Digital Commons Network^™

Modeling X-Chromosome Inactivation And Reactivation During Human Development, Shafqat A Khan, Thorold W Theunissen

2020-Current year OA Pubs

Stem-cell-based embryo models generate much excitement as they offer a window into an early phase of human development that has remained largely inaccessible to scientific investigation. An important epigenetic phenomenon during early embryogenesis is the epigenetic silencing of one of the two X chromosomes in female embryos, which ensures an equal output of X-linked gene expression between the sexes. X-chromosome inactivation (XCI) is thought to be established within the first three weeks of human development, although the inactive X-chromosome is reactivated in primordial germ cells (PGCs) that migrate to the embryonic gonads. Here, we summarize our current understanding of X-chromosome …

The Association Of Long-Term Exposure To Criteria Air Pollutants, Fine Particulate Matter Components, And Airborne Trace Metals With Late-Life Brain Amyloid Burden In The Atherosclerosis Risk In Communities (Aric) Study, Erin E Bennett, Dean F Wong, Et Al.

2020-Current year OA Pubs

BACKGROUND: Studies suggest associations between long-term ambient air pollution exposure and outcomes related to Alzheimer's disease (AD). Whether a link exists between pollutants and brain amyloid accumulation, a biomarker of AD, is unclear. We assessed whether long-term air pollutant exposures are associated with late-life brain amyloid deposition in Atherosclerosis Risk in Communities (ARIC) study participants.

METHODS: We used a chemical transport model with data fusion to estimate ambient concentrations of PM

RESULTS: At PET imaging, eligible participants (N = 318) had a mean age of 78 years, 56% were female, 43% were Black, and 27% had mild cognitive impairment. We …

Identifying Contributors To Disparities In Patient Access Of Online Medical Records: Examining The Role Of Clinician Encouragement, Bryan A Sisk, Sunny Lin, Joyce Joy E Balls-Berry, Argentina E Servin, Jennifer W Mack

2020-Current year OA Pubs

OBJECTIVE: The aim of this study was to understand the influence of clinician encouragement and sociodemographic factors on whether patients access online electronic medical records (EMR).

MATERIALS AND METHODS: We analyzed 3279 responses from the Health Information National Trends Survey 5 cycle 4 survey, a cross-sectional, nationally representative survey administered by the National Cancer Institute. Frequencies and weighted proportions were calculated to compare clinical encouragement and access to their online EMR. Using multivariate logistic regression, we identified factors associated with online EMR use and clinician encouragement.

RESULTS: In 2020, an estimated 42% of US adults accessed their online EMR and …

Organizational Preparedness For The Use Of Large Language Models In Pathology Informatics, Steven N Hart, Noah G Hoffman, Peter Gershkovich, Chancey Christenson, David S Mcclintock, Lauren J Miller, Ronald Jackups, Vahid Azimi, Nicholas Spies, Victor Brodsky

2020-Current year OA Pubs

In this paper, we consider the current and potential role of the latest generation of Large Language Models (LLMs) in medical informatics, particularly within the realms of clinical and anatomic pathology. We aim to provide a thorough understanding of the considerations that arise when employing LLMs in healthcare settings, such as determining appropriate use cases and evaluating the advantages and limitations of these models. Furthermore, this paper will consider the infrastructural and organizational requirements necessary for the successful implementation and utilization of LLMs in healthcare environments. We will discuss the importance of addressing education, security, bias, and privacy concerns associated …

Interrater Reliability Of Motor Severity Scales For Hemifacial Spasm, Ha Yeon Lee, Ingyun Park, Minnie P Luu, Jerry Zhao, Jeanne P Vu, Elizabeth Cisneros, Brian D Berman, H A Jinnah, Han-Joon Kim, Catherine Y Liu, Joel S Perlmutter, Sarah Pirio Richardson, Anne Weissbach, Glenn T Stebbins, David A Peterson

2020-Current year OA Pubs

To compare the inter-rater reliability (IRR) of five clinical rating scales for video-based assessment of hemifacial spasm (HFS) motor severity. We evaluated the video recordings of 45 HFS participants recruited through the Dystonia Coalition. In Round 1, six clinicians with expertise in HFS assessed the participants' motor severity with five scales used to measure motor severity of HFS: the Jankovic rating scale (JRS), Hemifacial Spasm Grading Scale (HSGS), Samsung Medical Center (SMC) grading system for severity of HFS spasms (Lee's scale), clinical grading of spasm intensity (Chen's scale), and a modified version of the Abnormal Involuntary Movement Scale (Tunc's scale). …

Rationale And Design Of A Randomised Phase Iii Registration Trial Investigating Finerenone In Participants With Type 1 Diabetes And Chronic Kidney Disease: The Fine-One Trial, Hiddo J L Heerspink, Janet B Mcgill, Et Al.

2020-Current year OA Pubs

AIMS: Despite guideline-recommended treatments, including renin angiotensin system inhibition, up to 40 % of individuals with type 1 diabetes develop chronic kidney disease (CKD) putting them at risk of kidney failure. Finerenone is approved to reduce the risk of kidney failure in individuals with type 2 diabetes. We postulate that finerenone will demonstrate benefits on kidney outcomes in people with type 1 diabetes.

METHODS: FINE-ONE (NCT05901831) is a randomised, placebo-controlled, double-blind phase III trial of 7.5 months' duration in ∼220 adults with type 1 diabetes, urine albumin/creatinine ratio (UACR) of ≥ 200-< 5000 mg/g (≥ 22.6-< 565 mg/mmol) and eGFR of ≥ 25-< 90 ml/min/1.73 m

RESULTS: The primary endpoint is relative change in …

Difelikefalin Suppresses Itch And Reduces Scratching Independent Of Inflammation In A Murine Model Of Atopic Dermatitis, Masato Tamari, Lydia Zamidar, Aaron M Ver Heul, Kristine Nograles, Joana Goncalves, Emma Guttman-Yassky, Mark Lebwohl, Brian S Kim

2020-Current year OA Pubs

BACKGROUND: Therapies specifically targeting nonhistaminergic pruritus are largely lacking. Difelikefalin (DFK) has been found to reduce itch in various chronic pruritic conditions, including atopic dermatitis (AD).

OBJECTIVE: We sought to investigate the ability of DFK to impact scratching behavior, inflammatory mediators, and neuronal signaling in a murine model of AD.

METHODS: The ears of C57BL/6 mice were topically treated with MC903 for 12 consecutive days to induce AD-like inflammation and itch. Before MC903 treatment, mice were treated with either DFK (0.5 mg/kg, intraperitoneal injection twice daily) or vehicle (saline). Skin ear thickness, histological analysis, flow cytometry, RNA-sequencing, and differential gene …

Factors Associated With Shorter-Interval Cervical Cancer Screening For Young Women In Three United States Healthcare Systems, Anne Marie Mccarthy, Jasmin A Tiro, Ellen Hu, Sarah Ehsan, Jessica Chubak, Aruna Kamineni, Sarah Feldman, Steven J Atlas, Michelle I Silver, Sarah Kobrin, Jennifer S Haas

2020-Current year OA Pubs

Frequently changing cervical cancer screening guidelines over the past two decades have been inconsistently adopted in the United States. Current guidelines set the recommended screening interval to three years for average-risk women aged 21-29 years. Few studies have evaluated how patient and provider factors are associated with implementation of cervical cancer screening intervals among younger women. This study evaluated multilevel factors associated with screening interval length among 69,939 women aged 21-29 years with an initial negative Pap screen between 2010 and 2015 across three large health systems in the U.S. Shorter-interval screening was defined as a second screening Pap within …

The Effect Of Glycemic Control On Left Ventricular Function In Clinical And Experimental Diabetes, Steven J Lavine, Petar Prcevski

2020-Current year OA Pubs

BACKGROUND: Glycemic control in diabetes mellitus (DM) has not improved cardiovascular outcomes with normal left ventricular (LV) function. We assessed the effect on LV dysfunction using a canine model of LV dysfunction and DM, and in patients with DM and LV dysfunction.

METHODS: Chronic LV dysfunction was produced by coronary microsphere embolization in 34 canines (15-25 kg). Following 8 weeks of stabilization, DM was induced in 24 canines and randomized to good or poor glycemic control for 3 months. Ten canines without DM were controls. Hemodynamic and Doppler echocardiographic data were obtained prior to and following pressure loading. We reviewed …

First-In-Human Phase I/Ib Study Of Niz985, A Recombinant Heterodimer Of Il-15 And Il-15rα, As A Single Agent And In Combination With Spartalizumab In Patients With Advanced And Metastatic Solid Tumors, Rom Leidner, Kevin Conlon, Douglas G Mcneel, Andrea Wang-Gillam, Sumati Gupta, Robert Wesolowski, Monica Chaudhari, Nadia Hassounah, Jong Bong Lee, Lang Ho Lee, Jessica A O'Keeffe, Nancy Lewis, George N Pavlakis, John A Thompson

2020-Current year OA Pubs

BACKGROUND: Preclinically, interleukin-15 (IL-15) monotherapy promotes antitumor immune responses, which are enhanced when IL-15 is used in combination with immune checkpoint inhibitors (ICIs). This first-in-human study investigated NIZ985, a recombinant heterodimer comprising physiologically active IL-15 and IL-15 receptor α, as monotherapy and in combination with spartalizumab, an anti-programmed cell death protein-1 (anti-PD-1) monoclonal antibody, in patients with advanced solid tumors.

METHODS: This phase I/Ib study had two dose-escalation arms: single-agent NIZ985 administered subcutaneously thrice weekly (TIW, 2 weeks on/2 weeks off) or once weekly (QW, 3 weeks on/1 week off), and NIZ985 TIW or QW administered subcutaneously plus spartalizumab (400 …

Comprehensive Mr Imaging Qa Of 0.35 T Mr-Linac Using A Multi-Purpose Large Fov Phantom: A Single-Institution Experience, Shanti Marasini, Hailei Zhang, Lara Dyke, Mike Cole, Benjamin Quinn, Austen Curcuru, Bruce Gu, Rocco Flores, Taeho Kim

2020-Current year OA Pubs

PURPOSE: Magnetic resonance-guided radiotherapy (MRgRT) is desired for the treatment of diseases in the abdominothoracic region, which has a broad imaging area and continuous motion. To ensure accurate treatment delivery, an effective image quality assurance (QA) program, with a phantom that covers the field of view (FOV) similar to a human torso, is required. However, routine image QA for a large FOV is not readily available at many MRgRT centers. In this work, we present the clinical experience of the large FOV MRgRT Insight phantom for periodic daily and monthly comprehensive magnetic resonance imaging (MRI)-QA and its feasibility compared to …

The Impact Of Adding Cost Information To A Conversation Aid To Support Shared Decision Making About Low-Risk Prostate Cancer Treatment: Results Of A Stepped-Wedge Cluster Randomised Trial, Mary C Politi, Rachel C Forcino, Katelyn Parrish, Marie-Anne Durand, A James O'Malley, Rachel Moses, Krista Cooksey, Glyn Elwyn

2020-Current year OA Pubs

BACKGROUND: Decision aids help patients consider the benefits and drawbacks of care options but rarely include cost information. We assessed the impact of a conversation-based decision aid containing information about low-risk prostate cancer management options and their relative costs.

METHODS: We conducted a stepped-wedge cluster randomised trial in outpatient urology practices within a US-based academic medical center. We randomised five clinicians to four intervention sequences and enroled patients newly diagnosed with low-risk prostate cancer. Primary patient-reported outcomes collected postvisit included the frequency of cost conversations and referrals to address costs. Other patient-reported outcomes included: decisional conflict postvisit and at 3 …

Immune Adjuvant Therapy With Interleukin-7 In A Lymphopenic Patient With Aplastic Anemia And Mucormycosis, Zachary D. Crees, Dilan A. Patel, Alexandra Dram, Miriam Kim, Michael D. Bern, Allison R. Eberly, Kristan Augustin, Richard S. Hotchkiss, John F. Dipersio

2020-Current year OA Pubs

BACKGROUND: We report the case of a patient with aplastic anemia and pancytopenia on immune-suppressive therapy who developed invasive pulmonary infection with mucormycosis and was treated with immune adjuvant therapy.

CASE SUMMARY: Given the patient's profound lymphopenia and progressive invasive mucor despite dual antifungal drug therapy, interleukin (IL)-7, a cytokine that induces lymphocyte activation and proliferation, was instituted and resulted in normalization of absolute lymphocyte counts and was temporally associated with clearance of fungal pathogens and resolution of clinical symptoms.

CONCLUSION: Patients with life-threatening fungal infections are frequently immune suppressed and immune adjuvant therapies should be considered in patients who …

Characterization Of Copy-Number Variants In A Large Cohort Of Patients With Von Willebrand Disease Reveals A Relationship Between Disrupted Regions And Disease Type, Brooke Sadler, Pamela A Christopherson, Crystal L Perry, Daniel B Bellissimo, Sandra L Haberichter, Gabe Haller, Lilian Antunes, Veronica H Flood, Jorge Di Paola, Robert R Montgomery, Zimmerman Program Investigators

2020-Current year OA Pubs

BACKGROUND: Genetic analysis for von Willebrand disease (VWD) commonly utilizes DNA sequencing to identify variants in the von Willebrand factor (

OBJECTIVES: This study aimed to characterize CNVs in a large sample of VWF mutation-negative VWD patients.

METHODS: To determine the role of CNVs in VWD, a VWF high-resolution comparative genomic hybridization array was custom-designed to avoid multiple sequence variations, repeated sequences, and the

RESULTS: Among the 204 patients, 7 unique CNVs were found, with a total of 24 CNVs (12%). Of the 7 unique CNVs, 1 was novel, 1 was found in a VWF database, and 5 were previously …

Derivation, Validation, And Clinical Relevance Of A Pediatric Sepsis Phenotype With Persistent Hypoxemia, Encephalopathy, And Shock, L. Nelson Sanchez-Pinto, Tellen D. Bennett, Emily K. Stroup, Yuan Luo, Mihir Atreya, Juliane Bubeck-Wardenburg, Grace Chong, Alon Geva, E. Vincent S. Faustino, Reid W. Farris, Mark W. Hall, Colin Rogerson, Sareen S. Shah, Scott L. Weiss, Robinder G. Khemani

2020-Current year OA Pubs

OBJECTIVES: Untangling the heterogeneity of sepsis in children and identifying clinically relevant phenotypes could lead to the development of targeted therapies. Our aim was to analyze the organ dysfunction trajectories of children with sepsis-associated multiple organ dysfunction syndrome (MODS) to identify reproducible and clinically relevant sepsis phenotypes and determine if they are associated with heterogeneity of treatment effect (HTE) to common therapies.

DESIGN: Multicenter observational cohort study.

SETTING: Thirteen PICUs in the United States.

PATIENTS: Patients admitted with suspected infections to the PICU between 2012 and 2018.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: We used subgraph-augmented nonnegative matrix factorization to …

New Devices In Glaucoma, Lilian Chan, Marlene R Moster, Amanda K Bicket, Arsham Sheybani, Steven R Sarkisian, Thomas W Samuelson, Iqbal Ike K Ahmed, Eydie Miller-Ellis, Oluwatosin U Smith, Qi N Cui

2020-Current year OA Pubs

Glaucoma remains a leading cause of blindness globally. Minimally invasive treatment techniques are rapidly expanding the availability of therapeutic options for glaucoma. These include devices aimed at enhancing outflow through the subconjunctival space, Schlemm's canal, and suprachoroidal space, sustained-release drug delivery devices, and extraocular devices aiming to reduce glaucomatous progression through other novel means. In this review, we provide an overview of several novel devices either newly available or in development for the medical and surgical management of glaucoma. Further studies are required to determine the long-term efficacy of these devices and how they will integrate into the current landscape …

Neurosurgical Management Of Non-Spastic Movement Disorders, Sean D Mcevoy, David D Limbrick, Jeffrey Steven Raskin

2020-Current year OA Pubs

BACKGROUND: Non-spastic movement disorders in children are common, although true epidemiologic data is difficult to ascertain. Children are more likely than adults to have hyperkinetic movement disorders defined as tics, dystonia, chorea/athetosis, or tremor. These conditions manifest from acquired or heredodegenerative etiologies and often severely limit function despite medical and surgical management paradigms. Neurosurgical management for these conditions is highlighted.

METHODS: We performed a focused review of the literature by searching PubMed on 16 May 2023 using key terms related to our review. No temporal filter was applied, but only English articles were considered. We searched for the terms (("Pallidotomy"[Mesh]) …

Development Of A Comprehensive Cardiac Atlas On A 1.5 Tesla Magnetic Resonance Linear Accelerator, Aronne M Schottstaedt, Eric S Paulson, Jason C Rubenstein, Xinfeng Chen, Eenas A Omari, X Allen Li, Chris J Schultz, Lindsay L Puckett, Clifford G Robinson, Filippo Alongi, Elizabeth M Gore, William A Hall

2020-Current year OA Pubs

BACKGROUND AND PURPOSE: The 1.5 Tesla (T) Magnetic Resonance Linear Accelerator (MRL) provides an innovative modality for improved cardiac imaging when planning radiation treatment. No MRL based cardiac atlases currently exist, thus, we sought to comprehensively characterize cardiac substructures, including the conduction system, from cardiac images acquired using a 1.5 T MRL and provide contouring guidelines.

MATERIALS AND METHODS: Five volunteers were enrolled in a prospective protocol (NCT03500081) and were imaged on the 1.5 T MRL with Half Fourier Single-Shot Turbo Spin-Echo (HASTE) and 3D Balanced Steady-State Free Precession (bSSFP) sequences in axial, short axis, and vertical long axis. Cardiac …

The Vcam1-Apoe Pathway Directs Microglial Chemotaxis And Alleviates Alzheimer's Disease Pathology, Shun-Fat Lau, Wei Wu, Hiu Yi Wong, Li Ouyang, Yi Qiao, Jiahui Xu, Jessica Hiu-Yan Lau, Carlton Wong, Yuanbing Jiang, David M Holtzman, Amy K Y Fu, Nancy Y Ip

2020-Current year OA Pubs

In Alzheimer's disease (AD), sensome receptor dysfunction impairs microglial danger-associated molecular pattern (DAMP) clearance and exacerbates disease pathology. Although extrinsic signals, including interleukin-33 (IL-33), can restore microglial DAMP clearance, it remains largely unclear how the sensome receptor is regulated and interacts with DAMP during phagocytic clearance. Here, we show that IL-33 induces VCAM1 in microglia, which promotes microglial chemotaxis toward amyloid-beta (Aβ) plaque-associated ApoE, and leads to Aβ clearance. We show that IL-33 stimulates a chemotactic state in microglia, characterized by Aβ-directed migration. Functional screening identified that VCAM1 directs microglial Aβ chemotaxis by sensing Aβ plaque-associated ApoE. Moreover, we found …

N7-Methylguanosine Methylation Of Trnas Regulates Survival To Stress In Cancer, Raquel García-Vílchez, Ana M Añazco-Guenkova, Judith López, Sabine Dietmann, Mercedes Tomé, Sonia Jimeno, Mikel Azkargorta, Félix Elortza, Laura Bárcena, Monika Gonzalez-Lopez, Ana M Aransay, Manuel A Sánchez-Martín, Pablo Huertas, Raúl V Durán, Sandra Blanco

2020-Current year OA Pubs

Tumour progression and therapy tolerance are highly regulated and complex processes largely dependent on the plasticity of cancer cells and their capacity to respond to stress. The higher plasticity of cancer cells highlights the need for identifying targetable molecular pathways that challenge cancer cell survival. Here, we show that N

Pancreatic Tail Cancer In The Setting Of Pancreatitis With A Review Of The Literature: A Case Report, Shinji Rho, Sooyoung Martin, Zack Nigogosyan, Vladimir Kushnir, Aaron J Mintz, Zishuo Ian Hu

2020-Current year OA Pubs

Environmental risk factors for pancreatic cancer include acute and chronic pancreatitis, obesity, and tobacco use. Differentiating a pancreatic neoplasm in a patient with pancreatitis can be challenging due to their similar presentations. A 57-year-old African American man with a history of congestive heart failure, pancreatitis, and incomplete pancreas divisum presented with an epigastric abdominal pain that radiated to his back. Imaging showed necrotizing pancreatitis, a developing splenic infarct, and a mass at the pancreas tail. The patient was discharged with pain medications and was recommended follow-up imaging after resolution of his pancreatitis. He was readmitted to the emergency department 2 …

Allogeneic Hematopoietic Cell Transplantation Improves Outcome In Myelodysplastic Syndrome Across High-Risk Genetic Subgroups: Genetic Analysis Of The Blood And Marrow Transplant Clinical Trials Network 1102 Study, Jurjen Versluis, Peter Westervelt, Et Al.

2020-Current year OA Pubs

PURPOSE: Allogeneic hematopoietic cell transplantation (HCT) in patients with myelodysplastic syndrome (MDS) improves overall survival (OS). We evaluated the impact of MDS genetics on the benefit of HCT in a biological assignment (donor

METHODS: We performed targeted sequencing in 309 patients age 50-75 years with International Prognostic Scoring System (IPSS) intermediate-2 or high-risk MDS, enrolled in the Blood and Marrow Transplant Clinical Trials Network 1102 study and assessed the association of gene mutations with OS. Patients with

RESULTS: The distribution of gene mutations was similar in the donor and no donor arms, with

CONCLUSION: HCT improved OS compared with non-HCT …

Knowledge, Beliefs, And Practices Related To Coronavirus Disease 2019 (Covid-19) Infection And Vaccination In Healthcare Personnel Working At Nonacute Care Facilities, Armaghan-E-Rehman Mansoor, Caroline A O'Neil, David Mcdonald, Victoria J Fraser, Hilary M Babcock, Jennie H Kwon, Cdc Prevention Epicenters Program

2020-Current year OA Pubs

OBJECTIVE: To characterize experiences, beliefs, and perceptions of risk related to coronavirus disease 2019 (COVID-19), infection prevention practices, and COVID-19 vaccination among healthcare personnel (HCP) at nonacute care facilities.

DESIGN: Anonymous survey.

SETTING: Three non-acute-care facilities in St. Louis, Missouri.

PARTICIPANTS: In total, 156 HCP responded to the survey, for a 25.6% participation rate). Among them, 32% had direct patient-care roles.

METHODS: Anonymous surveys were distributed between April-May 2021. Data were collected on demographics, work experience, COVID-19 exposure, knowledge, and beliefs about infection prevention, personal protective equipment (PPE) use, COVID-19 vaccination, and the impact of COVID-19.

RESULTS: Nearly all respondents …

Polygenic Risk Score Predicts Risk Of Primary Sclerosing Cholangitis In Inflammatory Bowel Disease, Ming-Hsi Wang, Jessica J Friton, Laura E Raffals, Jonathan A Leighton, Shabana F Pasha, Michael F Picco, Kelly Monroe, Billy D Nix, Rodney D Newberry, William A Faubion

2020-Current year OA Pubs

BACKGROUND: Forty distinct primary sclerosing cholangitis (PSC) genomic loci have been identified through multiancestry meta-analyses. The polygenic risk score (PRS) could serve as a promising tool to discover unique disease behaviour, like PSC, underlying inflammatory bowel disease (IBD).

AIM: To test whether PRS indicates PSC risk in patients with IBD.

MATERIALS AND METHODS: Mayo Clinic and Washington University at St Louis IBD cohorts were used to test our hypothesis. PRS was modelled through the published PSC loci and weighted with their corresponding effect size. Logistic regression was applied to predict the PSC risk.

RESULTS: In total, 63 (5.6%) among 1130 …

Dmrt1 Regulates Human Germline Commitment, Naoko Irie, Sun-Min Lee, Valentina Lorenzi, Haiqi Xu, Jinfeng Chen, Masato Inoue, Toshihiro Kobayashi, Carmen Sancho-Serra, Elena Drousioti, Sabine Dietmann, Roser Vento-Tormo, Chun-Xiao Song, M Azim Surani

2020-Current year OA Pubs

Germline commitment following primordial germ cell (PGC) specification during early human development establishes an epigenetic programme and competence for gametogenesis. Here we follow the progression of nascent PGC-like cells derived from human embryonic stem cells in vitro. We show that switching from BMP signalling for PGC specification to Activin A and retinoic acid resulted in DMRT1 and CDH5 expression, the indicators of migratory PGCs in vivo. Moreover, the induction of DMRT1 and SOX17 in PGC-like cells promoted epigenetic resetting with striking global enrichment of 5-hydroxymethylcytosine and locus-specific loss of 5-methylcytosine at DMRT1 binding sites and the expression of DAZL representing …

Racial And Ethnic Disparities In Cervical Cancer Screening From Three U.S. Healthcare Settings, Jennifer C Spencer, Jane J Kim, Jasmin A Tiro, Sarah J Feldman, Sarah C Kobrin, Celette Sugg Skinner, Lei Wang, Anne Marie Mccarthy, Steve J Atlas, Sandi L Pruitt, Michelle I Silver, Jennifer S Haas

2020-Current year OA Pubs

INTRODUCTION: This study sought to characterize racial and ethnic disparities in cervical cancer screening and follow-up of abnormal findings across 3 U.S. healthcare settings.

METHODS: Data were from 2016 to 2019 and were analyzed in 2022, reflecting sites within the Multi-level Optimization of the Cervical Cancer Screening Process in Diverse Settings & Populations Research Center, part of the Population-based Research to Optimize the Screening Process consortium, including a safety-net system in the southwestern U.S., a northwestern mixed-model system, and a northeastern integrated healthcare system. Screening uptake was evaluated among average-risk patients (i.e., no previous abnormalities) by race and ethnicity as …

Neratinib + Fulvestrant + Trastuzumab For Hr-Positive, Her2-Negative, Her2-Mutant Metastatic Breast Cancer: Outcomes And Biomarker Analysis From The Summit Trial, K Jhaveri, H Park, C Ma, R Bose, L Peterson, Et Al.

2020-Current year OA Pubs

BACKGROUND: HER2 mutations are targetable alterations in patients with hormone receptor-positive (HR+) metastatic breast cancer (MBC). In the SUMMIT basket study, patients with HER2-mutant MBC received neratinib monotherapy, neratinib + fulvestrant, or neratinib + fulvestrant + trastuzumab (N + F + T). We report results from 71 patients with HR+, HER2-mutant MBC, including 21 (seven in each arm) from a randomized substudy of fulvestrant versus fulvestrant + trastuzumab (F + T) versus N + F + T.

PATIENTS AND METHODS: Patients with HR+ HER2-negative MBC with activating HER2 mutation(s) and prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) therapy received N + …

Identifying And Addressing Barriers To Implementing Core Electronic Health Record Use Metrics For Ambulatory Care: Virtual Consensus Conference Proceedings, Deborah R. Levy, Amanda J. Moy, Nate Apathy, Julia Adler-Milstein, Lisa Rotenstein, Bidisha Nath, S. Trent Rosenbloom, Thomas Kannampallil, Rebecca G. Mishuris, Aram Alexanian, Amber Sieja, Michelle R. Hribar, Jigar S. Patel, Christine A. Sinsky, Edward R. Melnick

2020-Current year OA Pubs

Precise, reliable, valid metrics that are cost-effective and require reasonable implementation time and effort are needed to drive electronic health record (EHR) improvements and decrease EHR burden. Differences exist between research and vendor definitions of metrics. PROCESS:  We convened three stakeholder groups (health system informatics leaders, EHR vendor representatives, and researchers) in a virtual workshop series to achieve consensus on barriers, solutions, and next steps to implementing the core EHR use metrics in ambulatory care. CONCLUSION:  Actionable solutions identified to address core categories of EHR metric implementation challenges include: (1) maintaining broad stakeholder engagement, (2) reaching agreement on standardized measure …

A Blood Biomarker Test For Brain Amyloid Impacts The Clinical Evaluation Of Cognitive Impairment, Mark Monane, B Joy Snider, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study was to examine clinicians' patient selection and result interpretation of a clinically validated mass spectrometry test measuring amyloid beta and ApoE blood biomarkers combined with patient age (PrecivityAD® blood test) in symptomatic patients evaluated for Alzheimer's disease (AD) or other causes of cognitive decline.

METHODS: The Quality Improvement and Clinical Utility PrecivityAD Clinician Survey (QUIP I, ClinicalTrials.gov Identifier: NCT05477056) was a prospective, single-arm cohort study among 366 patients evaluated by neurologists and other cognitive specialists. Participants underwent blood biomarker testing and received an amyloid probability score (APS), indicating the likelihood of a positive result …

In Silico Trial Of Simulation-Free Hippocampal-Avoidance Whole Brain Adaptive Radiotherapy, Alex T Price, Kylie H Kang, Francisco J Reynoso, Eric Laugeman, Christopher D Abraham, Jiayi Huang, Jessica Hilliard, Nels C Knutson, Lauren E Henke

2020-Current year OA Pubs

BACKGROUND AND PURPOSE: Hippocampal-avoidance whole brain radiotherapy (HA-WBRT) can be a time-consuming process compared to conventional whole brain techniques, thus potentially limiting widespread utilization. Therefore, we evaluated the

MATERIALS AND METHODS: Ten patients previously treated for central nervous system cancers with cone-beam computed tomography (CBCT) imaging were included in this study. The CBCT was the adaptive image-of-the-day to simulate first fraction on-board imaging. Initial contours defined on the MRI were rigidly matched to the CBCT. Online ART was used to create treatment plans at first fraction. Dose-volume metrics of these simulation-free plans were compared to standard-workflow HA-WBRT plans on each …