Digital Commons Network^™

Diagnosis And Management Of Cardiometabolic Disease After Spinal Cord Injury: Identifying Gaps In Physician Training And Practices, Ryan Solinsky

Faculty, Staff and Students Publications

CONTEXT: Cardiometabolic disease (CMD) frequently occurs in individuals with spinal cord injury (SCI), with growing awareness surrounding the expansive scope of this problem. As CMD has significant morbidity and mortality, early guidelines-based screening and management have been established. However, the extent to which these guidelines have been adopted are unclear.

OBJECTIVE: Describe physicians' screening and management pattern for CMD in patients with SCI, as compared to SCI-specific CMD screening guidelines, and elucidate variables linked to screening and management patterns.

METHODS: SCI medicine-boarded physicians were surveyed on screening timing for CMD following acute SCI, along with their practice pattern and comfort …

Outcomes Of Retained Gastrointestinal Debris During Upper Endoscopy, Joseph Cano, Rehman Sheikh, Sharon Wolfson, Aaron P Thrift, Uma Munnur, Robert J Sealock

Faculty, Staff and Students Publications

Background and study aims: Gastrointestinal debris retention (GIDR) during endoscopy can result in aborted procedures, intubation, and aspiration. GIDR has increased significance with uptake of glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Outcome analysis is vital to risk-stratify patients with GIDR during endoscopy. Our study evaluated the effect of GIDR on endoscopic complications.

Patients and methods: This was a retrospective review of patients who underwent endoscopy between May 2016 and December 2021 with documented GIDR. The study included 138 patients with GIDR and 275 controls. Propensity score matching between patients with GIDR and controls was performed in a 1:2 ratio based …

Influence Of Preoperative Blood Pressure On Postoperative Bleeding Complications Following Mohs Micrographic Surgery, Ida F Orengo, Ikue Shimizu, Suzanne Alkul

Faculty, Staff and Students Publications

Background: Hypertension is a common comorbidity in patients undergoing Mohs micrographic surgery (MMS). Evidence in other surgical fields has suggested that high blood pressure increases the risk of perioperative bleeding, predisposing patients to complications such as hematomas, dehiscence, wound infection, and necrosis.

Methods: We reviewed medical charts of all 530 patients who underwent MMS at our institution in one calendar year to identify whether an association exists between preoperative blood pressure and bleeding outcomes in patients undergoing MMS.

Results: Perioperative variables, including history of diagnosed hypertension, preoperative systolic blood pressure >160 mm Hg, systolic blood pressure >180 mm Hg, anticoagulation/antiplatelet …

Causes Of Death Across Different Locations In The United States, 2015 To 2022, Dmitry Abramov, Salim S Virani, Abdul Mannan Khan Minhas

Faculty, Staff and Students Publications

Objective: The objective of this study was to investigate the leading underlying causes of death across different locations in the USA from 2015 to 2022.

Methods: Data on the leading underlying causes of death in each location of death-including medical outpatient facility or emergency room, medical inpatient facility, medical facility/dead on arrival, decedent's home, hospice facility, and nursing home/long-term care-within the USA in individuals ≥18 years were extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database.

Results: There were 22,236,700 deaths in our studied locations during the study period. Most deaths …

Association Between Hemoglobin A1c And Pediatric Asthma Control, Tianshi David Wu, Anna Yue Qiu, Emily P Brigham, Nadia N Hansel, Meredith C Mccormack

Faculty, Staff and Students Publications

Purpose: To examine the relationship between Hemoglobin A1c (HbA1c) and asthma outcomes in an urban cohort of children with asthma.

Methods: The AIRWEIGHS Study was a randomized controlled clinical trial of an air cleaner intervention testing the hypothesis that overweight/obese children would experience greater improvement in asthma control compared to normal weight children. The study enrolled 164 children with asthma from Baltimore, MD and assessed HbA1c levels and asthma outcomes during clinic visits at baseline and three months. HbA1c levels were analyzed as a continuous measure and categorized as either normal (< 5.7%) or consistent with pre-diabetes (≥5.7%). Asthma outcomes included standardized questionnaires, spirometry, and fractional exhaled nitric oxide (FeNO). Generalized Estimating Equation (GEE) regression models were used to analyze the association between the HbA1c and asthma outcomes.

Results: Participants included 164 children with an average …

The Utilization Of Microbial Cell-Free Dna Next-Generation Sequencing For The Detection Of Human Herpesvirus-8 In A Quaternary Care Center, Todd Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

Background: Human herpesvirus-8 (HHV8) can present with cutaneous or extracutaneous manifestations. While violaceous skin lesions characterize cutaneous Kaposi sarcoma, extracutaneous HHV8 is challenging to diagnose due to nonspecific symptoms.

Objectives: We evaluated the role of microbial cell-free DNA next-generation sequencing (mcfDNA NGS) in diagnosing HHV8-related illness.

Design: Retrospective analysis.

Methods: Between 2017 and 2024, we reviewed the medical charts of 10 immunosuppressed patients at a quaternary care center who had positive HHV8 mcfDNA NGS results.

Results: The clinical and laboratory turnaround times of mcfDNA NGS were 3 and 1 days, respectively (8.5 and 7 days for immunohistochemistry vs 5.5 and …

Editorial: Pathogenesis And Clinical Treatment Of Diabetic Nephropathy, Haiyong Chen

Faculty, Staff and Students Publications

No abstract provided.

Skewed Adaptive Immune Responses Are Involved In Alpha-1 Antitrypsin Deficiency Emphysema, Christine Cong, Alan Waich Cohen, Adrianne S Colborg, Konstantin Tsoyi, Maria C Basil, Edward Cantu, Ivan O Rosas, Neil J Mckenna, Raúl San-José Estépar, Igor Barjaktarevic, Andrew A Wilson, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Long-Term Anti-Sars-Cov-2 Antibody Trajectories After Neutralizing Monoclonal Antibody Treatment, Hallie C Prescott, Thomas W Barrett, Robin L Dewar, Nicole Engen, Anna L Goodman, Timothy J Hatlen, Helene Highbarger, Thomas L Holland, Gareth Hughes, Tomas O Jensen, Muhammad A Khan, Ioannis Kalomenidis, Nayon Kang, Sylvain Laverdure, Prasad Manian, Vidya Menon, Ravi Patel, Srikanth Ramachandruni, Tauseef Rehman, Kathryn Shaw-Saliba, Birgit Thorup Røge, David M Vock, Amy C Weintrob, Barnaby E Young, Anne P Frosch, Strive Network And Therapeutics For Inpatients With Covid-19 (Tico) Study Groups

Faculty, Staff and Students Publications

Background: Neutralizing monoclonal antibodies (nMAbs) have been used to treat COVID-19 and are increasingly being used to treat other infections. However, there is concern that by neutralizing the SARS-CoV-2 virus, nMAbs may decrease the availability of antigens to the immune system, potentially impairing the endogenous polyclonal immune response and decreasing long-term immune protection.

Methods: We compared 28 and 90-day anti-SARS-CoV-2 spike protein neutralization activity and anti-SARS-CoV-2 nucleocapsid response for patients hospitalized with COVID-19 infection randomized to receive nMAbs or placebo in the large platform ACTIV-3/TICO trials. We pooled results from four trials of anti-spike nMAbs. For most tested agents, measurements …

Advancing Narcolepsy Advocacy: Bridging Patient Narratives And Systemic Change, Amir Sharafkhaneh

Faculty, Staff and Students Publications

We introduce the Stigma-to-Structure Advocacy Framework, a novel, evidence-based model designed to transform narcolepsy advocacy by systematically bridging patient narratives with structural change. Narcolepsy remains a profoundly underdiagnosed and misunderstood neurological disorder, with persistent diagnostic delays and pervasive cultural stigma undermining patient well-being and access to care. Despite recent progress in awareness and support, advocacy efforts remain fragmented and insufficiently integrated with health policy, particularly in low- and middle-income countries. This perspective advances a strategic evolution of narcolepsy advocacy through the Stigma-to-Structure Advocacy Framework, which is anchored in three pillars: narrative-driven awareness, clinical system integration, and policy activation. Drawing on …

Transposable Element Activity Captures Human Pluripotent Cell States, Alison R S Pashos, Patrizia Pessina, Justin Brumbaugh, Bruno Di Stefano

Faculty, Staff and Students Publications

Human pluripotent stem cells (hPSCs) exist in multiple, transcriptionally distinct states and serve as powerful models for studying human development. Despite their significance, the molecular determinants and pathways governing these pluripotent states remain incompletely understood. Here, we demonstrate that transposable elements act as sensitive indicators of distinct pluripotent cell states. We engineered hPSCs with fluorescent reporters to capture the temporal expression dynamics of two state-specific transposable elements, LTR5_Hs, and MER51B. This dual reporter system enables real-time monitoring and isolation of stem cells transitioning from naïve to primed pluripotency and further towards differentiation, serving as a more accurate readout of pluripotency …

Monoallelic Expression Can Govern Penetrance Of Inborn Errors Of Immunity, Roosheel Patel, Meredith Ramba, Enrica Calzoni, Lei Haley Huang, Jay Levy, Sofija Buta, Angelica Lee, Christos Sazeides, Zoe Prue, David P Hoytema Van Konijnenburg, Ivan K Chinn, Luis A Pedroza, James R Lupski, Erica G Schmitt, Megan A Cooper, Anne Puel, Xiao Peng, Stéphanie Boisson-Dupuis, Jacinta Bustamante, Satoshi Okada, Marta Martin-Fernandez, Jordan S Orange, Jean-Laurent Casanova, Joshua D Milner, Dusan Bogunovic

Faculty, Staff and Students Publications

Inborn errors of immunity (IEIs) are genetic disorders that underlie susceptibility to infection, autoimmunity, autoinflammation, allergy and/or malignancy1. Incomplete penetrance is common among IEIs despite their monogenic basis2. Here we investigate the contribution of autosomal random monoallelic expression (aRMAE), a somatic commitment to the expression of one allele3,4, to phenotypic variability observed in families with IEIs. Using a clonal primary T cell system to assess aRMAE status of genes in healthy individuals, we find that 4.30% of IEI genes and 5.20% of all genes undergo aRMAE. Perturbing H3K27me3 and DNA methylation alters …

Whole Exome Sequencing As A Screening Tool In Dogs: A Pilot Study, Luc Peelman, Filip Van Nieuwerburgh, Jimmy H Saunders, Bart J G Broeckx

Faculty, Staff and Students Publications

Background: Whole-exome sequencing (WES) is used to selectively sequence all exons of protein-coding genes. WES is considered as a cost-effective and direct approach for identifying phenotype-associated variants in protein-coding regions and is as such situated between the traditional Sanger sequencing and whole genome sequencing (WGS). While WES is already widely used as a clinical tool in human and medical genetics, its use in veterinary medicine is currently restricted to research purposes. In this article, we aimed to provide baseline performance characteristics of a WES design to assess its suitability with future applications in veterinary clinical genetics in mind.

Methods: To …

A Network-Based Discovery Of Prognostic Markers In Recurrent Idh Wild-Type Gliomas, Yang Liu, Jason Huse, Kasthuri Kannan

Faculty, Staff and Student Publications

Background: Isocitrate dehydrogenase wild-type (IDH wild-type) gliomas represents the most aggressive subtype of diffuse gliomas, characterized by therapeutic resistance and dismal prognosis. Despite advances in molecular classification, reliable prognostic biomarkers for these tumors remain limited, particularly for recurrent disease. This study aims to identify gene expression signatures associated with survival outcomes in recurrent IDH wild-type gliomas, with the goal of improving patient stratification and potential therapeutic targeting.

Methods: We analyzed gene expression data from 180 recurrent IDH wild-type glioma samples from the Glioma Longitudinal AnalySiS (GLASS) Consortium. Using multiple computational approaches including a novel network-based method (netSurvival) and various survival …

National Healthcare Safety Network… We Need To Talk…., Misti Ellsworth, Luis Zeichner Ostrosky, Bela Patel, Robert Yetman, Phillip Chang

Faculty, Staff and Student Publications

No abstract provided.

Rates Of Multidrug-Resistant Gram-Negative Bacterial Infections In Hospitalized Non-Immunocompromised Pediatric Patients: A 9-Year Retrospective Study At A Lebanese Tertiary Medical Center, Ramia Zakhour, Sarah Khafaja, Rawan Korman, Celina F Boutros, Zeinab El Zein, Ahmad Chmaisse, Magda Haj, Amani Haddara, Zeina El-Houry, Malak Jbahi, Sarah Chamseddine, Samer Bou Karroum, Dana Al Oweini, Yolla Salama Youssef, Nour Youssef, Mayse Nasser, Danielle Fayad, Farida Abi Farraj, Clara El Nakib, Imad Isaac, Mireille Lteif, George F Araj, Ghassan S Dbaibo

Faculty, Staff and Student Publications

Introduction: Multidrug resistant (MDR) Gram-negative bacterial infections are considered a major public health threat. The objectives of this study were to describe the epidemiology, potential contributing factors, and antimicrobial resistance patterns associated with infections caused by MDR Gram-negative bacteria (GNB) in non-immunocompromised children and adolescents.

Methods: This was a retrospective observational study conducted at the American University of Beirut Medical Center (AUBMC) from 2009 to 2017. The study included non-immunocompromised patients 18 years of age or younger with infections caused by GNB isolated from a sterile site or nonsterile site in the setting of clinical infection.

Results: A total of …

Effect Of Palatoplasty Technique On Otologic Outcomes In Children With Cleft Palate, Shaina W Gong, Paul Hung, Chioma G Obinero, Jose Barrera, Zi Yang Jiang, Matthew R Greives, Zhen Huang

Faculty, Staff and Student Publications

Background: In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.

Objective: We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.

Methods: A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic …

In-Hospital Mortality And Hemorrhagic Risks In Traumatic Brain Injury Patients With Early Vs. Late Venous Thromboembolism, Sophie Samuel, Jalon Barnes, Lynn Yamane, Eugene Uh, Cyprian C Afunugo, Bosco Seong Kyu Yang, Huimahn Alex Choi

Faculty, Staff and Student Publications

Objective: This study reviewed the management and outcomes of traumatic brain injury (TBI) patients who developed venous thromboembolism (VTE) during hospitalization, focusing on the timing of VTE diagnosis and anticoagulation initiation.

Methods: This retrospective, single-center study utilized data from the University of Texas Trauma Database. Patients were categorized based on VTE diagnosis timing (early ≤7 days, late >7 days). The primary outcome was in-hospital mortality. Secondary outcomes included mortality specifically among patients who were receiving anticoagulation treatment, hemorrhagic complications, predictors associated with early anticoagulation initiation (defined as ≤ 7 days from VTE diagnosis), and whether anticoagulation timing influenced mortality.

Results: …

Steroids For Viral Meningitis: A Foe Or A Friend?, Rodrigo Hasbun

Faculty, Staff and Student Publications

No abstract provided.

A Comparison Of Floating Catchment Area Parameters With Applications To A Dataset Of Clinics Enrolled In A Statewide Child And Adolescent Psychiatric Consultation Program, Ryan Ramphul, Cici Bauer

Faculty, Staff and Student Publications

INTRODUCTION: Healthcare resources are often crucial but limited, requiring careful consideration and informed allocation based on population needs and potential healthcare access. In resource allocation settings, availability and accessibility of resources should be examined simultaneously. The two-step floating catchment area (2SFCA) method has been previously used to evaluate spatial accessibility to healthcare resources and services, and to address health-related disparities. The 2SFCA methods have regained significant popularity during the COVID-19 pandemic, as their application proved crucial in addressing priority public health data analysis, modeling, and accessibility challenges. However, comprehensive comparisons of the 2SFCA method input parameters in the context of …

Improved Depression Symptoms Among Low-Income Mexican Americans Participating In A Community-Clinical Diabetes Intervention, Paul G Yeh, Lisa A Mitchell-Bennett, Maribel Sifuentes, Belinda M Reininger

Faculty, Staff and Student Publications

Background: Adults with type 2 diabetes mellitus and comorbid depression face complex disease management. Salud y Vida, a diabetes management intervention for Mexican Americans in the Rio Grande Valley of Texas, may mitigate depression through social support and community-clinic referrals.

Methods: In a cohort study, 292 Salud y Vida participants completed the patient health questionnaire (PHQ-9) at baseline, month 6, and month 12. A PHQ-9 score of ≥5 indicated mild depression and activated a mental health referral. Using SAS 9.4 with significance set at < .05, we conducted multivariable longitudinal negative binomial regression to assess changes in depression level.

Results: The proportion of participants with a PHQ-9 ≥5 decreased from 36% at baseline to 18% …

Effects Of High-Intensity Interval Training On Biomarkers And Inflammatory Factors In Patients With Heart Failure: A Meta-Analysis Of Randomized Controlled Trials

Faculty, Staff and Student Publications

Background: There is still controversy about the effect of high-intensity interval training (HIIT) on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with moderate-intensity continuous training (MCT) and conventional healthcare activities. This article is to systematically investigate the effects of HIIT on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with MCT and conventional healthcare activities.

Methods: A computerized search of databases was conducted with the search year from the establishment of the database, and the screened results were subjected to quality assessment and data extraction, and the data was …

Heat Stress Prevention And Management In The Construction Industry: A Gap Analysis

Faculty, Staff and Student Publications

Background: Despite decades of efforts to prevent heat stress, it remains a major health risk to workers in the construction industry. This health risk has been exacerbated by the rising ambient temperatures from climate change, as well as the increased susceptibility to heat stress in an aging workforce.

Objective: To develop a tailored occupational safety management framework for heat stress prevention in construction, advancing workers’ health, safety, and well-being.

Methods: We built on the findings of a systematic review and analyzed a large industrial company’s current heat stress prevention program through stakeholder engagement, evidence-based practices, and gap analysis. We reviewed …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Marilyn M Schapira, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

Long Covid Risk Factors And Outcomes Among Solid Organ Transplant Recipients: A Retrospective Cohort Study

Faculty, Staff and Student Publications

Background: Solid organ transplant (SOT) recipients are not only at increased risk of morbidity and mortality due to acute COVID-19 but may also experience poor long-term outcomes due to post-acute COVID-19 syndromes, including long COVID.

Methods: This retrospective, registry-based chart review evaluated graft failure and mortality among SOT recipients diagnosed with COVID-19 at a large, urban transplant center in Houston, Texas, USA. Patient populations were analyzed separately according to their long COVID status at the time of transplant to preserve the temporal relationship between the exposure (long COVID) and the outcome (graft failure or mortality).

Results: In total, 146 (5%, …

Pragmatic Recruitment Strategies For A Text-Based Smoking Cessation Intervention For Sexual And Gender Minority Groups, Lorna Mcneill

Faculty, Staff and Student Publications

Background: SmokefreeSGM is a text-based smoking cessation intervention developed to support sexual and gender minorities (SGM) with their quitting efforts. We implemented a pragmatic recruitment strategy to enroll a study sample representative for SmokefreeSGM's feasibility trial. This study outlines the strategies employed to recruit SGM smokers in SmokefreeSGM's feasibility trial and provides a framework for researchers interested in working with this population.

Methods: This study recruited SGM smokers using ResearchMatch, social media/internet advertising, and field recruitment in the United States from January to June 2023, using convenience sampling. We evaluated enrollment rates across recruitment methods and various demographic characteristics such …

A Systematic Review Of Trauma-Informed Sexual Health Education Interventions For Adolescents And Young Adults Within The United States And Canada, Sheryl Mccurdy

Faculty, Staff and Student Publications

nterventions developed for adolescents and young adults and describe how they integrate key principles of a trauma-informed approach.

Methods: Using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines, Substance Abuse and Mental Health Services Administration (SAMHSA) principles, and Khan et al.'s review methodology, we reviewed sexual health intervention studies described as trauma-informed published between 2014 and 2023 within the United States and Canada.

Results: The review found three interventions integrated five to six aspects of a trauma-informed approach relative to Kahn's definition and SAMHSA's principles.

Conclusions: Based on the limited number of trauma-informed interventions being identified, …

Community-Level Factors Influencing The Duration Of Buprenorphine Treatment In Individuals With Opioid Use Disorder: A Cohort Study Using Us Longitudinal Claims Data, Cici Bauer

Faculty, Staff and Student Publications

Introduction: Buprenorphine is effective in reducing opioid-related morbidity and mortality; however, many patients discontinue treatment prematurely. While previous research has focused on individual-level predictors of retention, the influence of community context remains underexplored. This study aims to examine how community-level factors, such as social vulnerability, availability of buprenorphine-waivered providers and access to behavioural health services, affect the duration of buprenorphine treatment episodes for individuals with opioid use disorder (OUD).

Methods: We conducted a retrospective cohort study using longitudinal claims data from 2006 to 2022. Adults aged 18 and older who initiated buprenorphine treatment for OUD and maintained continuous enrolment were …

Feasibility Of Conducting A Pilot Randomized Trial Of A Mindfulness-Based Intervention Among Sheltered Young Adults Experiencing Homelessness, Ethel Jacko, Stanley Cron

Faculty, Staff and Student Publications

Purpose: Youth experiencing homelessness (YEH) are an underserved and difficult-to-reach population that experiences a disproportionate burden of trauma and stress compared to their housed peers. Prolonged trauma and stress can impact the development of negative emotions, reactive stress responses, and impulsive decision-making, which can lead to risk-taking behaviors. Growing research shows that Mindfulness-Based interventions (MBIs) can improve coping, impulsivity, emotion regulation, and executive function although no MBIs tailored for YEH have been tested.

Methods: We conducted a pilot attention-control randomized trial to test the feasibility and acceptability of an adapted MBI, .b4me (pronounced dot be for me), for …

What We Know About The Peer Workforce And Economic Evaluation For Peer Recovery Support Services: A Systematic Review, Sheryl A Mccurdy

Faculty, Staff and Student Publications

Background: Peer recovery support services (PRSS) for substance use disorder (SUD) have expanded in the past 2 decades to be formally certified and reimbursed under Medicaid in almost every US state. This rapid expansion has been followed by a growth in research, but 2 persistent gaps remain: a lack of research on the peer workforce, and a lack of economic evaluation research. This systematic review examines the current literature on PRSS to summarize what is currently known about the SUD peer workforce and collect potential PRSS economic evaluation parameters, and clearly identify the current gaps in each category.

Methods: PRISMA …