Digital Commons Network^™

Five-Year Follow-Up Analysis Of Zuma-5: Axicabtagene Ciloleucel In Relapsed/Refractory Indolent Non-Hodgkin Lymphoma, Sattva S Neelapu, Julio C Chavez, Alison R Sehgal, Narendranath Epperla, Matthew L Ulrickson, Emmanuel Bachy, Pashna N Munshi, Carla Casulo, David G Maloney, Sven De Vos, Ran Reshef, Lori A Leslie, Olalekan O Oluwole, Ibrahim Yakoub-Agha, Rashmi Khanal, Joseph D Rosenblatt, Jacob Wulff, Rhine R Shen, Wangshu Zhang, Soumya Poddar, Harry Miao, Olga Nikolajeva, Caron A Jacobson

Faculty, Staff and Student Publications

Axicabtagene ciloleucel (axi-cel) is an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy approved for relapsed/refractory (R/R) follicular lymphoma (FL). Here, we report updated clinical outcomes from ZUMA-5 in 159 enrolled patients with R/R indolent non-Hodgkin lymphoma (iNHL; 127 with FL and 31 with marginal zone lymphoma) after a median follow-up of 64.6 months. Patients underwent leukapheresis and received lymphodepleting chemotherapy and axi-cel (2 × 106 CAR T cells/kg). The overall response rate was 90% (75% complete response rate). The median duration of response was 60.4 months, and the median progression-free survival (PFS) was 62.2 months; median time to next …

Agitation In Alzheimer’S Disease: From Assessment To Therapeutics, Antonio L Teixeira, Youngran Kim, Thiago M Cordeiro, Gabriel A De Erausquin, Natalia P Rocha

Faculty, Staff and Student Publications

Agitation is a neuropsychiatric syndrome characterized by excessive motor and/or verbal behaviors, with or without aggressive behaviors. The prevalence of agitation in Alzheimer’s disease varies from 5% to over 50%. Multiple factors have been implicated in its pathophysiology, including disease stage, comorbidity with other symptoms (e.g., psychosis, anxiety/depression), and psychosocial factors. Ruling out delirium and identifying environmental triggers are fundamental steps in the management of agitation in Alzheimer’s disease. For establishing an effective therapeutic plan, it is important to define duration, severity, and potential for harm. While non-pharmacological approaches are considered the first line of intervention, pharmacological agents …

Infection And Nonunion Rates In Open Fractures: Description Of 6,042 Fractures From The Flow And Prep-It Trials, Roman M Natoli, Lucas S Marchand, Sofia Bzovsky, Jennifer E Hagen, Mark J Gage, Christina A Stennett, Nathan N O'Hara, Kyle J Jeray, Brad Petrisor, Sheila Sprague, Gerard P Slobogean

Faculty, Staff and Student Publications

Background: Infection and nonunion are common sequelae of open fractures. Studies have shown infection and nonunion rates ranging from 2% to 52% and 12% to 17%, respectively. The present article describes the rates of surgical site infection (SSI) and delayed union/nonunion following open fractures in a large contemporary series of patients from prospective clinical trials with adjudicated outcomes.

Methods: A descriptive analysis was performed with use of patient data from the FLOW, Aqueous-PREP, and PREPARE-Open studies. These studies, published within the past 10 years, included multiple international trauma centers and shared definitions for SSI and delayed union/nonunion. SSI and delayed …

14,441 Genomics-Based Validated Automated Comprehensive Clinicopathologic Correlations For Myeloid Neoplasms., Ahmed Elsafty, Yomna Ahmed, Taher F Halawa, Shaoguang Li, Dongguang Li, Elena Agranovsky, Ahmed Soliman, Howida Talaat, Mohamed Montaser, Omar Elnady, Deyaa Elnady, Mohamed Mahmoud Moustafa, Nourhan Ibrahim, Maryana Gumenyak, Yasmin Soliman, Samah Ali, Elshaimaa Abdelrahman, Hatem M S Alahwal, Ahmed S Barefah, Ashraf Abdelghany, Sherif Ammar, Nermeen Abdel-Haleem, Osama Abdel-Kareem, Samir N Shamma, Naglaa Husein, Maha M Sakr, Heba-Allah E Abdelrhman, Menatalla Nadim, Hany Girguis, Manal Othman, Ola Soliman, Walaa H Behery, Lamis Eltoukhy, Heldez A Mohamed, Aya M Hassan, Fatma-Elzahraa A Bebers, Marwa Abdel-Zaher, Sara A Abbas, Shady Attia, Mohamed A Saada, Amira S Eid, Soha E Khorshed, Khaled Talaat, Mohamed Saad Hamed Mahmoud, Mahmoud M S Mahmoud, Ola M S Mahmoud, Abdel-Rahman O Abdel-Kareem, Ahmed K Talaat, Haitham Heneish, Ibrahim I Samaha, Mones Safwat, Mohamed K Talaat, Alaa O Abdel-Kareem, Hadeel Abdel-Monem, Ramy Abaza, Hazem Abaza, Nora Ahmad, May A Maarouf, Iman A Shaheen, Ahmed S Abdelhafiz, Amera Rabee, Yara M Montaser

Faculty, Staff and Student Publications

The dataset (Elsafty_Reports_of_Myeloid_Neoplasms_2024) consists of 14,441 comprehensive clinicopathologic correlations (CPCs) for myeloid neoplasms (MN) with corresponding laboratory results. Specialized online platform utilizing these laboratory results automatically generated the diagnostic and prognostic CPCs. These results include complete blood counts (CBC), peripheral blood smear (PBS) findings, blast/promyelocyte count with dysplasia screening by flow cytometry, and molecular results by NGS/PCR. Two Hematopathologists, who performed the CBC and PBS review, collected their 10,794 real-world reports of cases served in Egypt with molecular studies performed in the USA and Europe. These newly-diagnosed cases included 243 chronic myeloid leukemia (CML) cases with 257 mutations/aberrations; 4,567 non-CML …

Estimated Impact Of 2022–2023 Influenza Vaccines On Annual Hospital Burden In The United States, Kaiming Bi, Shraddha Ramdas Bandekar, Anass Bouchnita, Annalise Cramer, Spencer J Fox, Rebecca K Borchering, Matthew Biggerstaff, Lauren Ancel Meyers

Faculty, Staff and Student Publications

During the COVID-19 pandemic early years, infection prevention measures suppressed transmission of seasonal influenza and other respiratory viruses. The early onset and moderate severity of the US 2022-2023 influenza season may have resulted from reduced use of nonpharmaceutical interventions or lower population immunity after 2 y of limited influenza virus circulation. We used a mathematical model of influenza virus transmission that incorporates vaccine-derived protection against both infection and severe disease to estimate the impact of influenza vaccines on healthcare burden. Assuming reported levels of past vaccine effectiveness (VE) against infection and hospitalization, we estimate that influenza vaccines prevented 69,886 (95% …

Sex Differences In Atherosclerotic Coronary Artery Disease Patterns, Kazumasa Ikeda, Daniel Munhoz, Sofie Brouwers, Jeroen Sonck, Hitoshi Matsuo, Toshiro Shinke, Hirohiko Ando, Brian Ko, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Ketina Arslani, Antonio Maria Leone, Domenico Galante, Lokien X Van Nunen, William F Fearon, Evald Høj Christiansen, Stephane Fournier, Liyew Desta, Andy Yong, Julien Adjedj, Javier Escaned, Masafumi Nakayama, Ashkan Eftekhari, Frederik M Zimmermann, Koshiro Sakai, Tatyana Storozhenko, Bruno R Da Costa, Gianluca Campo, Colin Berry, Damien Collison, Thomas Johnson, Tetsuya Amano, Divaka Perera, Allen Jeremias, Ziad Ali, Bernard De Bruyne, Frederic Bouisset, Takashi Kubo, Nobuhiro Tanaka, Kazuhiro Satomi, Nils P Johnson, Carlos Collet, Takuya Mizukami

Faculty, Staff and Student Publications

Background: Sex differences in coronary artery disease (CAD) have been increasingly recognized, as women present with distinct clinical characteristics and outcomes compared with men. This study investigated the impact of sex on pathophysiological CAD patterns (focal versus diffuse) in stable patients undergoing percutaneous coronary interventions (PCI).

Methods: We conducted a subanalysis of the PPG Global (Pullback Pressure Gradient Global Registry) study, a multicenter, prospective trial including 993 patients (236 [23.8%] women and 757 [76.2%] men) with hemodynamically significant CAD, defined as fractional flow reserve ≤0.80. The pullback pressure gradient metric categorized CAD patterns as focal or diffuse. Patient-reported outcomes were …

Prognosis And Treatment Response Stratification According To Loss Of Proofreading (Lop), Giulia Maddalena, Fadl A Zeineddine, Saikat Chowdhury, Mohammad A Zeineddine, Abdelrahman M Yousef, Francesca Bergamo, Sara Lonardi, Timothy A Yap, Michael Geoffrey White, Michael J Overman, Scott Kopetz, John Paul Shen

Faculty, Staff and Student Publications

Background: Only a subset of polymerase epsilon (POLE) mutations is associated with hypermutant phenotype; we hypothesized that only loss-of-proofreading (LOP) POLE mutations are associated with favorable immunotherapy response.

Methods: This retrospective cohort study included a pan-cancer cohort of 69,223 patients from cBioPortal and a cohort of patients with 41 POLE mutant metastatic colorectal (CRC) treated with immunotherapy at the MD Anderson Cancer Center between January 2017 and May 2023. We evaluated prognosis according to POLE mutation functionality.

Results: In the pan-cancer cBioPortal cohort (n=69,223) POLE was mutated in 2.8% (1,965) of tumors; of these, only 7.5% (n=148) had …

Effects Of Residual Pah Exposure From Firefighters’ Skin And Turnout Gear On Biospecimen Microrna Expression, Jooyeon Hwang, Jenny R Gipson, Chao Xu, Timothy Vanwagoner, Xin Xu, Robert J Agnew, Willard M Freeman

Faculty, Staff and Student Publications

Firefighters are routinely exposed to polycyclic aromatic hydrocarbons (PAHs) during fire suppression activities, molecular biomarkers reflecting such exposure remain underexplored. Thus, we explored an integrated exposure assessment framework linking PAH contamination on turnout gear and skin to changes in microRNA (miRNA) expression in skin and blood biospecimens. Our goals are to evaluate the relationship between fire-related PAH exposure and miRNA expression profiles in firefighters, and to identify candidate miRNA biomarkers of occupational exposure. This prospective study enrolled 25 firefighters. PAHs on turnout gear and skin were quantified post-fire using gas chromatography/mass spectrometry. Concurrently, skin tape strips and blood were collected …

Imaging Features Of High-Grade Astrocytoma With Piloid Features: A Single Center Case Series, Heba Al Qudah, Jackson D Hamilton, Maria A Gubbiotti, Ahmed Msherghi, Hamza A Salim, Sahar Alizada, Ho-Ling Liu, Vinodh A Kumar, Max Wintermark, Rami W Eldaya

Faculty, Staff and Student Publications

High-grade astrocytoma with piloid features (HGAP) is a recently described IDH-wildtype tumor with limited literature describing its imaging features. We present our institution's experience and the largest imaging-focused cohort of HGAP reported to date, offering a comprehensive analysis of MRI features of seventeen intracranial and one spinal HGAP, while introducing novel imaging features that have not been previously described. These include focal areas of diffusion restriction, surrounding spiculated, finger-like enhancement and increased perfusion metrics. Additionally, we highlight imaging features of HGAP arising in patients with Neurofibromatosis Type 1, such as intraventricular tumor spread, unusual temporal lobe location and multifocal presentation.

Late Morbidity And Mortality In Survivors Of Childhood Ependymoma: A Report From The Childhood Cancer Survivor Study (Ccss), Katharine R Lange, Peter De Blank, Mengqi Xing, Sedigheh Mirzaei, Deo Kumar Srivastava, Kevin Oeffinger, Joseph Neglia, Kevin Krull, Paul C Nathan, Rebecca Howell, Kirsten K Ness, Lucie M Turcotte, Wendy Leisenring, Gregory T Armstrong, Tara Brinkman, Daniel C Bowers, Mehmet Fatih Okcu

Faculty, Staff and Student Publications

Background/objectives: Treatment of childhood ependymoma evolved from 1970 to 1999 by reducing radiation volumes and incorporating chemotherapy. The impact of these changes on long-term health outcomes remains unknown. In this report, we evaluated temporal changes in all-cause and cause-specific late mortality, chronic health conditions (CHCs), and subsequent neoplasms (SNs) in the Childhood Cancer Survivor Study (CCSS) cohort of adult survivors of pediatric ependymoma, diagnosed between 1970 and 1999.

Methods: A total of 404 five-year survivors of ependymoma (47.5% female, 80.7% non-Hispanic White, median 6 (range 0-20) years at diagnosis, 22 (5-49) years from diagnosis) diagnosed between 1970 and 1999 and …

First-Line Met Tyrosine Kinase Inhibitors Versus Immunotherapy ± Chemotherapy For Patients With Met Exon 14 Skipping Mutant Metastatic Nsclc, Federica Pecci, Hui Li, Alessandro Di Federico, Jia Wu, Hong Chen, Eleonora Gariazzo, Francesco Mantuano, Edoardo Garbo, Mihaela Aldea, Valentina Santo, Don Gibbons, Hai Tran, Francesco Paoloni, Guilherme Rossato De Almeida, Giulio Metro, Andrea De Giglio, Francesco Gelsomino, Xinan Wang, Marcello Tiseo, Julia Rotow, Andrea Ardizzoni, J Jack Lee, Mark M Awad, Alfredo Addeo, Lingzhi Hong, Marcelo V Negrao, Pasi A Jänne, John V Heymach, Jianjun Zhang, Biagio Ricciuti, Xiuning Le

Faculty, Staff and Student Publications

Purpose: First-line treatment options for MET exon 14 skipping-mutant metastatic non-small cell lung cancer vary because of differences in drug approvals and clinical experience. This study investigates factors influencing outcomes with first-line MET tyrosine kinase inhibitors (TKI) versus immune checkpoint inhibitors (ICI) ± chemotherapy.

Experimental design: Clinicopathologic data were collected from patients with metastatic MET exon 14 skipping-mutant non-small cell lung cancer treated with first-line MET TKI or ICI ± chemotherapy at five centers. Primary endpoints were real-world progression-free survival (rwPFS) and overall survival (OS) to first-line MET TKI versus ICI ± chemotherapy. Subgroup analyses by clinical and tumor characteristics …

Efficacy Of Medical-Legal Partnerships To Address Health-Harming Legal Needs: A Systematic Review Of Experimental Studies In The Field, Jemima John, Thomas Murphy, Emily Zientek, Winston Liaw, Odinakachukwu Dimgba, Thien-An Nguyen, Catherine Burnett, Mary Aitken, Shreela Sharma

Faculty, Staff and Student Publications

Background: Despite the documented success of medical-legal partnerships (MLPs), there is a dearth of robust experimental-based research on their efficacy. This review synthesizes the findings of MLP interventions and identifies opportunities for MLP expansion in vulnerable communities.

Methods: Articles were eligible if they tested the experimental effects of an MLP intervention on health-harming legal needs (HHLNs) and had full text for review. Two reviewers independently screened articles for inclusion and assessed the quality (risk of bias) of each study.

Results: Seven studies were eligible. Populations were largely women, of color, and of lower socioeconomic status. All studies demonstrated positive effects …

Primary Intramedullary Spinal Melanocytomas: Case Report And Review Of Clinical Features, Diagnosis, And Management, Gil Kimchi, Samantha Varela, Juan Pablo Zuluaga-Garcia, Francisco Call-Orellana, Esteban Ramirez Ferrer, Romulo Augusto Andrade De Almeida, Maria A Gubbiotti, Isabella C Glitza, Andrew J Bishop, Jonathan D Grant, Robert Y North, Christopher A Alvarez-Breckenridge, Laurence D Rhines, Claudio E Tatsui

Faculty, Staff and Student Publications

Objective: Intramedullary melanocytomas are extremely rare spinal cord tumors with distinct histopathological and imaging characteristics. This report reviews the literature on this pathology and presents a representative case study, highlighting aspects of diagnosis and management.

Methods: A scoping review of PubMed, Web of Science, and Embase databases was conducted to identify reports on intramedullary melanocytomas, focusing on clinical presentation, imaging features, histopathology, treatment, and outcomes. Case reports and case series were included due to the rarity of these tumors.

Results: Twelve manuscripts met the inclusion criteria, including 15 patients. In the majority of patients, intramedullary melanocytomas present with progressive myelopathy …

Implementing Pst In Older Adults Facing Major Surgery: A Randomised Controlled Pilot Study, Victoria Tang, Lejla Pepic, Erika Higuchi, Christina Keny, Elizabeth Macias Lopez, Ezenwa C Onyema, Harleen Sandhu, Veronica Yank, Patrick J Raue

Faculty, Staff and Student Publications

Introduction: Depressive symptoms are common in the growing geriatric surgical population and are associated with important patient-centred surgical outcomes, including postoperative delirium, discharge to postacute care facility and decline in functional status. Few interventions have been developed to address depressive symptoms in the perioperative setting.

Methods and analysis: We designed a feasibility and acceptability study of a nine-session problem-solving therapy (PST) telehealth perioperative intervention aimed at reducing postoperative functional decline and depressive symptoms among at-risk older adults undergoing major surgical procedures. Acceptability will be evaluated using a patient-centred five-question survey, assessing participant satisfaction and perceived usefulness of the perioperative intervention. …

Hepatic Ischemia-Reperfusion Injury: Underlying Mechanisms And Concepts In Liver Surgery And Liver Transplantation, Jie Zhao, Lidan Hou, Kenneth J Dery, Xiaoyi Yuan, Kang Ho Kim, Jerzy W Kupiec-Weglinski, David R Hall, Caitlin J Thornley, Mark J Hobeika, Holger K Eltzschig, Cynthia Ju

Faculty, Staff and Student Publications

Hepatic ischemia-reperfusion injury (H-IRI) is a critical complication in liver surgery and liver transplantation, contributing to graft dysfunction and poor clinical outcomes. When hepatocyte protective mechanisms are insufficient to counteract energy depletion and oxidative stress during ischemia, cell death occurs. Tissue damage during H-IRI leads to the release of damage-associated molecular patterns (DAMPs), which recruit and activate immune cells such as neutrophils and monocytes, orchestrating the initiation, progression, and eventual resolution of sterile inflammation. Extended criteria donor (ECD) livers, particularly steatotic ones, are more vulnerable to H-IRI, leading to poorer outcomes and limiting expansion of the donor pool. However, the …

Genome-Wide Crispr Screens Identify Critical Targets To Enhance Car-Nk Cell Antitumor Potency, Alexander Biederstädt, Rafet Basar, Jeong-Min Park, Nadima Uprety, Rejeena Shrestha, Francia Reyes Silva, Merve Dede, John Watts, Sunil Acharya, Donghai Xiong, Bin Liu, May Daher, Hind Rafei, Pinaki Banerjee, Ping Li, Sanjida Islam, Huihui Fan, Mayra Shanley, Jingling Jin, Bijender Kumar, Vernikka Woods, Paul Lin, Silvia Tiberti, Ana Karen Nunez Cortes, Xin Ru Jiang, Inci Biederstädt, Patrick Zhang, Ye Li, Seema Rawal, Enli Liu, Luis Muniz-Feliciano, Gary M Deyter, Elizabeth J Shpall, Natalie Wall Fowlkes, Ken Chen, Katayoun Rezvani

Faculty, Staff and Student Publications

Adoptive cell therapy using engineered natural killer (NK) cells is a promising approach for cancer treatment, with targeted gene editing offering the potential to further enhance their therapeutic efficacy. However, the spectrum of actionable genetic targets to overcome tumor and microenvironment-mediated immunosuppression remains largely unexplored. We performed multiple genome-wide CRISPR screens in primary human NK cells and identified critical checkpoints regulating resistance to immunosuppressive pressures. Ablation of MED12, ARIH2, and CCNC significantly improved NK cell antitumor activity against multiple treatment-refractory human cancers in vitro and in vivo. CRISPR editing augmented both innate and CAR-mediated NK cell function, associated with enhanced …

Whole-Exome Sequencing-Based Linkage Analysis Of Multiple Myeloma (Mm) And Monoclonal Gammopathy Of Undetermined Significance (Mgus) Pedigrees, Alyssa I Clay-Gilmour, Nicola J Camp, Xiaomu Wei, Angel Earle, Aaron Norman, Jason Sinnwell, Delphine Demangel, Rosalie Griffin, Charles Dumontet, James Mckay, Ken Offit, Vijai Joseph, Siwei Chen, Daniel O'Brien, Vincent Rajkumar, Robert Klein, Shaji Kumar, Steve Lipkin, Celine M Vachon

Faculty, Staff and Student Publications

Background/objectives: Family history is a known risk factor for multiple myeloma (MM) and its precursor condition, monoclonal gammopathy of undetermined significance (MGUS). Previous genome-wide association studies (GWASs) have identified 35 common loci associated with MM risk and 21 associated with MGUS. The objective of this study was to identify less common and rare genetic loci predisposing to MM/MGUS through whole-exome sequencing (WES)-based linkage analysis.

Methods: Multipoint linkage analysis was conducted using the Multipoint Engine for Rapid Likelihood Inference (MERLIN) with the Lander-Green algorithm on germline WES data from 79 pedigrees with 2 or more affected relatives (120 MM, 86 MGUS, …

Peripheral Microvascular And Cerebral White Matter Dysfunction In Schizophrenia: Implications Of A Body-Brain Endothelial Pathophysiology, Eric L Goldwaser, Alexa Yuen, Wyatt Marshall, Bhim M Adhikari, Joshua Chiappelli, Andrew Van Der Vaart, Mark Kvarta, Yizhou Ma, Xiaoming Du, Si Gao, Heather Bruce, Patrick Donnelly, Braxton Mitchell, Charles Hong, Danny J J Wang, Peter Kochunov, L Elliot Hong

Faculty, Staff and Student Publications

Background and hypothesis: Schizophrenia spectrum disorder (SSD) is a chronic neuropsychiatric illness accompanied by significant brain structural and functional abnormalities and higher rate of cardio- and cerebrovascular comorbidities. We hypothesized that genetic and environmental risk factors that led to SSD act throughout the body and demonstrated the association between lower integrity of peripheral vascular endothelium and white matter (WM) microstructure.

Study design: Microvascular endothelial function was evaluated using brachial artery post-occlusive reactive hyperemia (PORH), in which endothelial responses are measured under reduced blood flow and after blood flow is restored. White matter microstructure was assessed by multi-shell diffusion tensor imaging …

Use And Reporting Of Intervention Mapping For Adaptation: A Systematic Review Protocol, Eunyoung Kang, Hugo R Sánchez-Blas, Elizabeth O Obekpa, Maria E Fernandez

Faculty, Staff and Student Publications

Introduction: Intervention adaptation is likely to occur to some extent when implementing interventions in new implementation contexts. Using systematic frameworks can guide intentional and effective adaptation processes. Intervention Mapping for Adaptation (IM-ADAPT) is a framework that offers step-by-step guidance for systematic, theory-based intervention adaptation. Despite the increasing use of IM-ADAPT, there is limited understanding of the contexts in which it has been applied and how effectively it is used and reported. Addressing this knowledge gap can improve current adaptation practices and inform future enhancements of the IM-ADAPT framework and the broader science of intervention adaptation. This review aims to (1) …

Mutational Landscape And Clinical Impact Of Spen Mutations In Patients With Chronic Lymphocytic Leukemia, Priyatharsini Nirmalanantham, Andrés E Quesada, Anindita Ghosh, Pei Lin, Chi Y Ok, Richard K Yang, Hong Fang, Sofia Garces, Rashmi Kanagal-Shamanna, Sanam Loghavi, Mark J Routbort, Cameron Cheng Yin, Wang Wei, Sarah Pasyar, Roland Bassett, Siba El Hussein, Nitin Jain, Jan Burger, William G Wierda, Sa Wang, Carlos Bueso-Ramos, Keyur P Patel, Leonard Jeffrey Medeiros, Fatima Zahra Jelloul

Faculty, Staff and Student Publications

Background/objectives: NOTCH1 is frequently mutated in chronic lymphocytic leukemia (CLL) and is a marker of poor prognosis. In addition to NOTCH1, mutations in the NOTCH1 regulatory pathway including SPEN have been described in a limited number of CLL cases and others have suggested that these mutations are also associated with adverse patient outcomes Methods: In this study, 1617 CLL cases were assessed using targeted sequencing and a 29-gene panel and the results were correlated with prognosis.

Results: SPEN mutations were detected in 48 (2.9%) CLL patients: 92.4% were deleterious (frameshift or truncating nonsense mutations) and the remaining (7.6%) were …

Advancing Delirium Detection Through The Open Health Natural Language Processing Consortium And The Evolve To Next-Gen Accrual To Clinical Trials Network, Sunyang Fu, Min Ji Kwak, Jaerong Ahn, Zhiyi Yue, Shreyas Ranganath, Joseph R Applegate, Andrew Wen, Liwei Wang, Chenyu Li, Michele Morris, Kelly M Toth, Timothy D Girard, John D Osborne, Richard E Kennedy, Nelly-Estefanie Garduno-Rapp, Phillip Reeder, Justin F Rousseau, Chao Yan, You Chen, Mayur B Patel, Tyler J Murphy, Bradley A Malin, Chan Mi Park, Heling Jia, Sandeep Pagali, Allyson K Palmer, Jennifer St Sauver, Sunghwan Sohn, Elmer V Bernstam, Shyam Visweswaran, Yanshan Wang, Hongfang Liu

Faculty, Staff and Student Publications

Background: Delirium is often underdiagnosed in clinical practice and is not routinely coded for billing. While manual chart review can identify delirium, it is labor-intensive and impractical for large-scale studies. Natural language processing (NLP) can analyze unstructured text in electronic health records (EHRs) to extract meaningful clinical information.

Methods: To support national integration of NLP for EHR-based delirium identification across different institutions, we launched the Delirium Interest Group within the national Evolve to Next-Gen Accrual to Clinical Trials (ENACT) NLP Working Group. This paper outlines our initial efforts to standardize, evaluate, and translate an NLP-based delirium detection model into the …

Distinct Tumor-Associated Macrophage Signatures Shape The Immune Microenvironment And Patient Prognosis In Renal Cell Carcinoma, Youngsoo Han, Aidan Shen, Cheng-Chi Chao, Lucas Yeung, Aliesha Garrett, Jianming Zeng, Satoru Kawakita, Jesse Wang, Zhaohui Wang, Alireza Hassani, Xiling Shen, Chongming Jiang

Faculty, Staff and Student Publications

Renal cell carcinoma (RCC) accounts for 90% of adult renal cancer cases and is characterized by significant heterogeneity within its tumor microenvironment. This study tests the hypothesis that tumor-associated macrophages (TAMs) influence RCC progression and patient response to treatment by investigating the prognostic implications of TAM signatures. Utilizing independent single-cell RNA sequencing data from RCC patients, we developed eight distinct TAM signatures reflective of TAM presence. A LASSO Cox regression model was constructed to predict survival outcomes, evaluated using the TCGA dataset, and validated across independent RCC cohorts. Model performance was assessed through Kaplan-Meier survival plots, receiver operating characteristic (ROC) …

Menin Inhibitor Ds-1594b Drives Differentiation And Induces Synergistic Lethality In Combination With Venetoclax In Acute Myeloid Leukemia Cells With Rearranged Mixed-Lineage Leukemia And Mutated Nucleophosmin-1, Valerio Ciaurro, Vassilena Sharlandjieva, Anna Skwarska, Catherine Chahrour, Natalia Baran, Zhihong Zeng, Cassandra Ramage, Naval Daver, Bing Z Carter, Sovira Chaundhry, Palaniraja Thandapani, Maria Paola Martelli, Thomas A Milne, Marina Konopleva

Faculty, Staff and Student Publications

Mixed-lineage leukemia (MLL) rearrangements and Nucleophosmin-1 (NPM1) mutations are associated with acute leukemias whose pathogenesis is critically influenced by protein-protein interactions between menin and MLL. We hypothesized that targeting the menin-MLL interaction using DS-1594b and blocking the antiapoptotic BCL-2 protein using venetoclax may promote differentiation and enhance eradication of MLL-rearranged and NPM1-mutated leukemias models. We treated acute myeloid leukemia (AML) cell lines with MLL rearrangements, NPM1 mutations, other leukemias and primary samples from AML patients with venetoclax alone, DS- 1594b alone, and their combination. We measured proliferation, viability, apoptosis, and differentiation using a variety of cellular assays, Western blotting, and …

Integrating Pathogenic Variants, Polygenic Risk Score, And Family History For Prostate Cancer Risk Estimation In Men Of African Ancestry, Fei Chen, Xin Sheng, Anqi Wang, Yili Xu, Raymond Hughley, Wei Xiong, Loreall Pooler, Peggy Wan, Susan M Gundell, Godfrey Kigozi, Gertrude Nakigozi, Fred Nalugoda, Joseph Kagaayi, Grace Nalwoga Kigozi, Stephen Mugamba, Emmanuel Kyasanku, James Nkale, Vitalis Ofumbi Olwa, Alexander Lubwama, Alex Daama, Resty Nakajugo, Ben Adusei, Mohamed Jalloh, Serigne Magueye Gueye, Andrew A Adjei, James Mensah, Pedro W Fernandez, Akindele Olupelumi Adebiyi, J Olufemi Ogunbiyi, Oseremen Inokhoife Aisuodionoe-Shadrach, Lindsay Petersen, Wenlong Carl Chen, Jo Mcbride, Jeannette T Bensen, James L Mohler, Jack A Taylor, Caroline Andrews, Mbaaga Kigongo, Amanya Colline, Vicky Kiddu, Juliet Namugambe, Shallot Owamaani, Kuteesa Job, Benon Joseph Masaba, Frank Asiimwe, Proscovia Muwanga, Joy Namulondo, Florence Nagawa, Charity Kayiraba, Martin Ogwang, Ronald Okidi, David Oweka, Elio Kitara, James Obonyo, Daniel Lajul, Paul Matovu, Precious Arinda Muheki, Johnson Natumanya, Emmanuel Agaba, Emmanuel Aculokin, Amos Twongyeirwe, George Mutema, Denis Bitamazire, Eboneé N Butler, Sue Ann Ingles, Benjamin A Rybicki, Janet L Stanford, Wei Zheng, Sonja I Berndt, Stephen J Chanock, Chad D Huff, Joseph Lachance, Luc Multigner, Burcu F Darst, Timothy R Rebbeck, Laurent Brureau, Stephen Watya, David V Conti, Christopher A Haiman

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVE: The impact of germline pathogenic variants (PVs) in cancer predisposition genes on risk of prostate cancer (PCa) remains understudied in large populations of African ancestry. This study aims to characterize the range of genetic risk of PCa and aggressive disease phenotypes in men of African ancestry.

METHODS: We analyzed 7176 PCa cases and 4873 controls from seven countries across North America and Africa to assess the association between PVs in 37 cancer predisposition genes and the risk of overall, aggressive, and metastatic PCa. Genes significantly associated with PCa risk were used to estimate lifetime absolute risk based …

Examining Longitudinal Associations Between Polysubstance Use And Firearm-Related Risk Behaviors From Adolescence Into Emerging Adulthood: A Group-Based Multi-Trajectory Modeling Approach, Mike Henson-Garcia, Sitara M Weerakoon, Melissa Peskin, Elizabeth Baumler, Alexander Testa, Lauren Malthaner, Yu Lu, Jeff R Temple

Faculty, Staff and Student Publications

Introduction: Firearm access and associated risk behaviors (i.e., firearm storage and carriage) are established factors that increase the risk of firearm-related injuries. While extant research has demonstrated associations between singular substance use and these risks, little is known regarding the impact of polysubstance use on these outcomes. The present study aims to investigate the relationships between polysubstance use in adolescence and four specific firearm-related risks manifesting in emerging adulthood.

Methods: Ten years of annual data from a cohort of 1,042 adolescents initially aged 13-18 years were analyzed to identify polysubstance use trajectories and their associations with firearm-related behaviors in emerging …

Situational Confidence And Recovery Capital Among Justice-Involved Adults Receiving Medications For Opioid Use Disorder In A Jail-Based Setting, Elizabeth O Obekpa, Xulei He, Alejandro Betancur, Kathryn R Gallardo, Serena A Rodriguez, Sheryl A Mccurdy, J Michael Wilkerson

Faculty, Staff and Student Publications

Background: Justice-involved individuals with opioid use disorder (OUD) face heightened relapse risks during the reentry period. While medications for opioid use disorder (MOUD) are effective, long-term recovery also depends on psychological and structural supports, including situational confidence (perceived ability to resist substance use in high-risk situations) and recovery capital (the internal and external resources that support recovery).

Methods: This cross-sectional study examined situational confidence and its association with recovery capital among 107 justice-involved adults receiving MOUD in an urban jail in Texas. Participants completed the Brief Situational Confidence Questionnaire (BSCQ) and the 10-item Brief Assessment of Recovery Capital (BARC-10). Mental …

Assessing The Impact Of A Semi-Structured Intraoperative Anaesthesia Handoff Cognitive Aid On Surgical Patient Outcomes: Study Protocol For A Cluster Randomised Trial, Aubrey Samost-Williams, Charles E Green, Lillian S Kao, Srikanth Sridhar, Daniel I Sessler, Alparslan Turan, Eric J Thomas

Faculty, Staff and Student Publications

Introduction: Intraoperative anaesthesia handoffs represent a risk point in the care of surgical patients. Although often necessary to prevent fatigue, improve vigilance and optimise operational efficiency, critical information can be lost, potentially leading to postoperative complications. Structured handoffs can increase the transfer of knowledge during intraoperative anaesthesia handoffs, improving their quality. We therefore propose to test the primary hypothesis that a semi-structured intraoperative anaesthesia handoff cognitive aid reduces the number of serious 30-day complications in surgical patients.

Methods and analysis: We will enrol adults having non-cardiac surgery who are scheduled to have an intraoperative anaesthesia handoff for operational reasons. We …

Large-Scale Profiling Of Antibody Reactivity To Glycolipids In Patients With Guillain-Barré Syndrome, Robin C M Thomma, Susan K Halstead, Laura C De Koning, Eveline J A Wiegers, Dawn S Gourlay, Anne P Tio-Gillen, Wouter Van Rijs, Henning Andersen, Giovanni Antonini, Samuel Arends, Shahram Attarian, Fabio A Barroso, Kathleen J Bateman, Luana Benedetti, Peter Van Den Bergh, Jan Bürmann, Mark Busby, Carlos Casasnovas, Efthimios Dardiotis, Amy Davidson, Thomas E Feasby, Janev Fehmi, Giuliana Galassi, Tania Garcia-Sobrino, Volkan Granit, Gerardo Gutiérrez-Gutiérrez, Robert D M Hadden, Thomas Harbo, Hans-Peter Hartung, Imran Hasan, James K L Holt, Zhahirul Islam, Summer Karafiath, Hans D Katzberg, Noah Kolb, Susumu Kusunoki, Satoshi Kuwabara, Motoi Kuwahara, Helmar C Lehmann, Sonja E Leonhard, Lorena Martín-Aguilar, Soledad Monges, Eduardo Nobile-Orazio, Julio Pardo, Yann Pereon, Luis Querol, Ricardo C Reisin, Simon Rinaldi, Paolo Ripellino, Rhys C Roberts, Olivier Scheidegger, Nortina Shahrizaila, Kazim A Sheikh, Nicholas J Silvestri, Soren H Sindrup, Beth Stein, Cheng Y Tan, Hatice Tankisi, Leo H Visser, Waqar Waheed, Ruth Huizinga, Bart C Jacobs, Hugh J Willison

Faculty, Staff and Student Publications

Guillain-Barré syndrome is an acute polyradiculoneuropathy in which preceding infections often elicit the production of antibodies that target peripheral nerve antigens, principally gangliosides. Anti-ganglioside antibodies are thought to play a key role in the clinical diversity of the disease and can be helpful in clinical practice. Extensive research into clinical associations of individual anti-ganglioside antibody specificities has been performed. Recent research has highlighted glycolipid complexes, glycolipid combinations that may alter antibody binding, as targets. In this study, we investigated antibody reactivity patterns to glycolipids and glycolipid complexes using combinatorial array, in relation to clinical features in Guillain-Barré syndrome. In total, …

Brain Morphology Mediators Of The Link Between Childhood Trauma And Bipolar Disorder: A Large-Scale International Analysis, Leonardo Tozzi, Maria R Dauvermann, Emma Corley, Andrea Fernandes, Melody J Y Kang, Yanghee Im, Leila Nabulsi, Roberto Goya-Maldonado, Klaus Berger, Marco Hermesdorf, Hilary P Blumberg, Lejla Colic, Tamsyn E Van Rheenen, Elysha Ringin, Susan L Rossell, James A Karantonis, Lisa S Furlong, Tilo Kircher, Frederike Stein, Udo Dannlowski, Dominik Grotegerd, Jair C Soares, Mon-Ju Wu, Giovana B Zunta-Soares, Benson Mwangi, Joaquim Radua, Enric Vilajosana, Eduard Vieta, Melissa J Green, Emilie Olie, Guillaume Clain, Francesco Benedetti, Elisa Melloni, Beatrice Bravi, Delfina Janiri, Daniela Vecchio, Fabrizio Piras, Nerisa Banaj, Gabriele Sani, Gloria Roberts, Janice M Fullerton, Bronwyn J Overs, Philip B Mitchell, Jonathan Savitz, Lakshmi N Yatham, Josselin Houenou, Marion Leboyer, Amanda Rodrigue, David C Glahn, Sophia I Thomopoulos, Neda Jahanshad, Paul M Thompson, Ole A Andreassen, Christopher R K Ching, Dara M Cannon, Yann Quidé, Enigma Bipolar Disorder Working Group

Faculty, Staff and Student Publications

Childhood trauma is a risk factor for bipolar disorder, but the biological mechanisms of this association remain incompletely defined. Gray matter differences observed after trauma exposure overlap with those reported in bipolar disorder, suggesting that the association between childhood trauma and bipolar disorder might be mediated through brain morphology.

Our goal was to determine whether cortical thickness, cortical surface or subcortical volume mediate the association between childhood trauma and bipolar disorder. We leveraged a large multi-site dataset from the ENIGMA Bipolar Disorder Working Group, comprising of 1,031 participants with bipolar disorder and 2,221 controls from 19 international cohorts. To identify …

Validation Of A Risk Score For Cancer-Associated Thrombosis Using Nationwide Ehr Data, Ang Li, Omid Jafari, Barbara D Lam, Jun Y Jiang, Rock Bum Kim, Shengling Ma, Emily Zhou, Joyce W Tiong, Elizabeth C Chiang, Justine Ryu, Christopher I Amos, Jennifer La, Nathanael R Fillmore

Faculty, Staff and Student Publications

Importance: Venous thromboembolism (VTE) is associated with increased mortality and morbidity in patients with cancer. Existing risk prediction models are typically validated within individual sites, a fragmented approach that limits clinical adoption.

Objective: To validate the electronic health record cancer-associated thrombosis (EHR-CAT) score compared with the benchmark Khorana score in a contemporary cohort of patients with cancer across the nation, before and after treatment, excluding those at high risk of bleeding.

Design, setting, and participants: This prognostic study included patients in a nationwide longitudinal EHR database from January 2018 to December 2023 with follow-up continuing to April 2025. Patients with …