Digital Commons Network^™

Adolescent Coronal Shear Fractures Of The Distal Humerus: Surgical Approach And Outcomes, David Wright, Zachary Meyer, Charles A Goldfarb, Lindley B Wall

2020-Current year OA Pubs

PURPOSE: Isolated coronal shear fractures of the distal humerus in adolescents are rare injuries with unique surgical challenges. Respect for the posterior blood supply, open physes, and need for direct visualization to achieve anatomic reduction are critical considerations in surgical fixation. This study presents a case series and a surgical approach used in treating these patients.

METHODS: A retrospective review of patients aged 10-19 presenting to a single quaternary-care academic center from 2016 to 2023 with isolated capitellar and trochlear shear fractures was performed. Demographic data, injury mechanism, fracture classification, and surgical approach were recorded. Outcomes included elbow range of …

Hospitalizations As An Outcome Measure In Courage-Als, Stacy A Rudnicki, Timothy M Miller, Et Al.

2020-Current year OA Pubs

No abstract provided.

Nirfasterff: An Accessible, Cross-Platform Python Package For Fast Photon Modeling, Jiaming Cao, Samuel Montero-Hernandez, Rickson C Mesquita, Adam T Eggebrecht, Hamid Dehghani

2020-Current year OA Pubs

SIGNIFICANCE: Accurate and efficient photon modeling plays an essential role in the rapidly developing field of diffuse optical imaging, whereby the use of model-based analysis and image reconstruction can provide both educational and research benefits.

AIM: NIRFASTerFF is a cross-platform (Linux, macOS, and Windows) Python package for finite element method (FEM)-based light propagation modeling, supporting continuous-wave, frequency-domain, and time-resolved data for both exogenous and endogenous optical imaging applications. It also enables modeling of the autocorrelation function (

APPROACH: NIRFASTerFF incorporates highly parallelized FEM solvers for efficient computation on both CPU and GPU, leveraging OpenMP and CUDA acceleration. To support image …

Importance Of Defining Anatomy: Uncovering An Unexpected Finding With Ct Coronary Angiography After Abnormal Spect Results, Anushree Puttur, Laith Alhuneafat, Omar Obeidat, Andreas Kyvernitakis, Ahmad Jabri, Abdallah Naser, Ahmad Al-Abdouh, Farhan Katchi

2020-Current year OA Pubs

Coronary CT angiography extends beyond detecting obstructive coronary artery disease by providing vital anatomical insights into extra-coronary pathologies, including acute aortic syndromes. This non-invasive modality enables early identification of life-threatening conditions and informs multidisciplinary management strategies, underscoring its critical role in comprehensive diagnostic evaluation and patient-centered care.

Severe Neurological Presentation In Siblings With Coq5-Related Primary Coenzyme Q10 Deficiency: Expanding Clinical And Molecular Spectrum, Parith Wongkittichote, Rachel M Guerra, Daniel J Wegner, Samantha Toy, Jacqueline A Hauer, David J Pagliarini, Jorge L Granadillo

2020-Current year OA Pubs

Coenzyme Q

Comparing Effectiveness And Safety Of Left Atrial Appendage Closure Devices: A Network Meta-Analysis Of Randomized Controlled Trials, John W Davis, Steven L Mai, Wissam Harmouch, Jenna Reisler, Micaela Mackay, Elizabeth Davis, Pavel Osmancik, Michael W Rich

2020-Current year OA Pubs

INTRODUCTION: Atrial fibrillation-related stroke is a leading cause of morbidity and mortality. The comparative effectiveness and safety of left atrial appendage closure (LAAC) devices, compared with one another and with anticoagulation, is unclear.

METHODS: We conducted a systematic review and network meta-analysis (NMA) of all clinical trials comparing the Watchman and Amplatzer Amulet LAAC devices with each other or with warfarin or direct oral anticoagulants (DOACs). The primary comparison was between LAAC devices with secondary comparisons to anticoagulation. The primary effectiveness outcomes were any stroke and all-cause death. Safety outcomes included any thromboembolism, device embolization, and pericardial effusion.

RESULTS: There …

Progresssive Maculopathy In A Child Resulting From Vitreopapillary Traction On A Congenitally Anomalous Nerve, Ross M. Kennamer-Chapman, Lee M. Jampol, Rithwick Rajagopal

2020-Current year OA Pubs

PURPOSE: To present a case of worsening maculopathy and vision loss because of vitreopapillary traction associated with an anomalous optic nerve head in a pediatric patient successfully managed with pars plana vitrectomy.

METHODS: Retrospective case report.

RESULTS: A 13-year-old boy presented with unilateral maculopathy that slowly progressed over a 4-year period. As his visual acuity declined, he became increasingly symptomatic. The macular pathology occurred in the setting of vitreopapillary traction overlying multiple congenital optic nerve abnormalities, including a myelinated nerve fiber layer and a Bergmeister papilla. After pars plana vitrectomy to alleviate the traction, the patient's macular appearance improved, and …

Identifying Performance Differences Between Two Pulse Oximetry Systems In Simulated Critical Neonatal Conditions, Brian King, Jake Dove, Scott J Mcgonigle, Warwick A Ames, Zachary A Vesoulis

2020-Current year OA Pubs

OBJECTIVE: Pulse oximetry is used to guide critical clinical decisions in neonatology. We used a vital signs simulator to compare performance of two pulse oximetry systems in conditions not tested in standardized clinical verification studies.

STUDY DESIGN: We devised a set of simulated tissue translucency, perfusion, peripheral oxygen saturation (SpO

RESULTS: The mean SpO

CONCLUSION: Significant performance differences can be observed when comparing pulse oximeters at low translucency and perfusion conditions. Patient simulators cannot replace clinical testing but provide a safe and cost-effective method for additional performance profiling.

Management Of The Patent Ductus Arteriosus Among Infants Born At 23 To 32 Weeks' Gestation Between 2011 To 2022: A Report From In The Children's Hospitals Neonatal Consortium, Mark F Weems, Molly K Ball, Isabella Zaniletti, Sharifa Habib, Shannon Hamrick, Theresa R Grover, Sarah Keene, Karna Murthy, Michael Padula, Ranjit Philip, Rakesh Rao, Shawn Sen, Philip T Levy, Sharada H Gowda, Chnc Cardiac Focus Group

2020-Current year OA Pubs

OBJECTIVE: This study reports on patent ductus arteriosus (PDA) therapy trends across the Children's Hospital Neonatal Consortium.

STUDY DESIGN: We performed a 12-year (2011-2022) retrospective study of premature infants (<  33 weeks) with a PDA. We utilized descriptive statistics to compare demographic, inpatient, and discharge characteristics in 3-year epochs.

RESULT: From 54,813 infants, 19,843 (36%) had a diagnosis of PDA. Use of pharmacotherapy increased 44% (relative) over time, mostly with increased acetaminophen use. There was a 12.7-fold increase in exposure to multiple PDA medications over the study period. While the rate of definitive closure did not change, use of transcatheter PDA closure increased from 0 to 20.3% and surgical ligation decreased from 25.1% to 3.6%.

CONCLUSION: There has been …

Transdiagnostic Alterations In White Matter Microstructure Associated With Suicidal Thoughts And Behaviours In The Enigma Suicidal Thoughts And Behaviours Consortium, Laura S. Van Velzen, Alexander S. Hatoum, Et Al.

2020-Current year OA Pubs

No abstract provided.

Ambient Trichloroethylene Exposure And Parkinson Disease Risk In Medicare Beneficiaries, Brittany Krzyzanowski, Kassu Mehari Beyene, Jay R. Turner, Brad A. Racette

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Trichloroethylene (TCE) is an important environmental contaminant in the United States due to widespread use industrially. Epidemiologic studies suggest that occupational exposure to TCE and TCE-contaminated drinking water may increase the risk of Parkinson disease (PD). The aim of this study was to investigate the nationwide relationship between ambient TCE and PD risk.

METHODS: We performed a nationwide, population-based, case-control study to investigate the association between incident PD in US Medicare beneficiaries aged 67 years and older in 2016-2018 and their residential exposure to ambient (outdoor) TCE in 2002. We assigned residence based on the latitude and …

Genetic Influences For Distinct Impulsivity Domains Are Differentially Associated With Early Substance Use Initiation: Results From The Abcd Study, Ethan Kinstler, Aaron J Gorelik, Sarah E Paul, Adamya Aggarwal, Emma C Johnson, Melissa A Cyders, Arpana Agrawal, Ryan Bogdan, Alex P Miller

2020-Current year OA Pubs

BACKGROUND: Impulsivity is among the strongest correlates of substance involvement (i.e. a broad continuum of substance-related behaviors), and distinct domains (e.g. sensation seeking [SS] and urgency) are differentially correlated, phenotypically and genetically, with unique substance involvement stages. Examining whether polygenic influences for distinct impulsivity domains are differentially predictive of early substance use initiation - a major risk factor for later problematic use - may improve our understanding of the role of impulsivity in addiction etiology.

METHODS: Data collected from participants of genetically inferred European ancestry enrolled in the Adolescent Brain Cognitive Development Study

RESULTS: SS-PGS was significantly associated with any …

Type I Hybrid Effectiveness-Implementation Randomised Controlled Trial To Address Intergenerational Impact Of War Trauma And Resilience Among Second-Generation Refugee Children In The Usa: Resettled Refugee Families For Healing (Rrf4h) Study Protocol, Nhial T Tutlam, Tewodros W Liyew, Theresa S Betancourt, Byron J Powell, Shenyang Guo, Mary Mckay, Fred M Ssewamala

2020-Current year OA Pubs

INTRODUCTION: Children from refugee families resettled in the USA face higher risks of serious mental health challenges compared with their native-born peers. Research shows that refugee youth in high-income countries frequently suffer from trauma-associated disorders such as post-traumatic stress disorder (PTSD), depression and anxiety. The high prevalence of trauma-associated mental health problems among these youth may be attributed to their own trauma exposure, especially if born in conflict zones, and post-resettlement challenges like poverty, acculturation difficulties, racism and discrimination. However, they may also suffer from the effects of intergenerational trauma, where parental war trauma impacts them. This study aims to …

Vaccine Effectiveness Against Influenza A(H1n1), A(H3n2), And B-Associated Hospitalizations, United States, 1 September 2023 To 31 May 2024, Nathaniel M Lewis, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

BACKGROUND: The 2023-2024 influenza season included sustained elevated activity from December 2023 to February 2024 and continued activity through May 2024. Influenza A(H1N1), A(H3N2), and B viruses circulated during the season.

METHODS: During 1 September 2023 to 31 May 2024, a multistate sentinel surveillance network of 24 medical centers in 20 US states enrolled adults aged ≥18 years hospitalized with acute respiratory illness. Consistent with a test-negative design, cases tested positive for influenza viruses by molecular or antigen test, and controls tested negative for influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccine effectiveness (VE) against influenza-associated hospitalization …

Consensus-Based Disease Definitions For Endocrine Immune-Related Adverse Events Of Immune Checkpoint Inhibitors, Ling Zhu, Huda Al-Bahadili, Et Al.

2020-Current year OA Pubs

Immune checkpoint inhibitors (ICIs) are an important class of cancer treatment. Endocrine immune-related adverse events (E-irAEs) account for a significant proportion of irAEs in ICI-treated patients. Diagnosing E-irAEs accurately and timely can be challenging in the absence of clear categorization and standardization across oncology, endocrinology and other specialties. While existing guidelines provide some broad directions to diagnosis and management, they lack clarity on irAE-specific symptom evaluation and work-up, as well as assessment of severity. These limitations can then impact triage, time-sensitive management and care escalation to specialists such as oncoendocrinologists. The objective of this study was to develop consensus-based statements …

Prevalence Of Sleep Disturbance And Associated Risk Factors In Degenerative Cervical Myelopathy, Salim Yakdan, Karan Joseph, Jingyi Zhang, Miguel A Ruiz-Cardozo, Aryan Pradhan, Alisha Dhallan, Faraz Arkam, Willliam Mualem, Garrison Bentz, Diogo P Moniz Garcia, Benjamin Plog, Alexander T Yahanda, Daniel Hafez, Wilson Z Ray, Camilo A Molina, Jacob K Greenberg

2020-Current year OA Pubs

Retrospective Case-Control.

A Plain Language Summary Publication Of Patients' Survival With Endometrial Cancer Treated With Dostarlimab Plus Carboplatin-Paclitaxel, Matthew A Powell, Carolyn Mccourt, Et Al.

2020-Current year OA Pubs

What is the purpose of this PLS-P? The purpose of this plain language summary of publication is to help you understand recent findings from Part 1 of the RUBY study (full name ENGOT-EN6/GOG3031/RUBY trial). • Researchers sometimes study new combinations of already approved individual treatments to see if the combinations work well together and if they are safe to prescribe to patients. • In Part 1 of the RUBY study, the combination of

Estimated Waste Generation From 1 Million Basic Metabolic Panels: A Multisite U.S. Study, Seema Khattri Bhandari, Kwaku Twum, Erving T Laryea, Yaqing Du, Raeshun T Glover, Rachel G Brackbill, William Butler, Khushbu Patel, Christopher W Farnsworth, Christina C Pierre, Steven W Cotten, Joesph R Wiencek

2020-Current year OA Pubs

OBJECTIVES: Clinical laboratory operations consume large amounts of electricity and water and generate considerable quantities of solid waste. In this study, we quantified and compared the estimated solid waste produced from performing one million basic metabolic panels (BMPs) across five major high-throughput chemistry analyzer systems commonly used in the United States. Additionally, we estimated the carbon emissions associated with the electricity and water usage of each analyzer to better understand their environmental impact.

METHODS: Five academic medical centers each using a different clinical chemistry analyzer system, collected their respective annual vendor purchase data (January 2022-December 2022). Consumables including reagent cartridges, …

Apoe-Calypse Tau: Apoe-Tau Synergy In Alzheimer's Disease, Matthew Paul Lennol, Chiara Bordier, Léana Kamelher, Jason D Ulrich, David M Holtzman, Maud Gratuze

2020-Current year OA Pubs

Alzheimer's disease (AD), the most common cause of dementia, is characterized by the accumulation of amyloid-β (Aβ) in senile plaques and abnormally hyperphosphorylated tau proteins in neurofibrillary tangles. While much of the research has focused on Aβ, tau-mediated neurodegeneration is more closely associated with synaptic loss and cognitive decline in AD, emphasizing the need for a deeper understanding of tau pathology. In this context, the interaction between tau and APOE, particularly the main genetic risk factor for AD APOE ε4, remains underexplored. APOE encodes apolipoprotein E (apoE), a protein important in lipid metabolism. In addition to promoting Aβ deposition, emerging …

Understanding The Role Of Street Medicine In Harm Reduction: A Case Study Of Street Medicine St. Louis, Ari Gzesh, Jeremiah S Truel, Danielle R Adams, Luke Zabotka, Sara Malone, Nathanial S Nolan

2020-Current year OA Pubs

BACKGROUND: Homelessness results from, and exacerbates, various social determinants of health, including poverty, racism, and inadequate healthcare access, which are further compounded by physical and mental health challenges. The street medicine movement seeks to address these disparities by providing direct medical care and harm reduction services to unsheltered homeless in low-barrier settings. The development of trust is critical to providing this form of care. Few studies have sought to understand the factors influencing trust development in street medicine encounters.

METHODS: This case study of Street Medicine St. Louis aims to explore the factors that influence trust and how trust development …

Rtn4ip1 Is Required For The Final Stages Of Mitochondrial Complex I Assembly And Coq Biosynthesis, Monika Oláhová, Rachel M Guerra, Jack J Collier, Juliana Heidler, Kyle Thompson, Chelsea R White, Paulina Castañeda-Tamez, Alfredo Cabrera-Orefice, Robert N Lightowlers, Zofia M A Chrzanowska-Lightowlers, Alexander Galkin, Ilka Wittig, David J Pagliarini, Robert W Taylor

2020-Current year OA Pubs

A biochemical deficiency of mitochondrial complex I (CI) underlies approximately 30% of cases of primary mitochondrial disease, yet the inventory of molecular machinery required for CI assembly remains incomplete. We previously characterised patients with isolated CI deficiency caused by segregating variants in RTN4IP1, a gene that encodes a mitochondrial NAD(P)H oxidoreductase. Here, we demonstrate that RTN4IP1 deficiency causes a CI assembly defect in both patient fibroblasts and knockout cells, and report that RTN4IP1 is a bona fide CI assembly factor. Complexome profiling revealed accumulation of unincorporated ND5-module and impaired N-module production. RTN4IP1 patient fibroblasts also exhibited defective coenzyme Q biosynthesis, …

Family Income And Polygenic Scores Are Independently But Not Interactively Associated With Cognitive Performance Among Youth Genetically Similar To European Reference Populations, S E Paul, N M Elsayed, S M C Colbert, R Bogdan, A S Hatoum, D M Barch

2020-Current year OA Pubs

Cognitive abilities are heritable and influenced by socioeconomic status (SES). It is critical to understand the association between SES and cognition beyond genetic propensity to inform potential benefits of SES-based interventions and to determine if such associations vary across (i) cognitive domains, (ii) facets of SES, and/or (iii) genetic propensity for different aspects of cognition. We examined the contributions of neighborhood socioeconomic advantage, family income, and polygenic scores (PGS) for domains of cognition (i.e., general cognitive ability, executive function, learning and memory, fluid reasoning) in a sample of children (ages 9-10;

Gender Trends In Professional Advancement Among Academic Pediatric Neurologists, Juliet K Knowles, Renée A Shellhaas, Et Al.

2020-Current year OA Pubs

No abstract provided.

Recent Advances In The Identification And Quantification Of Xylazine And Medetomidine In Biological Specimens, Bridgit O Crews

2020-Current year OA Pubs

Xylazine is a veterinary sedative that is frequently detected in the illicit drug supply, often found mixed with illicitly manufactured fentanyl (IMF). It has been detected in the blood of overdose victims and patients who use illicit drugs. Xylazine is not approved for use in humans. It is an alpha-2-adrenergic receptor agonist that causes deep sedation that is non-responsive to naloxone, the antidote for opioid overdose. Chronic exposure to xylazine has been linked to severe wounds that can progress to amputation. Medetomidine is another related veterinary sedative that has more recently emerged as an adulterant in IMF. Medetomidine is also …

Chimeric Antigen Receptor Natural Killer (Car-Nk) Cells: From Preclinical Promise To Clinical Reality In Cancer Immunotherapy, Hunter Cassidy Cochran, Kevin Ashkan Ghobadi, Armin Ghobadi

2020-Current year OA Pubs

Chimeric antigen receptor (CAR) natural killer (NK) cell therapy represents an emerging frontier in cancer immunotherapy. CAR-NK cells offer the potential for "off-the-shelf" treatments with a favorable safety profile, due in part to their innate capacity for HLA-unrestricted tumor targeting and an absence of graft-versus-host disease. Landmark clinical studies using cord blood - derived CAR-NK cells and another employing iPSC-derived CAR-NK cells have reported impressive response rates, durable remissions, and minimal toxicity. Furthermore, a growing landscape of ongoing clinical trials is exploring innovative strategies to enhance persistence, overcome solid tumor challenges, and prevent antigen escape. These advances collectively underscore the …

Ibrutinib Added To Standard Conditioning And As Maintenance Therapy Following Autologous Hematopoietic Stem Cell Transplantation For Relapsed Or Refractory Activated-B-Cell Type Diffuse Large B-Cell Lymphoma: Primary Analysis Of The Us Intergroup Double-Blind Randomized Phase Iii Study Alliance A051301/Bmt-Ctn 1201, Charalambos Andreadis, Brad S Kahl, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

To improve outcomes in relapsed or refractory activated B-cell type Diffuse Large B-cell Lymphoma (ABC-DLBCL), we launched a randomized phase 3 trial evaluating 2-year progression free survival (2yPFS) with the addition of ibrutinib to autologous transplant. Patients received ibrutinib 560 mg or placebo with conditioning and for 12 additional cycles. Accrual was adversely affected by implementation of the ABC classifier in this setting and the changing treatment landscape of DLBCL. In all, 39 patients on ibrutinib and 38 on placebo were evaluable. 2yPFS was 57.6% on ibrutinib versus 40.8% on placebo (

A Modification To The Brand Transfer For Claw Hand: The Four-Tailed Extensor Carpi Radialis Brevis To Lateral Band Transfer, Lauren E Wessel, Nirbhay S Jain, Ambika E Paulson, Carrie Bettlach, Mitchell A Pet, Amy M Moore

2020-Current year OA Pubs

BACKGROUND: Claw deformity is a devastating consequence of low ulnar nerve palsy, resulting in loss of finger function. Traditionally, the Brand transfer is a favored intervention but requires lengthy grafts and bulky tenorrhaphies, risking adhesions in the lumbrical canal. We present a modified Brand tendon transfer, which extends the extensor carpi radialis brevis (ECRB) into 4 tails for individual grafting into the lateral band, decreasing adhesion risk and graft length need.

METHODS: Nine consecutive patients with claw hand were examined in detail to confirm the diagnosis and appropriateness for claw-correction surgery by the senior author. All patients underwent our modified …

Do Complex Psychometric Analyses Really Matter? Comparing Multiple Approaches Using Individual Participant Data From Antidepressant Trials, David Byrne, Frank Doyle, Susan Brannick, Robert M Carney, Pim Cuijpers, Alexandra L Dima, Kenneth E Freedland, Suzanne Guerin, David Hevey, Bishember Kathuria, Emma Wallace, Fiona Boland

2020-Current year OA Pubs

BACKGROUND: Psychometric methods are used to remove underperforming items and reduce error in existing measures, albeit different approaches can produce different results. This study aimed to determine the implications of applying different psychometric methods for clinical trial outcomes.

METHODS: Individual participant data from 15 antidepressant treatment trials from Vivli.org were analyzed. Baseline (pretreatment) and 8-week (range 4-12 weeks) outcome data from the Montgomery-Asberg Depression Rating Scale were subjected to best-practice factor analysis (FA), item response theory (IRT), and network analysis (NA) approaches. Trial outcomes for the original summative scores and psychometric-model scores were assessed using multilevel models. Percentage differences in …

Hemodynamic Characteristics Of Dilated Ascending Aorta In Patients With Bicuspid Aortic Valve, Yu Xia, Xuehuan Zhang, Shuai Zhu, Suwei Chen, Wentao Dong, Zhuo Chen, Nan Zhang, Jiafu Ou, Junming Zhu, Duanduan Chen, Tie Zheng

2020-Current year OA Pubs

BACKGROUND: The aim of this study is to investigate the influence of aortic diameter on hemodynamic environment characteristics in patient with the bicuspid aortic valve (BAV) and dilated ascending aorta (AAo).

METHOD: In this study, an MRI of one BAV patient with 4.5 cm AAo was collected and numerical model was constructed. Based on the images, three additional anatomical models were constructed with different AAo sizes of 4.0 cm, 5.0 cm and 5.5 cm respectively, while the size and the geometry of other parts were fixed. Then hemodynamics in these four models was simulated numerically and the flow patterns and …

Real-World Dosing And Persistence Of Oral Treprostinil Initiation Strategies In Patients With Pulmonary Arterial Hypertension, Daniel J Lachant, Ali Ataya, H James Ford, Meredith Broderick, Scott Seaman, Benjamin Wu, Murali M Chakinala

2020-Current year OA Pubs

In patients with pulmonary arterial hypertension (PAH), limited real-world data are available on persistence to oral treprostinil therapy, particularly while transitioning from parenteral prostacyclins. We compared persistence to oral treprostinil and total daily dose (TDD) achieved among patients with PAH initiating oral treprostinil de novo or while transitioning from parenteral prostacyclins using two real-world datasets: specialty pharmacy shipment records (Analysis 1) and ADAPT registry (Analysis 2). In Analysis 1, patients receiving oral treprostinil in 2017, 2020, and 2023 were included. In Analysis 2, de-identified data of patients enrolled in ADAPT from July 2017 to January 2022 were included. We conducted …