Digital Commons Network^™

Declining Prevalence Of Trichomonas Vaginalis Diagnosed By Wet Mount In A Cohort Of U.S. Women With And Without Hiv, Elizabeth M Daubert, Jodie Dionne, Jessica Atrio, Andrea K Knittel, Seble G Kassaye, Dominika Seidman, Amanda Long, Susan Brockmann, Igho Ofotokun, Margaret A Fischl, L Stewart Massad, Kathleen M Weber

2020-Current year OA Pubs

No abstract provided.

Gene-Based Association Study Of Rare Variants In Children Of Diverse Ancestries Implicates Tnfrsf21 In The Development Of Allergic Asthma, Selene Clay, Katherine Rivera-Spoljaric, Et Al.

2020-Current year OA Pubs

BACKGROUND: Most genetic studies of asthma and allergy have focused on common variation in individuals primarily of European ancestry. Studying the role of rare variation in quantitative phenotypes and in asthma phenotypes in populations of diverse ancestries can provide additional, important insights into the development of these traits.

OBJECTIVE: We sought to examine the contribution of rare variants to different asthma- or allergy-associated quantitative traits in children with diverse ancestries and explore their role in asthma phenotypes.

METHODS: We examined whole-genome sequencing data from children participants in longitudinal studies of asthma (n = 1035; parent-identified as 67% Black and 25% …

Effects Of Scapular Angular Deviations On Potential For Rotator Cuff Tendon Mechanical Compression, Rebekah L Lawrence, Laura B Richardson, Hannah L Bilodeau, Dane J Bonath, Daniel J Dahn, Mary-Ann Em, Sanjay Sarkar, Jonathan P Braman, Paula M Ludewig

2020-Current year OA Pubs

BACKGROUND: One proposed mechanism of rotator cuff disease is scapular motion impairments contributing to rotator cuff compression and subsequent degeneration.

PURPOSE: To model the effects of scapular angular deviations on rotator cuff tendon proximity for subacromial and internal mechanical impingement risk during scapular plane abduction.

STUDY DESIGN: Descriptive laboratory study.

METHODS: Three-dimensional bone models were reconstructed from computed tomography scans obtained from 10 asymptomatic subjects and 9 symptomatic subjects with a clinical presentation of impingement syndrome. Models were rotated to average scapular orientations from a healthy dataset at higher (120°) and lower (subject-specific) humeral elevation angles to investigate internal and …

Predictors Of Digital Amputation In Diabetic Patients With Surgically Treated Finger Infections, Ella Gibson, Carrie R Bettlach, Emma Payne, John Daines, Linh Vuong, Corinne Merrill, Ida K Fox, Mitchell A Pet

2020-Current year OA Pubs

BACKGROUND: Diabetes is a well-established risk factor for severe digital infection, and patients are more likely to require digital amputation for adequate source control. This study aims to identify factors predictive of digital amputation compared with preservation in patients with diabetes who present with surgically treated finger infections.

METHODS: Current Procedural Terminology (CPT) and International Classification of Diseases Versions 9 and 10 (ICD-9/10) databases from a single academic medical center were queried to identify patients with type 1 or type 2 diabetes mellitus who underwent surgical treatment in the operating room for treatment of a digital infection from 2010 to …

Il-33 Potentiates Histaminergic Itch, Anna M Trier, Aaron M Ver Heul, Avery Fredman, Victoria Le, Zhen Wang, Kelsey Auyeung, James Meixiong, Paola Lovato, Michael J Holtzman, Fang Wang, Xinzhong Dong, Andrew L Ji, Brian S Kim

2020-Current year OA Pubs

BACKGROUND: Itch is a common symptom that can greatly diminish quality of life. Histamine is a potent endogenous pruritogen, and while antihistamines are often the first-line treatment for itch, in conditions like chronic spontaneous urticaria (CSU), many patients remain symptomatic while receiving maximal doses. Mechanisms that drive resistance to antihistamines are poorly defined.

OBJECTIVES: Signaling of the alarmin cytokine IL-33 in sensory neurons is postulated to drive chronic itch by inducing neuronal sensitization to pruritogens. Thus, we sought to determine if IL-33 can augment histamine-induced (histaminergic) itch.

METHODS: Itch behavior was assessed in response to histamine after IL-33 or saline …

A Scoping Review Of Artificial Intelligence In Medical Education: Beme Guide No. 84, Morris Gordon, Janice Hanson, Et Al.

2020-Current year OA Pubs

BACKGROUND: Artificial Intelligence (AI) is rapidly transforming healthcare, and there is a critical need for a nuanced understanding of how AI is reshaping teaching, learning, and educational practice in medical education. This review aimed to map the literature regarding AI applications in medical education, core areas of findings, potential candidates for formal systematic review and gaps for future research.

METHODS: This rapid scoping review, conducted over 16 weeks, employed Arksey and O'Malley's framework and adhered to STORIES and BEME guidelines. A systematic and comprehensive search across PubMed/MEDLINE, EMBASE, and MedEdPublish was conducted without date or language restrictions. Publications included in …

Knee Flexion Angle Of Fixation During Anterolateral Ligament Reconstruction Or Lateral Extra-Articular Tenodesis: A Systematic Review And Meta-Analysis Of Lateral Extra-Articular Reinforcement Techniques Performed In Conjunction With Acl Reconstruction, David A Kolin, Jeffrey J Nepple, Et Al.

2020-Current year OA Pubs

BACKGROUND: Anterolateral ligament reconstruction (ALLR) or lateral extra-articular tenodesis (LET) is being used more frequently in conjunction with anterior cruciate ligament reconstruction (ACLR). However, the knee flexion angle at which fixation of ALLR or LET is performed during the procedure is quite variable based on existing technique descriptions.

PURPOSE/HYPOTHESIS: The purpose of this study was to identify whether flexion angle at the time of ALLR/LET fixation affected postoperative outcomes in a clinical population. It was hypothesized that ALLR/LET fixation at low versus high flexion angles would lead to no statistically significant differences in patient-reported outcome measures and graft failure rates. …

A Case Of Congenital Nephrotic Syndrome With Crescents Caused By A Novel Compound Heterozygous Pairing Of Nphs1 Genetic Variants, Kyle N Goodman, Pongpratch Puapatanakul, Kevin T Barton, Mai He, Jeffrey H Miner, Joseph P Gaut

2020-Current year OA Pubs

Congenital nephrotic syndrome is an autosomal recessive inherited disorder that manifests as steroid-resistant massive proteinuria in the first three months of life. Defects in the glomerular filtration mechanism are the primary etiology. We present a child who developed severe nephrotic syndrome at two weeks of age and eventually required a bilateral nephrectomy. Genetic testing revealed compound heterozygous variants in

Characteristics Of Patients With Non-Cancer Pain And Long-Term Prescription Opioid Use Who Have Used Medical Versus Recreational Marijuana, Whitney M Davidson, Anika Mahavni, Timothy Chrusciel, Joanne Salas, Lisa R Miller-Matero, Mark D Sullivan, Celeste Zabel, Patrick J Lustman, Brian K Ahmedani, Jeffrey F Scherrer

2020-Current year OA Pubs

OBJECTIVE: Marijuana use is increasingly common among patients with chronic non-cancer pain (CNCP) and long-term opioid therapy (LTOT). We determined if lifetime recreational and medical marijuana use were associated with more frequent and higher dose prescription opioid use.

DESIGN: Cross-sectional SUBJECTS: Eligible patients (n=1,037), who had a new period of prescription opioid use lasting 30-90 days, were recruited from two midwestern health care systems to a study of long-term prescription opioid use and mental health outcomes. The present cross-sectional analyses uses baseline data from this on-going cohort study.

METHODS: Primary exposures were participant reported lifetime recreational and medical marijuana use …

Effects Of Complete And Partial Loss Of The 24s-Hydroxycholesterol-Generating Enzyme, Hong-Jin Shu, Luke H Ziolkowski, Sofia V Salvatore, Ann M Benz, David F Wozniak, Carla M Yuede, Steven M Paul, Charles F Zorumski, Steven Mennerick

2020-Current year OA Pubs

Brain cholesterol metabolic products include neurosteroids and oxysterols, which play important roles in cellular physiology. In neurons, the cholesterol oxidation product, 24S-hydroxycholesterol (24S-HC), is a regulator of signaling and transcription. Here, we examined the behavioral effects of 24S-HC loss, using global and cell-selective genetic deletion of the synthetic enzyme CYP46A1. Mice that are globally deficient in CYP46A1 exhibited hypoactivity at young ages and unexpected increases in conditioned fear memory. Despite strong reductions in hippocampal 24S-HC in mice with selective loss of CYP46A1 in VGLUT1-positive cells, behavioral effects were not recapitulated in these conditional knockout mice. Global knockout produced strong, developmentally …

Assessing Workflow In The Postanesthesia Care Unit, Laura Mcgrath, Emma Vierod

Doctor of Nursing Practice (DNP) Student Projects

The postanesthesia care unit (PACU) environment must function smoothly as a critical recovery area for monitoring of immediate postoperative patients. Timely responsiveness to complications is imperative to ensure patient safety. Following postanesthesia observation, a patient is discharged from the PACU to home or is admitted to the hospital. If this transition is delayed by excessive discharge times or poorly managed patient adverse events, it can cause major bottlenecks and issues with throughput for the perioperative setting. This project aims to study the present workflow in the PACU, identify gaps in the workflow and provide recommendations to perioperative leadership. Current PACU …

Reducing Unsecured Medications In Anesthetizing Area, Christine Bergesch, Kate Manuel

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: Anesthetic medications should be secured consistently to prevent adverse outcomes such as medication errors, drug diversion, and financial loss. Standardized practice for medication stewardship is not established by Washington University Department of Anesthesiology (WUDA). Anesthesia providers’ imprudent medication stewardship practices are a continuous challenge due to the controlled and time-sensitive drugs they provide. Purpose: The purpose of this quality improvement (QI) project was to decrease the number of medications left behind unsecured in anesthetizing areas, describe the most frequently encountered barriers and category of medications left behind unsecured, and improve knowledge and utilization of the …

Improving Anesthesia Clinicians’ Knowledge And Confidence When Selecting Prophylactic Antimicrobials For Patients On Concomitant Antimicrobial Therapy, Garry Gregson, Emily Shands

Doctor of Nursing Practice (DNP) Student Projects

Anesthesia clinicians at Barnes-Jewish Hospital (BJH) in Saint Louis, Missouri experienced uncertainty and discomfort when they selected preoperative antibiotics for patients who were already receiving concomitant therapeutic antimicrobials (CTA) unrelated to surgical prophylaxis. Various evidence-based interventions were proposed to address this issue. The first intervention was the addition of pathogens of concern to the surgical antimicrobial prophylaxis (SAP) protocol at BJH. The second intervention was the creation of a reference table that supplemented the revised protocol and allowed clinicians to efficiently determine the pathogens of concern for each surgery. This also included the CTAs efficacy for preventing surgical site infections …

Implementation Of A Standardized Handoff Reference Tool From The Intensive Care Unit To The Operating Room, Sophia Agbomah, Stacie Summers

Doctor of Nursing Practice (DNP) Student Projects

Background and Review of Literature: This quality improvement (QI) intervention evaluated the effectiveness of a standardized handoff reference tool for patients transferring from the Surgical Intensive Care Unit (SICU) to the operating room (OR) in a large metropolitan level I trauma center. There was minimal data to assess the quality of this sequence of patient transfer as no systematic ICU-OR handoff content practices were currently employed at the hospital. This project aimed to help fill the practice-knowledge gap that could impact some of the most vulnerable patients during ICU-OR transfer. Methods: Pre- and post-implementation staff surveys, live observations, and chart …

Impact Of Palliative Care Utilization Among Kidney Cancer Patients In Us Hospitals: A National-Scale Analysis, Rushin Patel, Mrunal Patel, Darshil Patel, Chieh Yang, Afoma Onyechi, Jessica Ohemeng-Dapaah, Zalak Patel, Safia Shaikh

2020-Current year OA Pubs

No abstract provided.

Virtual, Augmented, And Mixed Reality Applications For Surgical Rehearsal, Operative Execution, And Patient Education In Spine Surgery: A Scoping Review, Tim Bui, Miguel A Ruiz-Cardozo, Harsh S Dave, Karma Barot, Michael Ryan Kann, Karan Joseph, Sofia Lopez-Alviar, Gabriel Trevino, Samuel Brehm, Alexander T Yahanda, Camilo A Molina

2020-Current year OA Pubs

No abstract provided.

Inadequate Prophylaxis In Patients With Trauma: Anti-Xa-Guided Enoxaparin Dosing Management In Critically Ill Patients With Trauma, Grace Martin Niziolek, Lauren Mangan, Cassidi Weaver, Vanessa Prendergast, Raymond Lamore, Megan Zielke, Niels D Martin

2020-Current year OA Pubs

UNLABELLED: Venous thromboembolism (VTE) causes significant morbidity in patients with trauma despite advances in pharmacologic therapy. Prior literature suggests standard enoxaparin dosing may not achieve target prophylactic anti-Xa levels. We hypothesize that a new weight-based enoxaparin protocol with anti-Xa monitoring for dose titration in critically injured patients is safe and easily implemented.

METHODS: This prospective observational study included patients with trauma admitted to the trauma intensive care unit (ICU) from January 2021 to September 2022. Enoxaparin dosing was adjusted based on anti-Xa levels as standard of care via a performance improvement initiative. The primary outcome was the proportion of subtarget …

The Effect Of Breastfeeding Practices Of Undernourished Mothers In Rural Sierra Leone On Infant Growth And Mortality, Aminata Shamit Koroma, Kevin B Stephenson, Per O Iversen, Mark J Manary, David Taylor Hendrixson

2020-Current year OA Pubs

Breastfeeding provides optimal infant nutrition; however, <50% of infants are exclusively breastfed (EBF) for 6 months. We aimed to describe breastfeeding practices and their effects on growth and mortality among a high-risk mother-infant cohort in rural Sierra Leone. This was a secondary analysis of data from a randomized nutrition intervention trial among undernourished pregnant women. The study's primary outcomes were infant weight and length gains at 6 weeks of age. We included 1270 singleton infants in the analysis, with 1092 (85.6%) having 24-week outcome data. At 6 weeks, 88% were EBF, but the rate of EBF decreased to 17% at 24 weeks. The EBF infants at 6 weeks had improved length (difference of 0.9 mm/week; 95% CI 0.4 to 1.3;

How Sex Hormones Affect Migraine: An Interdisciplinary Preclinical Research Panel Review, Frederick Godley Iii, John Meitzen, Hadas Nahman-Averbuch, Mary Angela O'Neal, David Yeomans, Nanette Santoro, Nina Riggins, Lars Edvinsson

2020-Current year OA Pubs

Sex hormones and migraine are closely interlinked. Women report higher levels of migraine symptoms during periods of sex hormone fluctuation, particularly during puberty, pregnancy, and perimenopause. Ovarian steroids, such as estrogen and progesterone, exert complex effects on the peripheral and central nervous systems, including pain, a variety of special sensory and autonomic functions, and affective processing. A panel of basic scientists, when challenged to explain what was known about how sex hormones affect the nervous system, focused on two hormones: estrogen and oxytocin. Notably, other hormones, such as progesterone, testosterone, and vasopressin, are less well studied but are also highlighted …

Utilization Of Augmented Reality Head-Mounted Display For The Surgical Management Of Thoracolumbar Spinal Trauma, Michael Ryan Kann, Miguel A Ruiz-Cardozo, Samuel Brehm, Tim Bui, Karan Joseph, Karma Barot, Gabriel Trevino, Abigail Carey-Ewend, Som P Singh, Matthew De La Paz, Ahmed Hanafy, Michael Olufawo, Rujvee P Patel, Alexander T Yahanda, Alexander Perdomo-Pantoja, Magalie Cadieux, Brenton Pennicooke, Camilo A Molina, Et Al.

2020-Current year OA Pubs

No abstract provided.

Immune Response To Sars-Cov-2 Variants After Immunization With Different Vaccines In Mexico, Erika Garay, Sean P J Whelan, Rebecca M Dubois, Sara M O'Rourke, Angel Eduardo Salgado-Escobar, José Esteban Muñoz-Medina, Carlos F Arias, Susana López

2020-Current year OA Pubs

There is limited information on the antibody responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in subjects from developing countries with populations having a high incidence of co-morbidities. Here, we analysed the immunogenicity of homologous schemes using the ChAdOx1-S, Sputnik V, or BNT162b2 vaccines and the effect of a booster dose with ChAdOx1-S in middle-aged adults who were seropositive or seronegative to the SARS-CoV-2 spike protein before vaccination. The study was conducted post-vaccination with a follow-up of 4 months for antibody titre using enzyme-linked immunosorbent assay (ELISA) and pseudovirus (PV) neutralization assays (PNAs). All three vaccines elicited a superior …

Aducanumab Anti-Amyloid Immunotherapy Induces Sustained Microglial And Immune Alterations, Mika P Cadiz, Katelin A Gibson, Kennedi T Todd, David G Nascari, Nashali Massa, Meredith T Lilley, Kimberly C Olney, Md Mamun Al-Amin, Hong Jiang, David M Holtzman, John D Fryer

2020-Current year OA Pubs

Aducanumab, an anti-amyloid immunotherapy for Alzheimer's disease, efficiently reduces Aβ, though its plaque clearance mechanisms, long-term effects, and effects of discontinuation are not fully understood. We assessed the effect of aducanumab treatment and withdrawal on Aβ, neuritic dystrophy, astrocytes, and microglia in the APP/PS1 amyloid mouse model. We found that reductions in amyloid and neuritic dystrophy during acute treatment were accompanied by microglial and astrocytic activation, and microglial recruitment to plaques and adoption of an aducanumab-specific pro-phagocytic and pro-degradation transcriptomic signature, indicating a role for microglia in aducanumab-mediated Aβ clearance. Reductions in Aβ and dystrophy were sustained 15 but not …

A Comparative Biochemical And Pathological Evaluation Of Brain Samples From Knock-In Murine Models Of Gaucher Disease, Makaila L Furderer, Bahafta Berhe, Tiffany C Chen, Stephen Wincovitch, Xuntian Jiang, Nahid Tayebi, Ellen Sidransky, Tae-Un Han

2020-Current year OA Pubs

Gaucher disease (GD) is a lysosomal storage disorder stemming from biallelic mutations in

Multiomic Profiling Reveals Metabolic Alterations Mediating Aberrant Platelet Activity And Inflammation In Myeloproliferative Neoplasms, Fan He, Angelo Ba Laranjeira, Tim Kong, Shuyang Lin, Katrina J. Ashworth, Alice Liu, Nina M. Lasky, Daniel Ac Fisher, Maggie J. Cox, Mary C. Fulbright, Lilian Antunes-Heck, Layow Yu, Molly Brakhane, Bei Gao, Stephen M. Sykes, Angelo D'Alessandro, Jorge Di Paola, Stephen T. Oh

2020-Current year OA Pubs

Platelets from patients with myeloproliferative neoplasms (MPNs) exhibit a hyperreactive phenotype. Here, we found elevated P-selectin exposure and platelet-leukocyte aggregates indicating activation of platelets from essential thrombocythemia (ET) patients. Single-cell RNA-seq analysis of primary samples revealed significant enrichment of transcripts related to platelet activation, mTOR, and oxidative phosphorylation in ET patient platelets. These observations were validated via proteomic profiling. Platelet metabolomics revealed distinct metabolic phenotypes consisting of elevated ATP generation accompanied by increases in the levels of multiple intermediates of the tricarboxylic acid cycle, but lower α-ketoglutarate (α-KG) in MPN patients. Inhibition of PI3K/AKT/mTOR signaling significantly reduced metabolic responses and …

Circadian Immunity From Bench To Bedside: A Practical Guide, Huram Mok, Elaine Ostendorf, Alex Ganninger, Avi J. Adler, Guy Hazan, Jeffrey A. Haspel

2020-Current year OA Pubs

The immune system is built to counteract unpredictable threats, yet it relies on predictable cycles of activity to function properly. Daily rhythms in immune function are an expanding area of study, and many originate from a genetically based timekeeping mechanism known as the circadian clock. The challenge is how to harness these biological rhythms to improve medical interventions. Here, we review recent literature documenting how circadian clocks organize fundamental innate and adaptive immune activities, the immunologic consequences of circadian rhythm and sleep disruption, and persisting knowledge gaps in the field. We then consider the evidence linking circadian rhythms to vaccination, …

Concurrent Administration Of Serotonergic Antidepressants And Ozanimod In Participants With Relapsing Multiple Sclerosis From The Open-Label Extension Daybreak Trial, Robert T Naismith, Jeffrey A Cohen, Amit Bar-Or, Giancarlo Comi, Krzysztof W Selmaj, Hans-Peter Hartung, James K Sheffield, Anthony Krakovich, Daniel Tatosian, Chun-Yen Cheng, Jennifer Reardon, Vadim Khaychuk, Jon V Riolo, Diego Silva, Bruce Ac Cree

2020-Current year OA Pubs

BACKGROUND: Monoamine oxidase (MAO) inhibitors can interact with selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs). There is clinical interest surrounding use of ozanimod with SSRIs/SNRIs because the major metabolites of ozanimod are weak inhibitors of MAO-B in vitro.

OBJECTIVE: To evaluate the incidence of treatment-emergent adverse events (TEAEs) potentially related to serotonin accumulation (SA) during concomitant ozanimod and SSRI/SNRI use by performing analyses of data from an open-label, oral ozanimod 0.92 mg trial (DAYBREAK; NCT02576717).

METHODS: SA narrow (serotonin syndrome, neuroleptic malignant syndrome, and hyperthermia malignant) and broad (terms potentially associated with SA) MedDRA v24.0 searches were performed using …

Quantification Of Enteric Dysfunction In Cystic Fibrosis: Inter- And Intraindividual Variability, Laura A Duckworth, Kimberly A Sutton, Nurmohammad Shaikh, Jinli Wang, Carla Hall-Moore, Lori R Holtz, Phillip I Tarr, Ronald C Rubenstein

2020-Current year OA Pubs

OBJECTIVES: To test the utility of various biomarkers as indicators of gut dysfunction in cystic fibrosis (CF) and determine whether intraindividual variations in these measures are repeatable over short intervals and whether interindividual variations correlate with clinical outcomes.

STUDY DESIGN: We performed a cross-sectional, limited longitudinal study of children with CF aged 1-21 years who provided blood and stool samples at 2 or 3 visits, 2 weeks and 3 months apart, which were assayed for markers of intestinal inflammation (fecal calprotectin [fCal], lipocalin-2 [fLcn2], neopterin), and permeability (plasma lipopolysaccharide [LPS] antibodies, LPS-binding protein) by enzyme immunoassays. Control specimens were obtained …

Angptl3 Deficiency Impairs Lipoprotein Production And Produces Adaptive Changes In Hepatic Lipid Metabolism, Kendall H Burks, Yan Xie, In-Hyuk Jung, Sandip Mukherjee, Paul Lee, Upasana Pudupakkam, Ryan Wagoner, Ved Patel, Katherine Santana, Arturo Alisio, Brian N Finck, Nicholas O Davidson, Nathan O Stitziel, Et Al.

2020-Current year OA Pubs

Angiopoietin-like protein 3 (ANGPTL3) is a hepatically secreted protein and therapeutic target for reducing plasma triglyceride-rich lipoproteins and low-density lipoprotein (LDL) cholesterol. Although ANGPTL3 modulates the metabolism of circulating lipoproteins, its role in triglyceride-rich lipoprotein assembly and secretion remains unknown. CRISPR-associated protein 9 (CRISPR/Cas9) was used to target ANGPTL3 in HepG2 cells (ANGPTL3

A 3'Utr Insertion Is A Candidate Causal Variant At The Tmem106b Locus Associated With Increased Risk For Ftld-Tdp, Augustine Chemparathy, Chengran Yang, Carlos Cruchaga, Et Al.

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Single-nucleotide variants near

METHODS: An exploratory analysis identified structural variants on neurodegeneration-related genes. Subsequent analyses focused on an

RESULTS: The primary analysis included 432 participants (52.5% female, age range 45-92 years). We identified a 316 bp

DISCUSSION: We identified a novel

A Deep Learning Approach To Remove Contrast From Contrast-Enhanced Ct For Proton Dose Calculation, Xu Wang, Yao Hao, Ye Duan, Deshan Yang

2020-Current year OA Pubs

PURPOSE: Non-Contrast Enhanced CT (NCECT) is normally required for proton dose calculation while Contrast Enhanced CT (CECT) is often scanned for tumor and organ delineation. Possible tissue motion between these two CTs raises dosimetry uncertainties, especially for moving tumors in the thorax and abdomen. Here we report a deep-learning approach to generate NCECT directly from CECT. This method could be useful to avoid the NCECT scan, reduce CT simulation time and imaging dose, and decrease the uncertainties caused by tissue motion between otherwise two different CT scans.

METHODS: A deep network was developed to convert CECT to NCECT. The network …