Digital Commons Network^™

A Gut-Activated Nhr-86-Cyp Pathway Mediates The Neuroprotective Effects Of Enterococcus Faecium Probiotics In A Nematode Model Of Amyotrophic Lateral Sclerosis, Yu Sang, Jie Ren, Alejandro Aballay

Faculty, Staff and Student Publications

Neurodegenerative diseases are often associated with oxidative stress, and while probiotics may influence neuronal health, the underlying mechanisms remain poorly understood. Using the sod-1 A4VM amyotrophic lateral sclerosis (ALS) model in Caenorhabditis elegans, we investigated the protective effects of the probiotic Enterococcus faecium against oxidative stress-induced neurodegeneration. Animals fed E. faecium showed reduced motor neuron degeneration under oxidative stress compared to those maintained on a standard Escherichia coli diet. Transcriptome analysis revealed a significant enrichment of oxidoreductase genes, including cytochrome P450 (cyp) genes. RNAi-mediated knockdown of cyp genes impaired E. faecium-mediated neuroprotection, and this loss correlated with increased reactive oxygen …

Guadecitabine Improved Relapse-Free Survival In High-Risk Acute Myeloid Leukemia And Myelodysplastic Syndrome Patients After Transplant: Phase Ii Results From A Single Center, Betül Oran, Peter Thall, Amin Alousi, Gheath Al-Atrash, Rohtesh Mehta, David Marin, Partow Kebriaei, Uday Popat, Roland Bassett, Qaiser Bashir, Jin Im, Amanda Olson, Jessica Jewell, Portia Smallbone, Elizabeth Shpall, Richard Champlin

Faculty, Staff and Student Publications

This phase II, single-center clinical trial evaluated the efficacy and safety of guadecitabine, with or without donor lymphocyte infusion, following allogeneic stem cell transplantation in adult patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). The study had three treatment cohorts based on post-transplant disease status. Cohort 1 included patients with hematologic relapse after transplant (N=13). Cohort 2 consisted of patients with minimal residual disease (MRD) detected after transplant (N=18). Cohort 3 compromised patients in remission without MRD within 100 days after transplant (N=24). The primary objectives were achievement of morphological complete remission in cohort 1 and MRD eradication …

Endogenous Processes Underlying Clock-Like Mutational Signatures, Teresa Druck, Rami I Aqeilan, C Marcelo Aldaz, Nicola Zanesi, Kay Huebner

Faculty, Staff and Student Publications

Wellcome Trust scientists have shown that “mutational signatures” in specific nucleotide contexts accumulate in genomes of mammalian tissues, providing clues to underlying causes of specific signatures. Analysis of cancer genomes has identified more than 50 single‐base substitution (SBS) signatures, with SBS1, SBS5, and SBS40 linked to aging and present in normal tissues. SBS1 results from cytosine demethylation, whereas SBS5 and SBS40 arise from unknown endogenous mechanisms. We hypothesized that loss of fragile‐site genes drives these two signatures. FHIT, located at FRA3B, is frequently deleted in cancers, and Fhit‐deficient mouse tissues exhibit a mutation profile resembling human SBS5. Data mining of …

Preclinical Ischemic Stroke Multicenter Trials (Prism) Collective Statement: Opportunities, Challenges, And Recommendations For A New Era, Cenk Ayata, Philip M Bath, Anna M Planas, Stuart M Allan, Johannes Boltze, Ryan P Cabeen, Claire L Gibson, Marilyn J Cipolla, Marcio A Diniz, Stefano Fumagalli, Fahmeed Hyder, Raymond C Koehler, Arthur Liesz, Sarah K Mccann, Tim Magnus, Louise D Mccullough, Emily S Sena, Simone Beretta, Jaroslaw Aronowski, Francesca Bosetti, Clinton B Wright, Patrick D Lyden, Lauren H Sansing

Faculty, Staff and Student Publications

Preclinical stroke research faces a critical translational gap, with animal studies failing to reliably predict clinical efficacy. To address this, the field is moving toward rigorous, multicenter preclinical randomized controlled trials (mpRCTs) that mimic phase 3 clinical trials in several key components. This collective statement, derived from experts involved in mpRCTs, outlines considerations for designing and executing such trials. mpRCTs offer advantages such as increased sample sizes, robust statistical design, incorporation of heterogeneity, and standardized protocols, but they face challenges in finding the right balance between standardization and heterogeneity, appropriate stroke model selection, and outcome measures, as well as the …

Intratumoral Bacteria Are Immunosuppressive And Promote Immunotherapy Resistance In Head And Neck Squamous Cell Carcinoma, Natalie L Silver, Jin Dai, Travis D Kerr, Jessica Altemus, Rekha Garg, Hannah Simmons, Tyler Alban, Laura Noel-Romas, Vladimir Makarov, David J H Shih, Shwetha V Kumar, Akeem Santos, Rehan Akbani, Adam Burgener, Mohammed Dwidar, Neil Gross, Andrew G Sikora, Elias J Sayour, Apollo Stacy, Christian Jobin, Timothy A Chan, Renata Ferrarotto, Daniel J Mcgrail

Faculty, Staff and Student Publications

Despite the promise of immune checkpoint blockade (ICB) in head and neck squamous cell carcinoma (HNSCC), mediators of response are poorly understood. To address this, here we analyzed oropharyngeal HNSCCs treated with neoadjuvant durvalumab (anti-PDL1) alone or in combination with tremelimumab (anti-CTLA4) from the CIAO clinical trial ( NCT03144778 ). We found that only the total abundance of intratumoral bacteria predicted ICB response, which was validated in multiple independent cohorts. High intratumoral bacteria abundance was associated with an immunosuppressive tumor microenvironment, characterized by an accumulation of neutrophils coupled with depletion of T cells and other adaptive immune cells. Experimental elevation …

Developing Provider Digital Twins For Personalized Provider-Patient Communication Via A Rag-Based Conversational Framework, Pengze Li, Yutong Hu, Jianfu Li, Garit Gemeinhardt, Fang Li, Muhammad Amith, Licong Cui, Antonio J Forte, Cui Tao

Faculty, Staff and Student Publications

Digital twins have emerged as a paradigm in precision and personalized medicine, enabling data-driven modeling of individuals to support tailored interventions. While most existing work focuses on patient-oriented twins, little attention has been given to modeling the provider’s role, particularly in clinical communication. In this study, we present GRACE (Generalized RAG-Enhanced Conversation Framework), a framework for constructing a provider digital twin (ProDT) that emulates key aspects of clinicians’ communicative and cognitive behavior. GRACE integrates three modules: a physician-informed dialog script generation and optimization module for provider-patterned conversation, a Retrieval-Augmented Generation (RAG) pipeline for factual grounding and timely knowledge updating, and …

Recent Technological Advances In Monitoring And Neuromodulation Of Non-Malignant And Neurogenic Bladder Conditions, Chang Liu, Yifan Wang, Mario Romero-Ortega, Argyrios Stampas, Yingchun Zhang, Philippe Zimmern, Zhengwei Li

Faculty, Staff and Student Publications

Neurogenic bladder and lower urinary tract (LUT) dysfunctions encompass a wide variety of urinary disorders resulting from nervous system impairments. Unfortunately, conventional treatments are still limited and can have significant complication rates, especially when stent implantations or other surgical procedures are involved. Therefore, there is a critical need to develop novel therapeutic strategies and pharmacological approaches to address these challenging urological conditions. Recent technological advances offer promising solutions to overcome some of these challenges faced by patients with bladder and LUT dysfunction. This review summarizes recent progress in advanced urotechnologies, focusing on bladder monitoring and neuromodulation approaches, advanced medical instruments …

Core Outcome Set For Liver Trauma: A Consensus Approach Using Modified Delphi Methodology, Christian Damone Cain, Saskya Byerly, Nicole A Stassen, David Efron, Thomas M Scalea, John B Holcomb, Gregory J Jurkovich, Rachael Callcut, Deborah M Stein, John A Harvin, Grace Rozycki, David H Livingston, Chad G Ball, Demetrios Demetriades, Ali Salim, Rosemary Kozar, Ajai K Malhotra, Martin Croce, Timothy Fabian, Andrew B Peitzman, Dante Yeh

Faculty, Staff and Student Publications

Objectives: Liver trauma management has evolved over recent decades, shifting from primarily operative to algorithmic approaches incorporating initial non-operative management alongside operative intervention for severe injuries. Inconsistent core outcome measures between studies hamper meaningful clinical research and evidence synthesis. This study aimed to develop a core outcome set (COS) for liver trauma research to standardize outcome reporting and improve study comparability.

Methods: A modified Delphi consensus methodology after COMET (Core Outcome Measures in Effectiveness Trials) and COS-STAD (Core Outcome Set-Standards for Development) guidelines was employed and twenty trauma surgery experts were recruited through purposive sampling of high-impact publications and professional …

Pulmonary Hypertension Associated With Interstitial Lung Diseases, Arun Jose, Namita Sood, Jean M Elwing, Bindu Akkanti, Abubakr Bajwa, Roberto Bernardo, Rodolfo A Estrada, Munish Sharma, Francisco J Soto, Adriano R Tonelli, Divya Verma, Janine Vintch, Sandeep Sahay, Oksana A Shlobin

Faculty, Staff and Student Publications

Interstitial lung disease (ILD) is a term encompassing a wide array of pulmonary conditions characterized by inflammation and fibrosis of the pulmonary parenchyma. Pulmonary hypertension (PH) is frequently encountered in patients with fibrotic ILDs and poses unique difficulties for both diagnosis and management. Patients with ILD-associated pulmonary hypertension (ILD-PH) are complex, often ailing and presenting with multiple comorbidities whose individual contributions to the underlying PH can be challenging to disentangle. Evidence supporting treatment with PH-specific medications in ILD-PH is limited. This edition of "How I Do It" presents a longitudinal case-based discussion of ILD-PH to address these challenges, highlight pearls …

Evaluation Of Prophylactic Egd Versus Beta Blockade In Hepatocellular Carcinoma Patients On Anti-Angiogenic Cancer Treatments, Panayiotis D Kontoyiannis, Camila Ayerbe, Kok Hoe Chan, Sara Soliman, Victor Machicao, Julie H Rowe

Faculty, Staff and Student Publications

No abstract provided.

Nemolizumab As An Alternative Therapeutic Option For Indolent Systemic Mastocytosis, Sezim Minbaeva, Stephen K Tyring

Faculty, Staff and Student Publications

Indolent systemic mastocytosis (ISM) is a clonal mast cell disorder characterized by recurrent symptoms that can persist despite treatment with antihistamines, leukotriene antagonists, and mast cell stabilizers. Treatment options are limited when symptoms remain refractory, and avapritinib is contraindicated or declined. We describe the case of a 62-year-old female with an 11-year history of ISM who developed worsening pruritus and urticaria despite extensive conservative and biologic therapies, including topical corticosteroids, hydroxyzine, montelukast, omalizumab, and dupilumab. Given her history of stroke, she declined avapritinib. Nemolizumab was initiated with a 60 mg loading dose followed by 30 mg every four weeks. After …

Are Skip Laminectomy And Oblique Corpectomy Effective Options To Treat Degenerative Cervical Myelopathy While Preserving Motion? Results Of A Scoping Review, Justin L Lomax, Ankit Mehta, Aditya Vedantam, Rory Goodwin, Nathan Evaniew, Mario Ganau, Chris J Neal, Rex A W Marco, Ryan Quisling, Jonathan Palmer, Adam T Archie, Keith L Jackson, John G Devine, Jefferson R Wilson, Uzondu F Agochukwu

Faculty, Staff and Student Publications

Study Design

Scoping Literature Review.

Objective

The aim of this literature review is to examine the results of both skip laminectomy and oblique corpectomy in the setting of degenerative cervical myelopathy (DCM).

Methods

A scoping review of the relevant literature examining the efficacy of cervical skip laminectomy and oblique corpectomy in patients with DCM was conducted using the Medline database. Our review strategy aimed at answering two research questions. #1: Do clinical outcomes differ between patients undergoing cervical laminoplasty vs skip laminectomy in the setting of myelopathy. #2: Which outcomes can oblique corpectomy provide, and how its related complication profile …

Negotiating Health: A Qualitative Analysis Of Home Smoking Rules Among Families With Medically Vulnerable Infants, Yolanda R Villarreal, Thomas F Northrup, Stephen M Fischer, Jackson S Norwood, Angela L Stotts

Faculty, Staff and Student Publications

Introduction: Approximately 5000 child deaths are attributed to secondhand smoke exposure (SHSe) annually, which is three times the number of childhood cancers combined. Infants, medically fragile infants, are highly vulnerable to the harmful effects of SHSe, including respiratory infections and sudden infant death syndrome. While having a home smoking ban may mitigate these risks, implementation remains a challenge for many families. Our primary aim was to explore the familial and sociocultural factors associated with smoking-ban initiation and maintenance in households with medically fragile infants.

Methods: Qualitative interviews were conducted with 20 mothers participating in a behavioral intervention from 2015 to …

Mitochondrial Dysfunction In Alzheimer’S Disease And Related Sex Differences, Afzal Misrani, Conelius Ngwa, Fudong Liu

Faculty, Staff and Student Publications

Alzheimer's disease (AD), the most common form of dementia, accounts for 70% of cases and remains a major healthcare challenge due to its rising prevalence and lack of disease-modifying treatments. Clinically, AD is a sexually dimorphic disease. Women exhibit more rapid cognitive decline and accelerated brain atrophy during mild cognitive impairment and early dementia, whereas men more frequently present cardiovascular comorbidities, earlier mitochondrial dysfunction, and greater neuropsychiatric symptoms. AD is marked by amyloid-β (Aβ) plaques, neurofibrillary tangles, neuroinflammation, and neuronal loss, with mitochondrial dysfunction emerging as a key early contributor that exhibits sex specific phenotypes. Mitochondria are vital for neuronal …

Thrombelastography As A Predictive Tool For Thromboembolic Events After Extremity Trauma: A Secondary Analysis Of Prevent-Clot, Cory K Mayfield, Nathan N O'Hara, Prism S Schneider, Renan C Castillo, Robert V O'Toole, Katherine P Frey, William Obremskey, Deborah M Stein, Reza Firoozabadi, Stephen J Warner, Madhav A Karunakar, Joshua L Gary

Faculty, Staff and Student Publications

Background: Venous thromboembolism (VTE) poses significant risk of morbidity and mortality in orthopaedic trauma patients. Thromboelastography (TEG) analysis has been demonstrated to provide value in demonstrating hypercoagulability and predicting the risk of post-injury VTE. The primary aim was to investigate if TEG analysis at the time of admission following severe extremity trauma predicts thromboembolic events. We hypothesized that previously described elevations in maximal amplitude (MA) on initial TEG would correlate with an increased risk of VTE.

Methods: This was a secondary study of PREVENT CLOT, a multicenter, randomized trial that enrolled adult patients with an extremity fracture (from hip to …

Improved Surgical Management Of Complex Neonates With Heterotaxy Syndrome, Alexander C Mills, Ashley E Dawson, Michael C Scott, Alexis M Kennedy, Beau A Bequeaith, Ioannis Zoupas, Jorge D Salazar, Damien J Lapar

Faculty, Staff and Student Publications

Background: Neonatal management of congenital heart defects (CHD) among heterotaxy patients remains challenging due to significant heterogeneity in cardiac and visceral phenotypes. This study evaluated contemporary surgical outcomes and identified high-risk anatomic substrates.

Methods: A total of 41 heterotaxy CHD patients who underwent neonatal surgical repair and/or palliation over a 10-year period were evaluated at a single institution. Heterotaxy anatomy was characterized according to right atrial isomerism (RAI) or left atrial isomerism (LAI), and other cardiac defects. Multivariate Cox regression and Kaplan-Meier analyses evaluated operative and intermediate-term outcomes.

Results: Median age at initial operation was 7.0 days, and median operative …

Hyperglycemia In Combination With Excess Fat Intake Promotes Renal Pyroptosis And Fibrosis Through Gα12-Dependent Endoplasmic Reticulum Stress, Muhammad Sohaib Khan, Boram Kim, Yerim Jeon, Jihoon Tak, Yun Seok Kim, Sang Gil Lee, Eun Byul Lee, Chang-Hoon Lee, Cheol Bin Eom, Hyun Sook Lee, Hyeon-Ki Jang, Nakyeom Lee, Jeong Hae Kie, Jee Myung Yang, Yoon Mee Yang, Sang Geon Kim

Faculty, Staff and Student Publications

Background: Chronic exposure to free fatty acids (FFAs) and glucose may disrupt metabolic homeostasis and initiate pathological processes. This study investigated the effects of hyperglycemia and fat overload on renal endoplasmic reticulum (ER) stress, pyroptosis and fibrogenesis in mice and the underlying basis. We hypothesized that the combined insult would more severely induce Gα12-dependent ER stress and renal complications.

Methods: Mice were subjected to either high fat diet (HFD)+streptozotocin (STZ), or STZ treatment, and AZ2 was used as an anti-diabetic agent. Blood sera were used for blood biochemistry, and tissues were employed for RNA sequencing, immunoblottings, TEM, histology and immunohistochemistry. …

Proliferation And Apoptosis Adaptor Protein 15 (Pea15), A Potential Oncogenic Regulator Of Vhl And Hif1a Identified Through Proteomic Analysis In Hepatocellular Carcinoma, Yun Seong Jeong, Ji-Hyun Shin, Soo Mi Kim, Bo Hwa Sohn, Sun Young Yim, Ji Hoon Kim, Jae Jun Shim, Sung Hwan Lee, Yun Shin Chun, Sunyoung S Lee, Hui Dai, Ahmed Kaseb, Koo Jeong Kang, Holger K Eltzschig, A Robert Macleod, Xiaolin Luo, Alexey Revenko, Youngsoo Kim, Ju-Seog Lee

Faculty, Staff and Student Publications

No abstract provided.

Retrospective Longitudinal Analysis Of Blood Microrna-7-5p As A Possible Progression Biomarker In People With Parkinson’S Disease, Shayan Abdollah Zadegan, Corrine Hutchinson, Chiamaka Onuigbo, Juan D Martinez-Lemus, Laura Talbot, E Jeffrey Metter, Marie-Francoise Doursout, Emily Tharp, Jessika Suescun, Mohammad Shahnawaz, Timothy M Ellmore, Mya Schiess, Christopher Adams

Faculty, Staff and Student Publications

Background: MicroRNA-7-5p (miR-7-5p) may play a neuroprotective role in people with Parkinson's disease (PwP), as it has been found to regulate α-synuclein (α-syn) and the NLRP3 inflammasome in animal models of Parkinson's disease (PD).

Objective: The study aimed to investigate the use of miR-7-5p as a potential biomarker for disease progression in PwP by correlating it with time, clinical measures, and neurofilament light chain (NfL).

Methods: We performed a longitudinal retrospective analysis of blood miR-7-5p levels in 303 de novo PwP and 159 healthy controls (HCs) from the Parkinson's Progression Markers Initiative (PPMI) cohort. In PwP, a linear mixed-effects …

Defining Large Core Infarction: Comparing The Accuracy Of Non-Contrast Ct Aspects Versus Ct Perfusion Core Volume, Ngoc Mai Le, Joseph Samaha, Ananya S Iyyangar, Javier Gomez-Farias, Bruna Kfoury, Ritesh Bajaj, Connor Nguyen, Syed Shams, Camille Neal-Harris, Emmanuel Ebirim, Hussain Azeem, Anjan N Ballekere, Saagar Dhanjani, Eunyoung Lee, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

Background and purpose: We evaluated agreement and performance of non-contrast head-computerized tomography (NCHCT) and CT-perfusion (CTP) in identifying large core infarct in acute ischemic stroke (AIS) due to large vessel occlusion (LVO) undergoing endovascular therapy (EVT), using MRI as reference.

Methods: From our prospective multicenter registry, we identified patients with LVO-AIS due to internal carotid artery or middle cerebral artery M1occlusions who underwent EVT between 2017 and 2024. Final infarct volume (FIV) was defined using 24-48 h post-EVT diffusion-weighted imaging magnetic resonance imaging (MRI-FIV). To limit infarct growth bias, only patients with CTP-to-EVT start time < 3 h were included. Large core infarct was defined at FIV thresholds: 50, 70, and 100 mL. The primary outcome was agreement between NCHCT and CTP in identifying large core infarct using kappa-statistics. Large core was considered if NCHCT-ASPECTS< 6 or rCBF< 30% volume>70 mL on CTP (RAPID/Viz.AI). …

Cesarean Section Rates In Lucas Do Rio Verde, Brazil: Assessing The Impact Of Socioeconomic Status And Maternal And Neonatal Outcomes, Ramya Vemulapalli, Roni Arienti, Linder Wendt, Jay Brooks Jackson, Mary B Rysavy, Kimberly A Kenne

Faculty, Staff and Student Publications

Background

Brazil is globally known for its high rate of cesarean section despite endorsing the WHO’s current recommendation of 15%.

Objectives

Determine if socioeconomic status correlated with the rate of cesarean section (CS) at a mixed private and public hospital in the west-central region of Brazil. Describe the maternal and neonatal outcomes by mode of delivery (MOD) in the same population.

Design

Cohort study

Methods

Data from all delivering patients at São Lucas Hospital were collected during an 18-month period and analyzed. Demographics, baseline maternal health status, pregnancy and delivery information, maternal outcomes, and neonatal outcomes were entered into a …

Congenital Syphilis: From Near-Elimination To Crisis, Chad J Abresch, Irene A Stafford, Regan M Johnson, Kayode Olabanji, Ashleigh M Sutphen, Helen E Cejtin, Ashley Hoover

Faculty, Staff and Student Publications

This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia-convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts-we contrast prevention systems during near-elimination (1998-2005) with the current crisis (2018-2025). Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial/ethnic disparities worsening. American Indian/Alaska Native communities face rates up to 100 times higher than White populations in some …

Sickle Cell Crisis-Induced Painless Bilateral Orbital Bone Infarction: A Case Report, Luke Farson, Marina Shenouda, Agni Kakouri, Ashkan Kashanchi, Clark Sitton, Timothy Mcculley, Ying Chen

Faculty, Staff and Student Publications

Introduction: Sickle cell disease is associated with painful vaso-occlusive crises, bone infarction, avascular necrosis, and osteomyelitis. Sickle cell orbitopathy is a rare manifestation with signs similar to periorbital cellulitis and has subtle radiologic features.

Case presentation: We report a case of a five-year-old girl with sickle cell who presented with bilateral orbital infarctions and subperiosteal hematomas, notably without periorbital pain, and was treated with antibiotics and steroids.

Conclusion: Physicians should be aware of this rare manifestation, especially in the pediatric population, as it can affect subsequent management.

Glaucoma Risk With Metformin And Sulfonylurea Therapies In Type 2 Diabetes: A Retrospective Cohort Study., Jared Lim, Jingru Zhou, Hulin Wu, Ziqi Liu, David A Lee

Faculty, Staff and Student Publications

Background: Research on metformin, sulfonylureas, and open-angle glaucoma risk in type 2 diabetes mellitus (T2DM) has yielded inconsistent findings. This study examined associations between hypoglycemic treatments and glaucoma diagnosis rates.

Methods: This retrospective cohort study analyzed electronic health records of newly diagnosed T2DM patients from the Merative™ Explorys® Therapeutic Dataset (2010-2022), comparing three groups: metformin monotherapy, sulfonylureas plus metformin combination, and untreated controls. Propensity score matching balanced demographics, glycemic control, body mass index, blood pressure, lipid levels, and comorbidities. Cox proportional hazards models calculated adjusted hazard ratios for incident glaucoma.

Results: After 1:1 propensity score matching, metformin monotherapy (N=100,387) showed …

Fostering Connection And Shame Resilience Through Self-Compassion: An Innovative Elective For Health Professions Learners, Gioconda Mojica, Peggy Hsieh, Andrew J Revell, Rex Marco

Faculty, Staff and Student Publications

Background: Shame is an emotional experience in health professions education, often contributing to burnout, isolation, and threats to professional identity. Self-compassion has been identified as a protective factor against shame. This study describes the development and evaluation of an elective designed to foster shame resilience and cultivate self-compassion among health professions students.

Methods: A 6-h elective, Fostering Connection and Shame Resilience Through Self-Compassion, was offered over 3 monthly 2-h sessions. Each session included a shared meal, abbreviated large-group conceptual learning, reflective writing, guided self-compassion practices, and small-group discussions. Participants completed the Self-Compassion Scale-Short Form (SCS-SF) at the beginning and …

Biomechanical And Computational Modeling Of Metastatic Acetabular Defects: Influence Of Tumor Location On The Risk Of Fracture, Jacob Doddridge, Hongjia He, Rui Yang, E U Conrad, Nicholas Dunbar

Faculty, Staff and Student Publications

Background: Metastatic bone disease can lead to pathologic fracture of the pelvis which affects quality of life. There are limited validated approaches for biomechanical modeling, classification, or surgical treatment of metastatic acetabular defects.

Methods: An artificial hemipelvis bone was used to calibrate a computed tomography-based computational model of the pelvis with varying locations and sizes of acetabular defects. Metastatic defects affecting the anterior and posterior column, medial wall, and their combinations were created. Mechanical testing was performed on each defect, and images of the lateral surface of the acetabulum were analyzed by digital image correlation to measure peak surface strains. …

Open Capsulorrhaphy With Capsular Shift And Open Coracohumeral Ligament Reconstruction For Chronic Recurrent Multidirectional Shoulder Instability, Anna E Sumpter, Christopher S Frey, Matthew T Provencher, Lance E Leclere

Faculty, Staff and Student Publications

Background: This case features the surgical reconstruction of the coracohumeral ligament (CHL) in conjunction with open capsulorrhaphy and capsular shift for the management of chronic, recurrent, multidirectional shoulder instability (MDI). While there is a paucity of existing literature examining the clinical outcomes of this technique, biomechanical studies have implied its potential to restore stability. This procedure may be of particular benefit to patients who have failed previous conservative management and/or attempts at surgical stabilization, as well as those with severe joint hyperlaxity or connective tissue disorders.

Indications: This patient failed extensive physical therapy, as well as previous arthroscopic labral repair …

Healthcare Utilization Following Implementation Of A Pediatric Social Needs Screening Program, Ashley Gibson, Kaleigh Riggs-Harpur, Midhat Jafry, Mallika Mathur, Yen-Chi Le, Sandra Mckay

Faculty, Staff and Student Publications

Objective: This study evaluated differences in healthcare utilization among a pediatric primary care population following implementation of a universal social needs screening and referral program. It was hypothesized that emergency, sick, and hospitalization visits would decrease post-implementation, with stable or increased preventive care.

Methods: A retrospective, observational study was conducted using electronic health record data from 2 cohorts at different time periods at a large academic pediatric primary care clinic. The pre-implementation group included patients with a well-child visit from 08/2021 to 07/2022; the post-implementation group included patients from 09/2022 to 08/2023. Healthcare utilization measures of emergency department visits, hospitalizations, …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

Faculty, Staff and Student Publications

Background: The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods: This project was conducted with pediatric residents and faculty during the 2019-20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

Circulating Biomarkers In Subjects With Progressive Pulmonary Fibrosis: Data From The Inbuild Trial, Toby M Maher, R Gisli Jenkins, Francesco Bonella, Shervin Assassi, Claudia Diefenbach, Carina Ittrich, Klaus B Rohr, Martin Kolb

Faculty, Staff and Student Publications

Background: We investigated the prognostic potential of circulating biomarkers at baseline and the effects of nintedanib on changes in these biomarkers in subjects with progressive pulmonary fibrosis (PPF).

Methods: In the INBUILD trial, subjects with PPF received nintedanib (n=332) or placebo (n=331). Associations between biomarker levels at baseline and the rate of forced vital capacity (FVC) decline (mL·year-1) over 52 weeks, time to interstitial lung disease (ILD) progression (absolute decline in FVC % predicted ≥10%) or death over 52 weeks, time to first acute exacerbation or death over the whole trial, and time to death over the whole trial were …