments And Childhood Cancer Survival, Thanh T Hoang, Rutu A Rathod, Omar Rosales, Maria I Castellanos, Jeremy M Schraw, Elyse Burgess, Erin C Peckham-Gregory, Abiodun O Oluyomi, Michael E Scheurer, Amy E Hughes, Philip J Lupo

Faculty, Staff and Students Publications

Background: Environmental toxicants may impact survival in children with cancer, but the literature investigating these associations remains limited. Because oil and gas developments emit several hazardous air pollutants, the authors evaluated the relationship between residential proximity to oil or gas development and survival across 21 different pediatric cancers.

Methods: The Texas Cancer Registry had 29,730 children (≤19 years old) diagnosed with a primary cancer between 1995 to 2017. Geocoded data were available for 285,266 active oil or gas wells and 109,965 horizontal wells. The authors calculated whether each case lived within 1000 m (yes/no) from each type of oil or …

Asn Kidney Health Guidance On The Management Of Obesity In Persons Living With Kidney Diseases, T Alp Ikizler, Holly J Kramer, Srinivasan Beddhu, Alex R Chang, Allon N Friedman, Meera N Harhay, Elizabeth Yakes Jimenez, Brandon Kistler, Aleksandra Kukla, Kristin Larson, Lindamarie U Lavenburg, Sankar Dass Navaneethan, John Ortiz, Rocio I Pereira, David B Sarwer, Philip R Schauer, Evan M Zeitler

Faculty, Staff and Students Publications

No abstract provided.

Functional Measures In Non-Copd Chronic Respiratory Diseases: A Systematic Review, Camile Ludovico Zamboti, Heloise Angélico Pimpão, Larissa Dragonetti Bertin, Gabriela Garcia Krinski, Tathielle Garcia, Sandro Laerth Souza Dos Santos Filho, Vinicius Cavalheri, Fabio Pitta, Carlos Augusto Camillo

Research outputs 2022 to 2026

Background/Objectives: The extensive range of instruments designed for evaluating functional performance (FP) in chronic respiratory diseases (CRD) other than chronic obstructive pulmonary disease (COPD) presents a challenge in selecting the most appropriate one. Therefore, this systematic review aimed to summarise FP instruments, their measurement properties, their minimum clinically important differences, and their associations with CRD course-related events or prognosis in non-COPD CRD. Methods: Studies employing patient-reported or performance-based instruments to assess FP in non-COPD CRD were systematically identified in the PubMed, PEDro, Embase, and Cochrane Library databases. COPD-exclusive studies or those solely reporting exercise capacity tests were excluded. Examination focused …

Prognostic Stratification In Dlbcl Patients With Aberrant Myc Gene, Jian-Rong Li, Vikram R Shaw, Abi Parthasarathy, Yong Li, Christopher I Amos, Chao Cheng

Faculty, Staff and Students Publications

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease characterized by a subset of patients who exhibit treatment resistance and poor prognoses. Genomic assays have been widely employed to identify high-risk individuals characterized by rearrangements in the MYC, BCL2 and BCL6 genes. These patients typically undergo more aggressive therapeutic treatments; however, there remains a significant variation in their treatment outcomes. This study introduces an MYC signature score (MYCSS) derived from gene expression profiles, specifically designed to evaluate MYC overactivation in DLBCL patients. MYCSS was validated across several independent cohorts to assess its ability to stratify patients based on MYC-related genetic …

Identifying High-Risk Multiple Myeloma Patients: A Novel Approach Using A Clonal Gene Signature, Jian-Rong Li, Christiana Wang, Chao Cheng

Faculty, Staff and Students Publications

Multiple myeloma (MM) is a heterogeneous disease with a small subset of high-risk patients having poor prognoses. Identifying these patients is crucial for treatment management and strategic decisions. In this study, we developed a novel computational framework to define prognostic gene signatures by selecting genes with expression driven by clonal copy number alterations. We applied this framework to MM and developed a clonal gene signature (CGS) consisting of 22 genes and evaluated in five independent datasets. The CGS provided significant prognostic values after adjusting for well-established factors including cytogenetic abnormalities, International Staging System (ISS), and Revised ISS (R-ISS). Importantly, CGS …

Age Modulates The Predictive Value Of Self-Reported Sleepiness For All-Cause Mortality Risk: Insights From A Comprehensive National Database Of Veterans, Arash Maghsoudi, Mehrnaz Azarian, Amir Sharafkhaneh, Melissa B Jones, Hoormehr Nozari, Meir Kryger, Amin Ramezani, Javad Razjouyan

Faculty, Staff and Students Publications

Study objectives: Excessive daytime sleepiness is prevalent and overwhelmingly stems from disturbed sleep. We hypothesized that age modulates the association between excessive daytime sleepiness and increased all-cause mortality.

Methods: We utilized the Veterans' Health Administration data from 1999-2022. We enrolled participants with sleep related International Classification of Diseases 9/10 codes or sleep services. A natural language processing pipeline was developed and validated to extract the Epworth Sleepiness Scale (ESS) as a self-reported tool to measure excessive daytime sleepiness from physician progress notes. The natural language processing's accuracy was assessed through manual annotation of 470 notes. Participants were categorized into normal-ESS …

Metabolites Link Intake Of A Healthy Diet To Better Insulin And Glucose Homeostasis In The Microbiome And Insulin Longitudinal Evaluation Study (Miles), Alexis C Wood, Danielle J Lee, Patricia A Sheridan, Elizabeth T Jensen, Gautam Ramesh, Alain G Bertoni, Stephen S Rich, Yii-Der I Chen, David M Herrington, Jerome I Rotter, Mark O Goodarzi

Faculty, Staff and Students Publications

BACKGROUND: Dietary quality has been linked to better glycemic control, but the precise molecular mechanisms giving rise to these associations are not fully understood.

OBJECTIVES: To examine the association of metabolites associated with the intake of a healthy diet with measures of insulin/glucose homeostasis.

METHODS: Using cross-sectional data from 295 United States adults, the associations between 3 diet pattern scores and metabolome-wide metabolites were estimated via linear regression models, which controlled for demographic factors and health behaviors. Subsequently, the associations between the diet-related metabolites with 6 measures of glucose/insulin homeostasis were examined in similar models. A Bonferroni correction was applied …

Transcriptomic And Epigenomic Signatures Distinguish High- And Low-Risk Endotypes For Liver Tumor Development, Sandra L Grimm, Tia Talley, Rahul K Jangid, Amrit Koirala, Micah B Castillo, Preethi H Gunaratne, Cristian Coarfa, Cheryl L Walker

Faculty, Staff and Students Publications

The epigenome is a target for environmental exposures and a potential determinant of inter-individual differences in response. In genetically identical C57Bl/6 mice exposed from gestation to weaning to the endocrine-disrupting chemical (EDC) tributyltin (TBT), hepatic tumor development later in life varied across multiple cohorts over time and depending on sex and diet. In one cohort where approximately half of TBT-exposed male mice developed liver tumors at 10 months (Katz et al. Hepatic tumor formation in adult mice developmentally exposed to organotin, Environmental Health Perspectives, 128 (1), 17010, 2020), transcriptomic (RNA-seq) and epigenomic (ChIP-seq) profiling was performed on blood and liver …

Inpatient Falls: Epidemiology, Risk Assessment, And Prevention Measures. A Narrative Review, Taylor Locklear, Jeannie Kontos, Callaham A. Brock, Alexander B. Holland, Rachel Hemsath, Anna Deal, Shannon Leonard, Carsten Steinmetz, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such …

Anesthesia For Bronchoscopy-An Update, Basavana Goudra, Lalitha Sundararaman, Prarthna Chandar, Michael Green

Department of Anesthesiology Faculty Papers

The field of interventional pulmonology has grown immensely and is increasingly recognized as a subspecialty. The new procedures introduced in the last decade pose unique challenges, and anesthesiologists need to readapt to their specific demands. In this review, we extensively discuss the pathophysiology, technical aspects, preprocedural preparation, anesthetic management, and postprocedural challenges of many new procedures such as navigational bronchoscopy, endobronchial valve deployment, and bronchial thermoplasty. Majority of these procedures are performed under general anesthesia with an endotracheal tube. Total intravenous anesthesia with rocuronium as a muscle relaxant seems to be the standard US practice. The easy availability and proven …

Assessing The Relative Efficacy Of Components Of Opioid-Free Anaesthesia In Adult Surgical Patients: Protocol For A Systematic Review And Component Network Meta-Analysis, Amparo Belltall, Guido Mazzinari, Aisling Ní Eochagáin, Tom Wall, Ary Serpa Neto, Oscar Diaz-Cambronero, Daniel Sessler, Donal J Buggy, Juan Cata, Markus W Hollmann

Faculty, Staff and Student Publications

Introduction: The rise of opioid-free anaesthesia (OFA) aims to reduce postoperative pain while reducing opioid-related side effects during surgery. However, the various adjuvant agents used in OFA complicate the evaluation of their effectiveness and risks. Recent reviews question the clinical benefits of OFA, highlighting the need for thorough evaluation. This protocol describes a network meta-analysis to compare the effectiveness of OFA with opioid-based anaesthesia and will identify key components for optimal postoperative outcomes.

Methods and analysis: We will perform a systematic search of literature published in English without time restriction in Embase, The Cochrane Library, MEDLINE (via PubMed) and CINAHL, …

Short-Term Outcomes Of A Healthy Relationship Intervention For The Prevention Of Sexual Harassment And Sexual Assault In The Us Military: Pilot Pretest-Postest Study, Belinda Hernandez, Ross Shegog, Christine Markham, Susan Emery, Elizabeth Baumler, Laura Thormaehlen, Rejane Andina Teixeira, Yanneth Rivera, Olive Pertuit, Chelsey Kanipe, Iraina Witherspoon, Janis Doss, Victor Jones, Melissa Peskin

Faculty, Staff and Student Publications

BACKGROUND: Sexual harassment (SH) and sexual assault (SA) are serious public health problems among US service members. Few SH and SA prevention interventions have been developed exclusively for the military. Code of Respect (X-CoRe) is an innovative web-based, multilevel, SA and SH intervention designed exclusively for the active-duty Air Force. The program's goal is to increase Airmen's knowledge and skills to build and maintain respectful relationships, ultimately reducing SH and SA and enhancing Airmen's overall well-being and mission readiness.

OBJECTIVE: This pilot study aimed to assess the short-term psychosocial impact (eg, knowledge, attitudes, and self-efficacy) of the web-based component of …