Digital Commons Network^™

Surgeons, Physiatrists And Neurologists Speaking "Edx And Nerve Surgery": A Paradigm Shift For Nerve Injured Patients, Deng Pan, Aneri U Patel, J Megan Patterson, Anna Rose Johnson, Travis Gordon, Susan E Mackinnon

2020-Current year OA Pubs

Surgeons' ability to interpret electrodiagnostic (EDX) studies has greatly enhanced patient selection and outcome for nerve surgeries as it has informed our understanding of the classification of nerve injury. EDX measures axons present, lost, or demyelinated. It does not measure an area where axons experience chronic ischemia, making a Sunderland Zero nerve injury a clinical diagnosis that should be suspected when patients have normal EDX, decreased recruitment on electromyography (EMG), and no atrophy. Only observation of recovery in the earliest postoperative period would confirm a Sunderland Zero. In this article, we present an expanded classification of nerve injury, highlighting Sunderland …

Domain Mapping Of Disease Mutations Reveals Pathogenic Sorl1 Variants In Alzheimer's Disease, Olav M. Andersen, Carlos Cruchaga, Maria Victoria Fernandez, Et Al.

2020-Current year OA Pubs

No abstract provided.

Multi-Ancestry Genome-Wide Meta-Analysis Of 56,241 Individuals Identifies Known And Novel Cross-Population And Ancestry-Specific Associations As Novel Risk Loci For Alzheimer's Disease, Farid Rajabli, Bruno A. Bonitez, Nigel J. Cairns, John C. Morriswashington University School Of Medicine In St. Louis, Carlos Cruchaga, Oscar Harari, Laura Ibanez, Et Al.

2020-Current year OA Pubs

No abstract provided.

Mechanisms And Environmental Factors Shaping The Ecosystem Of Brain Macrophages, Silvia Penati, Simone Brioschi, Zhangying Cai, Claudia Z Han, Marco Colonna

2020-Current year OA Pubs

Brain macrophages encompass two major populations: microglia in the parenchyma and border-associated macrophages (BAMs) in the extra-parenchymal compartments. These cells play crucial roles in maintaining brain homeostasis and immune surveillance. Microglia and BAMs are phenotypically and epigenetically distinct and exhibit highly specialized functions tailored to their environmental niches. Intriguingly, recent studies have shown that both microglia and BAMs originate from the same myeloid progenitor during yolk sac hematopoiesis, but their developmental fates diverge within the brain. Several works have partially unveiled the mechanisms orchestrating the development of microglia and BAMs in both mice and humans; however, many questions remain unanswered. …

Case Report: Molecular Characterization Of Adult Atypical Teratoid Rhabdoid Tumor And Review Of The Literature, Miguel A Hernandez-Rovira, Michelle Connor, Robert C Osorio, Emilie Russler-Germain, Robert Schmidt, Gabrielle W Johnson, Julie Silverstein, Sonika Dahiya, Nyssa Fox Farrell, Mia C Weiss, Gregory J Zipfel, Jiayi Huang, Dimitrios Mathios

2020-Current year OA Pubs

BACKGROUND AND IMPORTANCE: Atypical teratoid rhabdoid tumors (ATRTs) are typically aggressive pediatric tumors with a median survival of 11 months. Due to the paucity of cases in adults, the clinical behavior of these pathologies is not well understood. Here we present the case of a 41-year-old female patient with postoperative hyperprogression of a sellar ATRT and provide a detailed description of the molecular composition of this tumor, the protocol used to treat this patient, and the ultimate outcome of this patient.

CLINICAL PRESENTATION: The patient is a 41-year-old woman who presented with headaches and double vision. MRI revealed a sellar/suprasellar …

Integrating Mapk Pathway Inhibition Into Standard-Of-Care Therapy For Pediatric Low-Grade Glioma, Erin E Crotty, Aimee A Sato, Mohamed S Abdelbaki

2020-Current year OA Pubs

Pediatric low-grade gliomas (pLGG) are a group of tumors largely driven by alterations in a single genetic pathway, known as the RAS-RAF-mitogen-activated protein kinase (MAPK) pathway. Recent biologic insights and therapeutic targeting of MAPK-alterations have dramatically shifted the treatment approach in pLGG. While chemotherapy remains front-line therapy for unresectable pLGG in most scenarios (with the notable exception of

Multidisciplinary Approach To Treating Complex Immune Dysregulation Disorders: An Adaptive Model For Institutional Implementation, Lauren A Henderson, Megan A Cooper, Anthony French, Et Al.

2020-Current year OA Pubs

Patients with immune dysregulation may present with varying combinations of autoimmunity, autoinflammation, immunodeficiency, atopy, lymphoproliferation, and/or malignancy, often with multisystem involvement. Recognizing specific patterns of immune dysregulation, coordinating and interpreting complex diagnostic testing, and choosing initial (often empiric) treatment can be challenging. Centers are increasingly assembling multidisciplinary teams (MDTs) to standardize evaluation and optimize treatment of patients with complex immune dysregulation (immune dysregulation MDTs [immMDTs]). However, published information on the composition and function of immMDTs is sparse, and there is little guidance for those seeking to establish or optimize an immMDT. To inform this review, we assembled a panel of …

The Evolution And Application Of Multi-Omic Analysis For Pituitary Neuroendocrine Tumors, Sangami Pugazenthi, Shree S Pari, Ziyan Zhang, Julie Silverstein, Albert H Kim, Bhuvic Patel

2020-Current year OA Pubs

Pituitary neuroendocrine tumors (PitNETs) are a heterogeneous group of intracranial neoplasms that vary in hormonal activity, histological features, and clinical behavior. The rise of high-throughput sequencing and molecular profiling technologies has enabled multiomic approaches-including genomics, transcriptomics, epigenomics, proteomics, and metabolomics-to deepen our understanding of PitNET pathogenesis. These studies have identified key mutations, transcriptional lineages, epigenetic modifications, and proteomic features that contribute to tumor subtype classification, invasiveness, and treatment response. Integrative multi-omic analyses have further revealed distinct molecular subtypes, complex regulatory networks, and molecular profiles that can predict recurrence and therapeutic efficacy. These approaches hold strong potential for advancing personalized medicine …

A Multicenter Study To Assess Efficacy, Safety, And Tolerability Of Ropeginterferon Alfa-2b-Njft In Patients With Essential Thrombocythemia In The Us And Canada: Exceed-Et Trial, Lucia Masarova, Stephen T Oh, Et Al.

2020-Current year OA Pubs

No abstract provided.

The Role Of Complement In Normal Pregnancy And Preeclampsia, Richard M Burwick, Anuja Java, Jean F Regal

2020-Current year OA Pubs

Preeclampsia affects 3-4% of pregnancies with adverse effects for both mother and child. Minimal therapeutic options are available, and biomarkers are urgently needed to identify those at greatest risk early in the pregnancy. Both the innate and adaptive immune systems are well regulated during normal pregnancy including the complement system. A functioning complement system with some degree of complement activation participates in proper placental development, ensuring a healthy pregnancy and assisting with host defense. However, aberrant complement activation can lead to adverse pregnancy outcomes such as preeclampsia. An overview of the complement system will be presented, along with review of …

Identification Of Candidate Cardiomyopathy Modifier Genes Through Genome Sequencing And Rna Profiling, Malene E Lindholm, Gerald W Dorn, Et Al.

2020-Current year OA Pubs

BACKGROUND: Phenotypic heterogeneity is apparent among individuals with putative monogenic disease, such as familial hypertrophic cardiomyopathy. Genome sequencing (GS) allows interrogation of the full spectrum of inborn genetic variation in an individual and RNA profiling provides a snapshot of the cardiac-specific pathogenic effects on gene expression.

OBJECTIVES: Identify candidate genetic modifiers of hypertrophic cardiomyopathy phenotype.

METHODS: We performed GS of 48 individuals with variants in

RESULTS: GS identified the

CONCLUSION: Evaluation of the whole genome, even in the case of alleged monogenic disease, leads to important new insights. The identified variants, regions, and genes are candidates to modify disease presentation …

Adapting Data Science Competencies By Role And Purpose: Voice Ai, David A Dorr, Andrea Krussel, Rachel Hauck, Christie Jackson, Abhijeet Dalal, Steven Bedrick, Philip R O Payne, Bridge2ai-Voice Consortium;, William Hersh

2020-Current year OA Pubs

Competencies help define the skills and knowledge needed by learners. Often broad, educators integrate competencies to provide a framework for curricula or professional standards. For data science, the rate of change in the field, role variations, and specificity in key applications can be challenging. Our objective was to adapt general data science competencies for different learner roles in an emerging area: the clinical utility of Voice, Language, and Speech-based Artificial Intelligence/Machine Learning (AI/ML). Using a persona-inductive approach, we adapted competencies to support learners from varying professional and educational backgrounds and implemented these adaptations in a multi-institutional summer school. Results from …

Building Toward A Standard Model For Perinatal Mental Healthcare, R Christopher Sheldrick, Megan Deichen Hansen, Nicole H Cirino, Mary Kimmel, Courtney King, Deirdre Logan, Rena Menke, Karen Tabb

2020-Current year OA Pubs

BACKGROUND: Healthcare decision-making relies on models that synthesize complex components such as disease epidemiology, diagnostic accuracy, and treatment efficacy. A healthcare model serves as a framework to integrate health systems research, biological understanding, and diverse perspectives on health, enabling decision-makers to optimize access, quality, cost, and equity. The National Academy of Sciences, Engineering, and Medicine (NASEM) has underscored the need for a shared conceptualization in behavioral sciences to unify definitions and facilitate data synthesis. To achieve this, a standard model of perinatal mental healthcare is imperative.

OBJECTIVE: We propose the development of a standard model of perinatal mental healthcare, analogous …

Parp Inhibitors In Melanoma Treatment: Potential, Challenges, And Future Directions, Angela Anaeme, Karen Moussa, Abdallah N Mansour, George Nassief, George Ansstas

2020-Current year OA Pubs

Genome integrity is a critical driver of cellular stability, and defects in the processes that maintain genome health are potent sources of cancer progression. Homologous recombination deficiency (HRD), which damages cells through absent or erroneous repair of double-stranded DNA breaks, is a prime example of such cellular dysfunction. Poly(ADP-ribose) polymerase (PARP) inhibitors exploit these aberrancies in the cellular repair process by arresting the ability of the PARP enzyme to repair cellular and genetic damage, inducing the accumulation of DNA damage and cancer cell death. While the utility of PARP inhibitors has been established in many HRD-associated tumors - particularly breast, …

Sauna Use As A Novel Management Approach For Cardiovascular Health And Peripheral Arterial Disease, Sergio Sastriques-Dunlop, Santiago Elizondo-Benedetto, Mohamed A Zayed

2020-Current year OA Pubs

INTRODUCTION: Heat therapy (HT), particularly in the form of whole-body sauna bathing, has emerged as a promising intervention for the management of cardiovascular disease (CVD). Passive HT can induce both local and systemic physiological responses, primarily through repeated thermal stress consisting of short-term passive exposure to high temperatures. Such responses closely parallel the physiological adaptations observed during aerobic exercise. Peripheral arterial disease (PAD) poses significant health challenges, impacting millions of individuals worldwide. Supervised exercise is considered a cornerstone therapy for PAD, yet many patients face significant health-related barriers that complicate its broad implementation.

METHODS: We conducted a comprehensive review of …

Bronchus-Associated Lymphoid Tissue In Lung Transplantation: A Facilitator Of Rejection Or Regulator Of Tolerance?, Alexander N Wein, Charles R Liu, Daniel Kreisel

2020-Current year OA Pubs

The role of bronchus-associated lymphoid tissue (BALT) in the regulation of immune responses to transplanted lungs remains an area of interest and controversy. Early studies in a rat pulmonary transplant model suggested BALT may accelerate rejection of grafts by inducing a local and systemic inflammatory response. Such observations were corroborated in intrapulmonary tracheal transplant models in the rat. While some human studies have described the presence of BALT in grafts that have been chronically rejected, others did not observe an association between induction of BALT and adverse outcomes. More recent investigations have found that BALT, enriched in immunoregulatory cell populations, …

Evaluating And Supporting Leadership, Management, And Mentoring: A Framework For Catalyzing Responsible Research And Healthy Research Environments, Tristan Mcintosh, Alison L Antes

2020-Current year OA Pubs

Those who lead research teams have myriad roles and responsibilities that are pivotal to both producing rigorous and responsible scientific work and creating a supportive research environment that cultivates this work. We begin by presenting a leadership, management, and mentoring (LMM) framework focused on three critical roles researchers must play that have direct impact on the scientific work, the work environment, and research team dynamics: the role of research leader, research manager, and research mentor. Research leadership involves fostering a healthy research culture by building relationships where team members feel respected and supported. Research management involves providing oversight and direction …

Characterization Of Tlr9 Responsiveness In Cell Subsets Derived From In Vitro Pdc Differentiation Of Hematopoietic Stem And Progenitor Cells, Sabina Sánchez Hernández, Tobias Wang Bjerg, Ian Helstrup Nielsen, Anders Laustsen, Hai Q Tang, Lars Henning Pedersen, Eynav Klechevsky, Martin R Jakobsen, Rasmus O Bak

2020-Current year OA Pubs

Plasmacytoid dendritic cells (pDCs) are multifunctional immune cells with roles in both the innate and adaptive immune system. Their hallmark function is production of large amounts of type I interferons in response to viral infections, but they are also capable of producing a range of other cytokines, antigen presentation, and cytotoxicity. Their potential as an immunotherapy for cancer and infectious disease is being explored, but broad application of these cells is challenged by low frequency in the blood and low viability during

Articles That May Change Your Practice: Reviewing Intraosseous Or Intravenous? Reviewing Intraosseous Versus Intravenous First Approach To Access In Out-Of-Hospital Cardiac Arrest Data From Randomized Controlled Trials, Blaise Loughman, Fatou Ndaw, Aaron J Lacy, James L Li

2020-Current year OA Pubs

No abstract provided.

Articles That May Change Your Practice: Double-Sequential External Defibrillation In Out-Of-Hospital Cardiac Arrest, Michael J Defilippo, Christianne L Jafari, James L Li, Aaron J Lacy

2020-Current year OA Pubs

No abstract provided.

Articles That May Change Your Practice: Prehospital Extracorporeal Membrane Oxygenation Alerts And Extracorporeal Cardiopulmonary Resuscitation In Out-Of-Hospital Cardiac Arrest, James L Li, Aaron J Lacy, Bridgette B Svancarek

2020-Current year OA Pubs

No abstract provided.

Usability Of The Mayo Test Drive Remote Self-Administered Web-Based Cognitive Screening Battery In Adults Aged 35-100 With And Without Cognitive Impairment, Jay S Patel, Jason Hassenstab, Et Al.

2020-Current year OA Pubs

BACKGROUND: Mayo Test Drive (MTD): Mayo Test Development through Rapid Iteration, Validation and Expansion, is a web-based remote cognitive assessment platform for self-administered neuropsychological measures with previously demonstrated validity and reliability. We examined the usability of MTD and hypothesized that completion rates would be greater than 90%. We explored whether completion and participation rates differed by cognitive status and demographic factors.

METHODS: A total of 1,950 Mayo Clinic Study of Aging and Mayo Alzheimer's Disease Research Center participants (97% White, 99% Non-Hispanic) were invited to participate in this ancillary, uncompensated remote study. Most invitees were cognitively unimpaired (CU;

RESULTS: Baseline …

Managing Tbsrtc Iii Thyroid Nodules: Evaluating Repeat Fna, Molecular Testing, And Surgery, Christopher Dilli, William Mi, Daniel L Miller

2020-Current year OA Pubs

INTRODUCTION: Thyroid nodules are common, but most are benign. Concerning nodules undergo fine-needle aspiration (FNA) and are classified using The Bethesda System. Nodules with atypia of undetermined significance (AUS) [Bethesda III] have management options including surveillance, repeat FNA, molecular testing, and surgical evaluation. While molecular testing can reduce unnecessary surgeries, it is costly. This retrospective study assessed the feasibility of repeat FNA as a cost-effective alternative.

MATERIALS AND METHODS: We conducted a multi-institutional retrospective study of AUS nodules from 5 hospitals between September 1, 2018, and March 1, 2024. Only initial FNA cases were included; pediatric cases and those lost …

An Exploratory Graphical Analysis Of The Montgomery-Åsberg Depression Rating Scale Pre- And Post-Treatment Using Pooled Antidepressant Trial Secondary Data, David Byrne, Arunangshu Ghoshal, Fiona Boland, Susan Brannick, Robert M Carney, Pim Cuijpers, Alexandra L Dima, Kenneth E Freedland, Suzanne Guerin, David Hevey, Bishember Kathuria, Vincent Mcdarby, Emma Wallace, Frank Doyle

2020-Current year OA Pubs

BACKGROUND: The 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) is a commonly used measure of depression in antidepressant clinical trials. Numerous studies have adopted classical test theory perspectives to assess the psychometric properties of this scale, finding generally positive results. However, its network configural structure and stability is unexplored across different time-points and treatment groups.

AIMS: To assess the network structure and stability of the MADRS in clinical settings pre- and post-treatment, and to determine a configurally invariant and stable model across time-points and treatment groups (placebo and intervention).

METHOD: Individual participant data for 6440 participants from 14 clinical trials of …

Disclosing Disabilities: Barriers For Medical School Applicants, Sarah Leah Solomon, Aitan E. Magence, Harry Haran, Fern R. Juster, Kristina H. Petersen

2020-Current year OA Pubs

This study investigated the availability of accommodation request procedures for medical school admissions interviews and the accessibility of Technical Standards (TS) for candidates with disabilities (CWD) across Liaison Committee on Medical Education (LCME)-accredited institutions in the United States and Canada. Utilizing a cross-sectional study methodology, surveys were distributed to Deans of Admissions and Disabilities Resource Professionals (DRP) at all LCME-accredited US and Canadian MD programs. Surveys gathered data about interview formats, interview accommodation procedures, and TS accessibility during the 2018-2019 academic year. We received responses from 71 institutions (41.3%), with 56.3% survey completion rate (n = 40). Among respondents, interview …

Efficacy And Safety Of Dostarlimab In Combination With Chemotherapy In Patients With Dmmr/Msi-H Primary Advanced Or Recurrent Endometrial Cancer In A Phase 3, Randomized, Placebo-Controlled Trial (Engot-En6-Nsgo/Gog-3031/Ruby), Matthew A Powell, Carolyn Mccourt, Et Al.

2020-Current year OA Pubs

OBJECTIVES: Part 1 of the RUBY trial (NCT03981796) demonstrated improved survival in patients with primary advanced or recurrent endometrial cancer (EC) treated with dostarlimab plus carboplatin-paclitaxel versus placebo plus carboplatin-paclitaxel. Here, we examine additional efficacy and safety data from patients with mismatch repair deficient/microsatellite instability-high (dMMR/MSI-H) EC in the RUBY trial.

METHODS: Patients were randomized 1:1 to dostarlimab 500 mg or placebo plus carboplatin-paclitaxel every 3 weeks for 6 cycles followed by dostarlimab or placebo every 6 weeks for up to 3 years. In the dMMR/MSI-H population of RUBY Part 1, analysis of progression-free survival by investigator assessment compared with …

Microbial Degradation Of Persistent Organic Pollutants In Food Supply Chain, Pankaj Kumar, Ajay Singh, Manikant Tripathi, Deepti Diwan, R Manimekalai, Minaxi Sharma, Sudisha Jogajah, Ramesh Chandra Dubey, Gauri Dutt Sharma

2020-Current year OA Pubs

No abstract provided.

Assessing The Clinical Meaningfulness Of Slowing Cdr-Sb Progression With Disease-Modifying Therapies For Alzheimer's Disease, Sarah M Hartz, Suzanne E Schindler, Marissa L Streitz, Krista L Moulder, Jessica Mozersky, Guoqiao Wang, Chengjie Xiong, John C Morris

2020-Current year OA Pubs

INTRODUCTION: For many patients and caregivers, a major goal of disease-modifying treatments (DMTs) for Alzheimer's disease (AD) dementia is to extend independence in instrumental and basic activities of daily living (IADLs and BADLs). The goal of this study was to estimate the effect of treatments on the time remaining independent in IADLs and BADLs.

METHODS: Participants at the Knight Alzheimer Disease Research Center (Knight ADRC) who met eligibility criteria for recent DMT trials were studied: age ≥60 years at baseline, clinical diagnosis of very mild or mild AD dementia (global Clinical Dementia Rating [CDR] score 0.5 or 1), biomarker confirmation …

Acute Metabolic Decompensation After Liver Transplant In A Patient With Maple Syrup Urine Disease, Shao Ching Tu, Marium Khan, Katie Wolfe, Sakil S Kulkarni, Elizabeth Toolan, Dorothy K Grange

2020-Current year OA Pubs

Maple syrup urine disease (MSUD) is an inborn error of metabolism characterized by the accumulation of branched-chain amino acids (leucine, isoleucine, and valine) caused by a defect in the branched-chain alpha-keto acid dehydrogenase complex. Liver transplant is an effective therapy for MSUD, and patients can usually tolerate a regular diet after transplant without symptomatic metabolic decompensation. Most post-transplant patients do not follow a sick-day diet. We report a case of a 7-year-old male with MSUD Type IA, status post-liver transplant at 2 years of age, who presented with profound encephalopathy following poor oral intake and vomiting for 3 days. Broad …

Schistosomiasis Interventions In Africa: Assessment And Systematic Review, Christopher Yaw Dumevi, George Boateng Kyei, Patience B Tetteh-Quarcoo, James-Paul Kretchy, Irene Ayi, Patrick F Ayeh-Kumi

2020-Current year OA Pubs

No abstract provided.