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Implication Of The 2014 World Health Organization Integrated Management Of Childhood Illness Pneumonia Guidelines With And Without Pulse Oximetry Use In Malawi: A Retrospective Cohort Study, Shubhada Hooli, Charles Makwenda, Norman Lufesi, Tim Colbourn, Tisungane Mvalo, Eric D Mccollum, Carina King Jan 2023

Implication Of The 2014 World Health Organization Integrated Management Of Childhood Illness Pneumonia Guidelines With And Without Pulse Oximetry Use In Malawi: A Retrospective Cohort Study, Shubhada Hooli, Charles Makwenda, Norman Lufesi, Tim Colbourn, Tisungane Mvalo, Eric D Mccollum, Carina King

Faculty, Staff and Students Publications

BACKGROUND: Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO

METHODS: Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR).

RESULTS: The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI …


Spatial Analysis Of Nanoparticle Distribution In Human Breast Xenografts Reveals Nanoparticles Targeted To Cancer Cells Localized With Tumor-Associated Stromal Cells, Sean Healy, Elizabeth T Henderson, Suqi Ke, Jacqueline Kelly, Brian W Simons, Chen Hu, Robert Ivkov, Preethi Korangath Jan 2023

Spatial Analysis Of Nanoparticle Distribution In Human Breast Xenografts Reveals Nanoparticles Targeted To Cancer Cells Localized With Tumor-Associated Stromal Cells, Sean Healy, Elizabeth T Henderson, Suqi Ke, Jacqueline Kelly, Brian W Simons, Chen Hu, Robert Ivkov, Preethi Korangath

Faculty, Staff and Students Publications

The biological influence of physicochemical parameters of “targeted” nanoparticles on their delivery to cancer tumors remains poorly understood. A comparative analysis of nanoparticle distributions in tumors following systemic delivery across several models can provide valuable insights.

Methods: Bionized nanoferrite nanoparticles (iron oxide core coated with starch), either conjugated with a targeted anti-HER2 antibody (BH), or unconjugated (BP), were intravenously injected into athymic nude or NOD-scid gamma (NSG) female mice bearing one of five human breast cancer tumor xenografts growing in a mammary fat pad. Tumors were harvested 24 hours after nanoparticle injection, fixed, mounted, and stained. We performed detailed histopathology …


Sex-Specific Associations Between Urinary Bisphenols Concentrations During Pregnancy And Problematic Child Behaviors At Age 2 Years, Sarah Dee Geiger, Salma Musaad, Jennifer Hill, Andréa Aguiar, Susan Schantz Jan 2023

Sex-Specific Associations Between Urinary Bisphenols Concentrations During Pregnancy And Problematic Child Behaviors At Age 2 Years, Sarah Dee Geiger, Salma Musaad, Jennifer Hill, Andréa Aguiar, Susan Schantz

Faculty, Staff and Students Publications

Effects of prenatal bisphenol A (BPA) exposure on child behavior are mixed with some reports suggesting increased problematic behaviors in girls (e.g., aggression and emotional reactivity) and in boys (i.e., externalizing behaviors), while other reports suggest decreased problematic behaviors in girls. Little is known about the potential impact of pregnancy bisphenol S (BPS) exposure on child behavior. In a prospective cohort study (n=68), five maternal spot urine samples collected across pregnancy were pooled and analyzed for BPA and BPS. Child behavior at 2 years was assessed using the Child Behavior Checklist (CBCL). Linear regression models were used to assess associations …


Global Regulatory Reforms To Promote Equitable Vaccine Access In The Next Pandemic, Richard Mahoney, Peter J Hotez, Maria Elena Bottazzi Jan 2023

Global Regulatory Reforms To Promote Equitable Vaccine Access In The Next Pandemic, Richard Mahoney, Peter J Hotez, Maria Elena Bottazzi

Faculty, Staff and Students Publications

There is broad consensus that the global response to the Covid-19 pandemic was inadequate, leading to unacceptable levels of avoidable morbidity and mortality. Three strategic missteps led to the lack of equitable vaccine access: The heavy reliance on commercial vaccine manufacturers in high-income countries (HICs) versus low- and middle-income countries (LMICs); the emergence of vaccine nationalism restricting and delaying the supply of vaccines to LMICs; and an inadequate support or recognition for LMIC national regulatory authorities. To avoid these inequities in a future pandemic, we focus on three successful vaccine development and technology transfer case studies-the Hepatitis B vaccine produced …


Vaccine-Linked Chemotherapy Improves Cardiac Structure And Function In A Mouse Model Of Chronic Chagas Disease, Kathryn M Jones, Elise N Mangin, Corey L Reynolds, Liliana E Villanueva, Julio Vladimir Cruz, Leroy Versteeg, Brian Keegan, April Kendricks, Jeroen Pollet, Fabian Gusovsky, Maria Elena Bottazzi, Peter J Hotez Jan 2023

Vaccine-Linked Chemotherapy Improves Cardiac Structure And Function In A Mouse Model Of Chronic Chagas Disease, Kathryn M Jones, Elise N Mangin, Corey L Reynolds, Liliana E Villanueva, Julio Vladimir Cruz, Leroy Versteeg, Brian Keegan, April Kendricks, Jeroen Pollet, Fabian Gusovsky, Maria Elena Bottazzi, Peter J Hotez

Faculty, Staff and Students Publications

INTRODUCTION: Chagas disease, caused by chronic infection with the protozoan parasite Trypanosoma cruzi, affects 6-7 million people worldwide. The major clinical manifestation of Chagas disease is chronic Chagasic cardiomyopathy (CCC), which encompasses a spectrum of symptoms including arrhythmias, hypertrophy, dilated cardiomyopathy, heart failure, and sudden death. Current treatment is limited to two antiparasitic drugs, benznidazole (BNZ) and nifurtimox, but both have limited efficacy to halt the progression of CCC. We developed a vaccine-linked chemotherapy strategy using our vaccine consisting of recombinant Tc24-C4 protein and a TLR-4 agonist adjuvant in a stable squalene emulsion, in combination with low dose benznidazole treatment. …


Analysis Of Variable Major Protein Antigenic Variation In The Relapsing Fever Spirochete, Borrelia Miyamotoi, In Response To Polyclonal Antibody Selection Pressure, Robert D Gilmore, Brittany A Armstrong, Kevin S Brandt, Taylor J Van Gundy, Andrias Hojgaard, Job E Lopez, Alexander R Kneubehl Jan 2023

Analysis Of Variable Major Protein Antigenic Variation In The Relapsing Fever Spirochete, Borrelia Miyamotoi, In Response To Polyclonal Antibody Selection Pressure, Robert D Gilmore, Brittany A Armstrong, Kevin S Brandt, Taylor J Van Gundy, Andrias Hojgaard, Job E Lopez, Alexander R Kneubehl

Faculty, Staff and Students Publications

Borrelia miyamotoi is a tick-transmitted spirochete that is genetically grouped with relapsing fever Borrelia and possesses multiple archived pseudogenes that encode variable major proteins (Vmps). Vmps are divided into two groups based on molecular size; variable large proteins (Vlps) and variable small proteins (Vsps). Relapsing fever Borrelia undergo Vmp gene conversion at a single expression locus to generate new serotypes by antigenic switching which is the basis for immune evasion that causes relapsing fever in patients. This study focused on B. miyamotoi vmp expression when spirochetes were subjected to antibody killing selection pressure. We incubated a low passage parent …


Recent Advances In Biological Pumps As A Building Block For Bioartificial Hearts, Sunita Brimmer, Pengfei Ji, Aditya K Birla, Sundeep G Keswani, Christopher A Caldarone, Ravi K Birla Jan 2023

Recent Advances In Biological Pumps As A Building Block For Bioartificial Hearts, Sunita Brimmer, Pengfei Ji, Aditya K Birla, Sundeep G Keswani, Christopher A Caldarone, Ravi K Birla

Faculty, Staff and Students Publications

The field of biological pumps is a subset of cardiac tissue engineering and focused on the development of tubular grafts that are designed generate intraluminal pressure. In the simplest embodiment, biological pumps are tubular grafts with contractile cardiomyocytes on the external surface. The rationale for biological pumps is a transition from planar 3D cardiac patches to functional biological pumps, on the way to complete bioartificial hearts. Biological pumps also have applications as a standalone device, for example, to support the Fontan circulation in pediatric patients. In recent years, there has been a lot of progress in the field of biological …


Tissue-Specific Dna Methylation Variability And Its Potential Clinical Value, Ryan H Miller, Chad A Pollard, Kristin R Brogaard, Andrew C Olson, Ryan C Barney, Larry I Lipshultz, Erica B Johnstone, Yetunde O Ibrahim, James M Hotaling, Enrique F Schisterman, Sunni L Mumford, Kenneth I Aston, Tim G Jenkins Jan 2023

Tissue-Specific Dna Methylation Variability And Its Potential Clinical Value, Ryan H Miller, Chad A Pollard, Kristin R Brogaard, Andrew C Olson, Ryan C Barney, Larry I Lipshultz, Erica B Johnstone, Yetunde O Ibrahim, James M Hotaling, Enrique F Schisterman, Sunni L Mumford, Kenneth I Aston, Tim G Jenkins

Faculty, Staff and Students Publications

Complex diseases have multifactorial etiologies making actionable diagnostic biomarkers difficult to identify. Diagnostic research must expand beyond single or a handful of genetic or epigenetic targets for complex disease and explore a broader system of biological pathways. With the objective to develop a diagnostic tool designed to analyze a comprehensive network of epigenetic profiles in complex diseases, we used publicly available DNA methylation data from over 2,400 samples representing 20 cell types and various diseases. This tool, rather than detecting differentially methylated regions at specific genes, measures the intra-individual methylation variability within gene promoters to identify global shifts away from …


Corrigendum: Clinical And Immunological Effects Of P53-Targeting Vaccines, Shan Zhou, Chunmei Fan, Zhaoyang Zeng, Ken H Young, Yong Li Jan 2023

Corrigendum: Clinical And Immunological Effects Of P53-Targeting Vaccines, Shan Zhou, Chunmei Fan, Zhaoyang Zeng, Ken H Young, Yong Li

Faculty, Staff and Students Publications

[This corrects the article DOI: 10.3389/fcell.2021.762796.].


Astrocytic-Based Controller Shifts Epileptic Activity To The Chaotic State, Mojde Nahtani, Mehdi Siahi, Javad Razjouyan Jan 2023

Astrocytic-Based Controller Shifts Epileptic Activity To The Chaotic State, Mojde Nahtani, Mehdi Siahi, Javad Razjouyan

Faculty, Staff and Students Publications

Introduction: Investigating an effective controller to shift hippocampal epileptic periodicity to normal chaotic behavior will be new hope for epilepsy treatment. Astrocytes nourish and protect neurons and maintain synaptic transmission and network activity. Therefore, this study explored the ameliorating effect of the astrocyte computational model on epileptic periodicity.

Methods: Modified Morris-Lecar equations were used to model the hippocampal CA3 network. Network inhibitory parameters were employed to generate oscillation-induced epileptiform periodicity. The astrocyte controller was based on a functional dynamic mathematical model of brain astrocytic cells.

Results: Results demonstrated that the synchronization of two neural networks shifted the brain's chaotic state …


Cooperation Of Chromatin Remodeling Swi/Snf Complex And Pioneer Factor Ap-1 Shapes 3d Enhancer Landscapes, Bennett K Wolf, Yanding Zhao, Andrew Mccray, William H Hawk, Luke T Deary, Nicholas W Sugiarto, Ian S Lacroix, Scott A Gerber, Chao Cheng, Xiaofeng Wang Jan 2023

Cooperation Of Chromatin Remodeling Swi/Snf Complex And Pioneer Factor Ap-1 Shapes 3d Enhancer Landscapes, Bennett K Wolf, Yanding Zhao, Andrew Mccray, William H Hawk, Luke T Deary, Nicholas W Sugiarto, Ian S Lacroix, Scott A Gerber, Chao Cheng, Xiaofeng Wang

Faculty, Staff and Students Publications

The mechanism controlling the dynamic targeting of SWI/SNF has long been postulated to be coordinated by transcription factors (TFs), yet demonstrating a specific TF influence has proven difficult. Here we take a multi-omics approach to interrogate transient SWI/SNF interactors, chromatin targeting and the resulting three-dimensional epigenetic landscape. We utilize the labeling technique TurboID to map the SWI/SNF interactome and identify the activator protein-1 (AP-1) family members as critical interacting partners for SWI/SNF complexes. CUT&RUN profiling demonstrates SWI/SNF targeting enrichment at AP-1 bound loci, as well as SWI/SNF-AP-1 cooperation in chromatin targeting. HiChIP reveals AP-1-SWI/SNF-dependent restructuring of the three-dimensional promoter-enhancer architecture …


The Effect Of Multi-Material Architecture On The Ex Vivo Osteochondral Integration Of Bioprinted Constructs, Matthew L Bedell, Ziwen Wang, Katie J Hogan, Angelica L Torres, Hannah A Pearce, Letitia K Chim, K Jane Grande-Allen, Antonios G Mikos Jan 2023

The Effect Of Multi-Material Architecture On The Ex Vivo Osteochondral Integration Of Bioprinted Constructs, Matthew L Bedell, Ziwen Wang, Katie J Hogan, Angelica L Torres, Hannah A Pearce, Letitia K Chim, K Jane Grande-Allen, Antonios G Mikos

Faculty, Staff and Students Publications

Extrusion bioprinted constructs for osteochondral tissue engineering were fabricated to study the effect of multi-material architecture on encapsulated human mesenchymal stem cells’ tissue-specific matrix deposition and integration into an ex vivo porcine osteochondral explant model. Two extrusion fiber architecture groups with differing transition regions and degrees of bone- and cartilage-like bioink mixing were employed. The gradient fiber (G-Fib) architecture group showed an increase in chondral integration over time, 18.5 ± 0.7 kPa on Day 21 compared to 9.6 ± 1.6 kPa on Day 1 for the required peak push-out force, and the segmented fiber (S-Fib) architecture group did not, which …


Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (Eimo), Dana R Levin, Jon Steller, Arian Anderson, Jay Lemery, Benjamin Easter, David C Hilmers, Kris R Lehnhardt Jan 2023

Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (Eimo), Dana R Levin, Jon Steller, Arian Anderson, Jay Lemery, Benjamin Easter, David C Hilmers, Kris R Lehnhardt

Faculty, Staff and Students Publications

Goal: Current Space Medicine operations depend on terrestrial support to manage medical events. As astronauts travel to destinations such as the Moon, Mars, and beyond, distance will substantially limit this support and require increasing medical autonomy from the crew. This paper defines Earth Independent Medical Operations (EIMO) and identifies key elements of a conceptual EIMO system. Methods: The NASA Human Research Program Exploration Medical Capability Element held a 2-day conference at Johnson Space Center in Houston, TX with NASA experts representing all aspects of Space Medicine. Results: EIMO will be a process enabling progressively resilient deep space exploration systems and …


Symptoms, Physical Activity, And Biomarkers In Children At The End Of Leukemia Maintenance Therapy, Mary C Hooke, Derek L Salisbury, Michelle A Mathiason, Alicia S Kunin-Batson, Audrey Blommer, Jessica Hutter, Pauline Mitby, Ida Moore, Susan Whitman, Olga Taylor, Michael E Scheurer, Marilyn J Hockenberry Jan 2023

Symptoms, Physical Activity, And Biomarkers In Children At The End Of Leukemia Maintenance Therapy, Mary C Hooke, Derek L Salisbury, Michelle A Mathiason, Alicia S Kunin-Batson, Audrey Blommer, Jessica Hutter, Pauline Mitby, Ida Moore, Susan Whitman, Olga Taylor, Michael E Scheurer, Marilyn J Hockenberry

Faculty, Staff and Students Publications

Background: Symptoms in children with acute lymphocytic leukemia (ALL) change over the trajectory of treatment but little is known about their symptoms as treatment ends. Physical activity may help decrease symptom distress and is vital for ongoing development. The role of biomarkers in symptom science is emerging. The purpose of the study was to explore relationships between self-report of symptoms and physical activity, actigraphy measures, and cerebrospinal fluid (CSF) biomarkers.

Methods: Participants were children who were ages 3 to 18 years at the time of ALL diagnosis and were now in the last 12-week cycle of ALL maintenance. Self-reports of …


Advanced Photon Counting Ct Imaging Pipeline For Cardiac Phenotyping Of Apolipoprotein E Mouse Models, Alex J Allphin, Ali Mahzarnia, Darin P Clark, Yi Qi, Zay Y Han, Prajwal Bhandari, Ketan B Ghaghada, Alexandra Badea, Cristian T Badea Jan 2023

Advanced Photon Counting Ct Imaging Pipeline For Cardiac Phenotyping Of Apolipoprotein E Mouse Models, Alex J Allphin, Ali Mahzarnia, Darin P Clark, Yi Qi, Zay Y Han, Prajwal Bhandari, Ketan B Ghaghada, Alexandra Badea, Cristian T Badea

Faculty, Staff and Students Publications

Background: Cardiovascular disease (CVD) is associated with the apolipoprotein E (APOE) gene and lipid metabolism. This study aimed to develop an imaging-based pipeline to comprehensively assess cardiac structure and function in mouse models expressing different APOE genotypes using photon-counting computed tomography (PCCT).

Methods: 123 mice grouped based on APOE genotype (APOE2, APOE3, APOE4, APOE knockout (KO)), gender, human NOS2 factor, and diet (control or high fat) were used in this study. The pipeline included PCCT imaging on a custom-built system with contrast-enhanced in vivo imaging and intrinsic cardiac gating, spectral and temporal iterative reconstruction, spectral decomposition, and deep learning cardiac …


Safety Procedures To Work With West Nile Virus In Biosafety Level 3 Facilities, Freedom M Green, Shannon E Ronca Jan 2023

Safety Procedures To Work With West Nile Virus In Biosafety Level 3 Facilities, Freedom M Green, Shannon E Ronca

Faculty, Staff and Students Publications

West Nile virus (WNV) can cause severe and sometimes fatal disease, but we do not have treatments or therapeutics to manage these outcomes. Since its introduction to the USA in 1999, WNV has been handled in a biosafety level 3 laboratory to decrease risk to researchers, requiring strict safety protocols and important considerations with planning experiments. Recent changes in US guidelines suggest that WNV can be handled at a lower biosafety level due to its endemicity in the USA and generally minor symptoms, but some research still requires the use of the agent at biosafety level 3. This chapter will …


Vaxi-Dl: An Artificial Intelligence-Enabled Platform For Vaccine Development, P Preeti, Swarsat Kaushik Nath, Nevidita Arambam, Trapti Sharma, Priyanka Ray Choudhury, Alakto Choudhury, Vrinda Khanna, Ulrich Strych, Peter J Hotez, Maria Elena Bottazzi, Kamal Rawal Jan 2023

Vaxi-Dl: An Artificial Intelligence-Enabled Platform For Vaccine Development, P Preeti, Swarsat Kaushik Nath, Nevidita Arambam, Trapti Sharma, Priyanka Ray Choudhury, Alakto Choudhury, Vrinda Khanna, Ulrich Strych, Peter J Hotez, Maria Elena Bottazzi, Kamal Rawal

Faculty, Staff and Students Publications

Vaccine development is a complex and long process. It involves several steps, including computational studies, experimental analyses, animal model system studies, and clinical trials. This process can be accelerated by using in silico antigen screening to identify potential vaccine candidates. In this chapter, we describe a deep learning-based technique which utilizes 18 biological and 9154 physicochemical properties of proteins for finding potential vaccine candidates. Using this technique, a new web-based system, named Vaxi-DL, was developed which helped in finding new vaccine candidates from bacteria, protozoa, viruses, and fungi. Vaxi-DL is available at: https://vac.kamalrawal.in/vaxidl/ .


Protocol Of Detection Of West Nile Virus In Clinical Samples, Hephzibah Nwanosike, Freedom M Green, Kristy O Murray, Jill E Weatherhead, Shannon E Ronca Jan 2023

Protocol Of Detection Of West Nile Virus In Clinical Samples, Hephzibah Nwanosike, Freedom M Green, Kristy O Murray, Jill E Weatherhead, Shannon E Ronca

Faculty, Staff and Students Publications

West Nile virus (WNV) is one of the leading causes of arboviral encephalitis in the United States but is often underdiagnosed. Despite the wide breadth of WNV-induced clinical disease syndromes, many of the symptoms associated with WNV are nonspecific at the time of presentation; thus, choosing the right diagnostic tool is essential to not only understand the true burden of disease but also provide pathogen-directed interventions for WNV-infected patients. In this chapter, we briefly discuss the three most common types of diagnostic methods for WNV in human clinical samples: nucleic acid detection, enzyme-linked immunoassay (ELISA), and plaque reduction neutralization test …


Climate Change As A Social Determinant Of Health: An Interactive Case-Based Learning Activity, Arindam Sarkar, Nital P Appelbaum, Rathi Asaithambi, Connie Tran, Doris Lin, Anjali Aggarwal, Stephanie Nguyen Jan 2023

Climate Change As A Social Determinant Of Health: An Interactive Case-Based Learning Activity, Arindam Sarkar, Nital P Appelbaum, Rathi Asaithambi, Connie Tran, Doris Lin, Anjali Aggarwal, Stephanie Nguyen

Faculty, Staff and Students Publications

INTRODUCTION: Despite consensus on climate change's impact on humans, medical schools have not widely adopted inclusion of environmental topics into their mandatory curriculum. This educational activity explicitly addresses climate change as one of the environmental determinants of health (EDH).

METHODS: We developed a required, 1-hour module for all first-year medical students. This interactive, case-based, small-group activity was incorporated into a curriculum within an advising program but could be run independently. Before and after the session, participants completed evaluations assessing knowledge gains and attitude shifts.

RESULTS: Of 183 first-year students, 155 completed both pre- and postmodule surveys. Participants' rating increased on …


Acute Liver Failure And Unique Challenges Of Pediatric Liver Transplantation Amidst A Worldwide Cluster Of Adenovirus-Associated Hepatitis, Anna M Banc-Husu, Elizabeth A Moulton, Henry Shiau, Luz Helena Gutierrez Sanchez, Moreshwar S Desai, Dana Cerminara, Flor M Munoz, Leanne M Buffaloe, Kristen G Valencia-Deray, N Thao N Galvan, Julu Bhatnagar, Lindsey Estetter, Negar Rassaei, Sarah Reagan-Steiner, Jason Wicker, James J Dunn, Carl E Allen, Kalyani R Patel, Sanjiv Harpavat, John A Goss, Daniel H Leung Jan 2023

Acute Liver Failure And Unique Challenges Of Pediatric Liver Transplantation Amidst A Worldwide Cluster Of Adenovirus-Associated Hepatitis, Anna M Banc-Husu, Elizabeth A Moulton, Henry Shiau, Luz Helena Gutierrez Sanchez, Moreshwar S Desai, Dana Cerminara, Flor M Munoz, Leanne M Buffaloe, Kristen G Valencia-Deray, N Thao N Galvan, Julu Bhatnagar, Lindsey Estetter, Negar Rassaei, Sarah Reagan-Steiner, Jason Wicker, James J Dunn, Carl E Allen, Kalyani R Patel, Sanjiv Harpavat, John A Goss, Daniel H Leung

Faculty, Staff and Students Publications

Investigation into a recent cluster of acute hepatitis in children from the southeastern United States identified human adenovirus (HAdV) DNAemia in all 9 cases. Molecular genotyping in 5 of 9 (56%) children identified HAdV type 41 in all cases (100%). Importantly, 2 children from this cluster progressed rapidly to pediatric acute liver failure (PALF) and required liver transplantation. HAdV type 41, a known cause of self-limited gastroenteritis, has not previously been associated with severe cholestatic hepatitis and liver failure in healthy children. Adenovirus polymerase chain reaction assay and sequencing of amplicons performed on DNA extracted from formalin-fixed, paraffin-embedded liver tissue …


Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, Lise E Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E Schunk, Michael J Stoner, Arleta Rewers, Julie K Mcmanemy, Kimberly S Quayle, Jennifer L Trainor, Leah Tzimenatos, Jonathan E Bennett, Maria Y Kwok, Sage R Myers, Kathleen M Brown, T Charles Casper, Cody S Olsen, Nicole S Glaser Jan 2023

Emergency Department Presentations Of Diabetic Ketoacidosis In A Large Cohort Of Children, Lise E Nigrovic, Nathan Kuppermann, Simona Ghetti, Jeff E Schunk, Michael J Stoner, Arleta Rewers, Julie K Mcmanemy, Kimberly S Quayle, Jennifer L Trainor, Leah Tzimenatos, Jonathan E Bennett, Maria Y Kwok, Sage R Myers, Kathleen M Brown, T Charles Casper, Cody S Olsen, Nicole S Glaser

Faculty, Staff and Students Publications

Background: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of childhood diabetes. However, the influence of demographic factors on presentation are not well-defined.

Methods: We included children from 12 centers who were < 18 years with DKA (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate < 15 mEq/L) enrolled in the Pediatric Emergency Care Applied Research Network (PECARN) Fluid Therapies Under Investigation in DKA (FLUID) Trial. Data were also collected for children who presented to the centers during the enrollment period but were not enrolled due to disease or treatment-related reasons. We compared demographic, clinical, and biochemical findings among children with newly and previously diagnosed diabetes and children in different age groups.

Results: Of the 1,679 DKA episodes in 1,553 children, 799 (47.5%) episodes occurred in children with newly diagnosed diabetes and 396 (23.6%) were severe (pH < 7.1). Newly diagnosed children < 6 years of age were not more likely to have severe DKA in terms of pH, but had more severe hypocarbia and higher blood urea nitrogen levels, factors previously associated with the risk of cerebral injury. Lower socioeconomic status (SES) (based on family income and maternal education level) were associated with more severe DKA in new onset children, and recurrent DKA in the previously diagnosed children.

Conclusions: Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury.


Editorial: Biological Drivers Of Vector-Pathogen Interactions – Vol Ii, Ryan O M Rego, Job E Lopez, Alejandro Cabesas-Cruz Jan 2023

Editorial: Biological Drivers Of Vector-Pathogen Interactions – Vol Ii, Ryan O M Rego, Job E Lopez, Alejandro Cabesas-Cruz

Faculty, Staff and Students Publications

No abstract provided.


Clinical Trial Design Challenges And Opportunities For Emerging Treatments For Opioid Use Disorder: A Review, Brian D Kiluk, Bethea A Kleykamp, Sandra D Comer, Roland R Griffiths, Andrew S Huhn, Matthew W Johnson, Kyle M Kampman, Marco Pravetoni, Kenzie L Preston, Ryan Vandrey, Cecilia L Bergeria, Michael P Bogenschutz, Randall T Brown, Kelly E Dunn, Robert H Dworkin, Patrick H Finan, Peter S Hendricks, Elisabeth J Houtsmuller, Thomas R Kosten, Dustin C Lee, Frances R Levin, Aimee Mcrae-Clark, Charles L Raison, Kurt Rasmussen, Dennis C Turk, Roger D Weiss, Eric C Strain Jan 2023

Clinical Trial Design Challenges And Opportunities For Emerging Treatments For Opioid Use Disorder: A Review, Brian D Kiluk, Bethea A Kleykamp, Sandra D Comer, Roland R Griffiths, Andrew S Huhn, Matthew W Johnson, Kyle M Kampman, Marco Pravetoni, Kenzie L Preston, Ryan Vandrey, Cecilia L Bergeria, Michael P Bogenschutz, Randall T Brown, Kelly E Dunn, Robert H Dworkin, Patrick H Finan, Peter S Hendricks, Elisabeth J Houtsmuller, Thomas R Kosten, Dustin C Lee, Frances R Levin, Aimee Mcrae-Clark, Charles L Raison, Kurt Rasmussen, Dennis C Turk, Roger D Weiss, Eric C Strain

Faculty, Staff and Students Publications

Importance: Novel treatments for opioid use disorder (OUD) are needed to address both the ongoing opioid epidemic and long-standing barriers to existing OUD treatments that target the endogenous μ-opioid receptor (MOR) system. The goal of this review is to highlight unique clinical trial design considerations for the study of emerging treatments for OUD that address targets beyond the MOR system. In November 2019, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration sponsored a meeting to discuss the current evidence regarding potential treatments for OUD, including cannabinoids, …


Demographics Of Skin Cancer Knowledge Among Middle And High Schoolers In Texas, Dina H Zamil, Shangyi Fu, Zahra Majd, Emily Powell, Jenna H Zamil, Zeena Y Nawas, Ida F Orengo Jan 2023

Demographics Of Skin Cancer Knowledge Among Middle And High Schoolers In Texas, Dina H Zamil, Shangyi Fu, Zahra Majd, Emily Powell, Jenna H Zamil, Zeena Y Nawas, Ida F Orengo

Faculty, Staff and Students Publications

INTRODUCTION: Adolescents, an age group that can reduce sun exposure early, may benefit from school-based skin cancer education programs. Literature regarding the demographics of melanoma knowledge is sparse.

OBJECTIVES: This study sought to evaluate melanoma knowledge among students in Texas viewing John Wayne Cancer Foundation Block the Blaze (JWCFBTB) presentations and identify group differences with regard to sociodemographic factors.

METHODS: Before JWCFBTB presentations delivered in Houston and Dallas by health professions students, a pre-presentation melanoma knowledge quiz was distributed. This survey was adapted from a 2000 study evaluating melanoma knowledge in middle and high schoolers in Houston and Dallas. Respondents …


Habenular Molecular Targets For Depression, Impulsivity, And Addiction, Snigdha Srivastava, Benjamin R Arenkiel, Ramiro Salas Jan 2023

Habenular Molecular Targets For Depression, Impulsivity, And Addiction, Snigdha Srivastava, Benjamin R Arenkiel, Ramiro Salas

Faculty, Staff and Students Publications

No abstract provided.


Oral Gauze For Bleeding Control In Perioral And Perinasal Dermatologic Surgery, Riyad N H Seervai, Jose A Cervantes, Ikue Shimizu, Ida F Orengo Jan 2023

Oral Gauze For Bleeding Control In Perioral And Perinasal Dermatologic Surgery, Riyad N H Seervai, Jose A Cervantes, Ikue Shimizu, Ida F Orengo

Faculty, Staff and Students Publications

The use of oral gauze is a quick, cheap, and effective method of preventing bleeding into the patient's mouth during dermatologic surgery. We recommend this technique combined with appropriate positioning for lesions in the perioral and perinasal regions. Similar approaches may be applied for the prevention of bleeding into the ear canal during facial/periauricular surgery.


Pediatric Bipolar Disorder: Evolution In Clinical And Biological Markers And Future Perspectives, Kirti Saxena, Kiki Chang, Gabriele Sani Jan 2023

Pediatric Bipolar Disorder: Evolution In Clinical And Biological Markers And Future Perspectives, Kirti Saxena, Kiki Chang, Gabriele Sani

Faculty, Staff and Students Publications

No abstract provided.


Use Of Lithium In Pediatric Bipolar Disorders And Externalizing Childhood- Related Disorders: A Systematic Review Of Randomized Controlled Trials, Delfina Janiri, Lorenzo Moccia, Silvia Montanari, Valentina Zani, Claudia Prinari, Laura Monti, Daniela Chieffo, Marianna Mazza, Alessio Simonetti, Georgios D Kotzalidis, Luigi Janiri Jan 2023

Use Of Lithium In Pediatric Bipolar Disorders And Externalizing Childhood- Related Disorders: A Systematic Review Of Randomized Controlled Trials, Delfina Janiri, Lorenzo Moccia, Silvia Montanari, Valentina Zani, Claudia Prinari, Laura Monti, Daniela Chieffo, Marianna Mazza, Alessio Simonetti, Georgios D Kotzalidis, Luigi Janiri

Faculty, Staff and Students Publications

Background: Lithium is the standard treatment for bipolar disorders (BD) in adults. There is a dearth of data on its use in the pediatric age. This review aimed to investigate the use of lithium in pediatric bipolar disorder (BD) and other externalizing childhood-related disorders.

Methods: We applied the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria (PRISMA) to identify randomized controlled trials evaluating the use of lithium in pediatric (BD), conduct disorder (CD), attention deficit hyperactivity disorder, oppositional defiant disorder, and disruptive mood dysregulation disorder. The primary outcome of our study was to evaluate the efficacy of lithium compared …


Development Of A Peripheral Blood Transcriptomic Gene Signature To Predict Bronchopulmonary Dysplasia, Alvaro Moreira, Miriam Tovar, Alisha M Smith, Grace C Lee, Justin A Meunier, Zoya Cheema, Axel Moreira, Caitlyn Winter, Shamimunisa B Mustafa, Steven Seidner, Tina Findley, Joe G N Garcia, Bernard Thébaud, Przemko Kwinta, Sunil K Ahuja Jan 2023

Development Of A Peripheral Blood Transcriptomic Gene Signature To Predict Bronchopulmonary Dysplasia, Alvaro Moreira, Miriam Tovar, Alisha M Smith, Grace C Lee, Justin A Meunier, Zoya Cheema, Axel Moreira, Caitlyn Winter, Shamimunisa B Mustafa, Steven Seidner, Tina Findley, Joe G N Garcia, Bernard Thébaud, Przemko Kwinta, Sunil K Ahuja

Faculty, Staff and Students Publications

Bronchopulmonary dysplasia (BPD) is the most common lung disease of extreme prematurity, yet mechanisms that associate with or identify neonates with increased susceptibility for BPD are largely unknown. Combining artificial intelligence with gene expression data is a novel approach that may assist in better understanding mechanisms underpinning chronic lung disease and in stratifying patients at greater risk for BPD. The objective of this study is to develop an early peripheral blood transcriptomic signature that can predict preterm neonates at risk for developing BPD. Secondary analysis of whole blood microarray data from 97 very low birth weight neonates on day of …


Gastrointestinal Organoids In The Study Of Viral Infections, J Thomas Gebert, Francesca Scribano, Kristen A Engevik, Jacob L Perry, Joseph M Hyser Jan 2023

Gastrointestinal Organoids In The Study Of Viral Infections, J Thomas Gebert, Francesca Scribano, Kristen A Engevik, Jacob L Perry, Joseph M Hyser

Faculty, Staff and Students Publications

Viruses are among the most prevalent enteric pathogens. Although virologists historically relied on cell lines and animal models, human intestinal organoids (HIOs) continue to grow in popularity. HIOs are nontransformed, stem cell-derived, ex vivo cell cultures that maintain the cell type diversity of the intestinal epithelium. They offer higher throughput than standard animal models while more accurately mimicking the native tissue of infection than transformed cell lines. Here, we review recent literature that highlights virological advances facilitated by HIOs. We discuss the variations and limitations of HIOs, how HIOs have allowed for the cultivation of previously uncultivatable viruses, and how …