Digital Commons Network^™

Identification Of Cadm1 As An Immunotherapeutic Target And Evaluation Of A Novel Cadm1-Targeting Antibody-Drug Conjugate In Preclinical Osteosarcoma Models, Yifei Wang, Zhongting Zhang, Caterina Longo, Wendong Zhang, Qi Wang, Amer Najjar, Xiangjun Tian, Rossana N Lazcano Segura, Michael E Roth, Jonathan Gill, Douglas J Harrison, Zhaohui Xu, Yanhua Yi, Xin Zhou, Sylvester Jusu, Timothy M Stearns, Steven B Neuhauser, Carol J Bult, Jing Wang, Alexander J Lazar, Richard Gorlick

Faculty, Staff and Student Publications

Due to the paucity of validated cell surface osteosarcoma-specific targets, patients with this condition have long been excluded from the benefits of antibody-drug conjugate (ADC) therapy observed in patients with several solid and hematologic malignancies. Our comprehensive surfaceome profiling approach previously identified osteosarcoma-specific cell-surface antigens that are highly expressed in osteosarcomas but minimally expressed in normal tissues. As a result, one such antigen, CADM1, was selected for the generation of an ADC. We tested a CADM1-targeting ADC with a tesirine payload (SG3249) in vitro in osteosarcoma, rhabdomyosarcoma, and neuroblastoma patient-derived xenograft cell lines. In vivo, we tested six CADM1-expressing osteosarcoma …

Fibrinogen-Associated Plasma Metabolites And Implications For Coagulation, Inflammation, And Vascular Diseases, Jayna C Nicholas, Taryn Alkis, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, Clary B Clish, Paul S De Vries, Yan Gao, Robert E Gerzsten, Xiuqing Guo, Andrew D Johnson, Martin G Larson, Rozenn N Lemaitre, Bruce M Psaty, Vasan Ramachandran, Alexander P Reiner, Stephen S Rich, Benjamin Rodriguez, Jian Rong, Jerome I Rotter, Jeanette Simino, Nicholas L Smith, James Wilson, Jie Yao, Alanna C Morrison, Bing Yu, Laura M Raffield

Faculty, Staff and Student Publications

Background: Fibrinogen is a critical coagulation factor that plays an essential role in thrombosis and is elevated in individuals with chronic inflammation. Here, we used fibrinogen as a representative quantitative measure of pro-coagulant risk and evaluated metabolites associated with fibrinogen levels through non-targeted plasma metabolomic profiling (Broad and Metabolon platforms).

Methods: Our analysis included 10,533 individuals across six U.S. based cohorts representing diverse population groups. The cross-sectional relationship between each of 789 tested metabolites and plasma fibrinogen concentration was assessed with adjustment for relevant covariates such as age, sex, body mass index, and circulating lipoprotein levels.

Results: Meta-analysis of per-cohort …

Comparison Of Surgery And Medicine On The Impact Of Diverticulitis (Cosmid) Trial: A Protocol For A Pragmatic Randomised Study Of Diverticulitis Treatment In The Usa, Mariam N Hantouli, Robert H Schmicker, Janice E Tufte, Fadwa G Ali, Robert D Bennett, Jessica N Cohan, Bryan A Comstock, Thomas Curran, Giana H Davidson, Samuel Eisenstein, Katherine N Fischkoff, Fergal J Fleming, Irena Gribovskaja-Rupp, Mehraneh Dorna Jafari, Larry G Kessler, Mukta K Krane, Sarah O Lawrence, James T Mccormick, Stefanos G Millas, Arden M Morris, Kelsey M Pullar, Caroline E Reinke, Julia T Saraidaridis, Vlad V Simianu, Suzanne P Watkins, Nicole B White, Elizabeth C Wick, Nicole Wieghard, David R Flum, Thomas E Read

Faculty, Staff and Student Publications

Introduction: Each year, millions of people experience recurrent diverticulitis episodes. Elective sigmoid colon resection reduces the risk of recurrence, but The American Society of Colon and Rectal Surgeons recommends individualising surgical decisions based on the impact of the condition on a patient's quality of life (QoL). However, no threshold for QoL impairment has been established to guide decision-making, and evidence comparing elective colectomy with medical management in terms of QoL limitation is limited. To address these gaps and to guide treatment decision-making, we designed the Comparison of Surgery and Medicine on the Impact of Diverticulitis (COSMID) trial.The COSMID trial is …

Multi-Institutional Normal Tissue Complication Probability (Ntcp) Prediction Model For Mandibular Osteoradionecrosis: Results From The Predmorn Study, Laia Humbert-Vidan, Christian R Hansen, Steven Petit, Carles Muñoz-Montplet, Katrina Hueniken, Abdallah S R Mohamed, Deborah P Saunders, Vinod Patel, Gerda M Verduijn, Wilma D Heemsbergen, Arjen Van Der Schaaf, Max Witjes, Suzanne P M De Vette, Mohammad Moharrami, Abdul A Khan, Jordi Marruecos Querol, Irene Oliveras Cancio, Mike Oliver, Peter Reich, Stacey A Santi, Andrew G Pearce, Stephen Y Lai, Andrew P King, Ali Hosni, Andrew J Hope, Erin E Watson, Johannes A Langendijk, Jørgen Johansen, Amy C Moreno, Clifton D Fuller, Lisanne V Van Dijk, Teresa Guerrero Urbano

Faculty, Staff and Student Publications

Purpose: Mandibular osteoradionecrosis (ORN) is a severe late complication affecting patients with head and neck cancer (HNC) treated with radiation therapy (RT) that significantly impacts patients' quality of life and can require costly interventions. Although radiation dose is a key factor, other clinical and demographic risk factors also influence ORN development. Previous predictive models have primarily been single-institutional, limiting their generalizability. In this first analysis from the PREDMORN Consortium, we have aimed to reproduce existing statistical association and modeling analyses on the largest and most diverse mandibular ORN cohort worldwide to allow comparison with previous studies.

Methods and materials: This …

Characterization Of Inflammatory Pseudotumors In A Large Animal Model Of Liver Cancer, Erik N K Cressman, Samantha Hicks, Natalie W Fowlkes, Danielle L Stolley, Maria Sophia Stenkamp

Faculty, Staff and Student Publications

Background: The development of relevant and robust large animal models of hepatocellular carcinoma is needed to test new therapeutic strategies for this disease. Transgenic approaches hold promise in addressing this complex problem. One such model, the Oncopig, has been reported to develop tumors of up to 4 cm in diameter within 7-14 days at sites of in situ vector inoculation. However, the resulting lesions reportedly contained an extensive inflammatory component that has not been evaluated in detail.

Methods: Herein, we describe our results from multiparametric characterization of the lesions generated using liver biopsy cores incubated in vector solution and replaced …

Modality-Agnostic, Patient-Specific Digital Twins Modeling Temporally Varying Digestive Motion, Jorge Tapias Gomez, Nishant Nadkarni, Lando S Bosma, Jue Jiang, Ergys D Subashi, William P Segars, James M Balter, Mert R Sabuncu, Neelam Tyagi, Harini Veeraraghavan

Faculty, Staff and Student Publications

No abstract provided.

Twin And Cotwin Predictors Of Fetal Demise After Laser Photocoagulation Therapy In Advanced Stage Twin-Twin Transfusion Syndrome: A Fetal Heart Society Research Collaborative Study, Shiraz A Maskatia, Fu-Sheng Chou, Betul Yilmaz, Lisa Howley, Vidhya Annavajjhala, Lindsay Freud, Allison Divanovic, Laxmi Ghimire, Anita J Moon-Grady

Faculty, Staff and Student Publications

Background: Current models to predict outcomes in advanced twin-twin transfusion syndrome are limited. We hypothesized that twin and cotwin echocardiographic factors would improve model performance for donor and recipient demise following laser photocoagulation therapy.

Methods: We performed a multicenter retrospective cohort study of stage 3 to 4 twin-twin transfusion syndrome referred for laser photocoagulation therapy. Fetal echocardiograms were analyzed at a core laboratory. We used multivariable logistic regression models to select variables used for generalized linear mixed-effects modeling. Separate models were developed for donor and recipient demise, using both twin and cotwin variables. Models were assessed by area under the …

Celltra: Aligning Cell Names With Gene Expression Via A Pathway-Informed Transformer, Zhao Li, Zaiyi Zheng, Rongbin Li, Wenbo Chen, Yuntao Yang, Meer A Ali, Jundong Li, W Jim Zheng

Faculty, Staff and Student Publications

Motivation: Single-cell RNA sequencing (scRNA-Seq) technology enables detailed exploration of gene expression at the individual cell level, crucial for annotating cell types and understanding cellular diversity. Traditional methods for cell type annotation often rely on marker genes and manual labeling, posing challenges due to low data quality and incomplete reference datasets.

Results: We developed CeLLTra, a novel contrastive learning framework that leverages a Transformer-based model integrating biological pathway information to group genes into super tokens, effectively capturing comprehensive gene expression from scRNA-Seq data. By combining this pathway-informed Transformer with a pretrained domain-specific language model, CeLLTra accurately aligns cell-type annotations with …

Nf2 Loss Malignantly Transforms Human Pancreatic Acinar Cells And Enhances Cell Fitness Under Environmental Stress, Yi Xu, Michael H Nipper, Angel A Dominguez, Chenhui He, Francis E Sharkey, Sajid Khan, Han Xu, Daohong Zhou, Lei Zheng, Yu Luan, Jun Liu, Pei Wang

Faculty, Staff and Student Publications

Pancreatic ductal adenocarcinoma (PDAC) occurs as a complex, multifaceted event driven by the interplay of tumor-permissive genetic mutations, the nature of the cellular origin, and microenvironmental stress. In this study, using primary human pancreatic acinar 3D organoids, we performed a CRISPR-KO screen targeting 199 potential tumor suppressors curated from clinical PDAC samples. Our data revealed significant enrichment of a list of candidate genes, with neurofibromatosis type 2 associated gene (NF2) emerging as the top target. Functional validation confirmed that loss of NF2 promoted the transition of PDAC to an invasive state, potentially through extracellular matrix modulation. NF2 inactivation …

Peroxisomal Integrity In Demyelination-Associated Microglia Enables Cellular Debris Clearance And Myelin Renewal In Mice, Joseph A Barnes-Vélez, Xiaohong Zhang, Yaren L Peña Señeriz, Kiersten A Scott, Yinglu Guan, Jian Hu

Faculty, Staff and Student Publications

Demyelination associated microglia (DMAM) orchestrate the regenerative response to demyelination by clearing myelin debris and promoting oligodendrocyte maturation. Peroxisomal metabolism has emerged as a candidate regulator of DMAMs, though the cell-intrinsic contribution in microglia remains undefined. Here we elucidate the role of peroxisome integrity in DMAMs, using cuprizone-mediated demyelination coupled with conditional KO of peroxisome biogenesis factor 5 (PEX5) in microglia. Absent demyelination, PEX5 conditional KO (PEX5cKO) had minimal impact on homeostatic microglia. However, during cuprizone-induced demyelination, the emergence of DMAMs unmasked a critical requirement for peroxisome integrity. At peak demyelination, PEX5cKO DMAMs exhibited increased lipid droplet burden and reduced …

Cholesterol Efflux Protein, Abca1, Supports Anticancer Functions Of Myeloid Immune Cells, Shruti V Bendre, Yu Wang, Basel Hajyousif, Rajendra K C, Shounak G Bhogale, Dhanya Pradeep, Natalia Krawczynska, Claire P Schane, Erin Weisser, Avni Singh, Simon Han, Hannah Kim, Lara Kockaya, Anasuya Das Gupta, Adam T Nelczyk, Hashni Epa Vidana Gamage, Yifan Fei, Desirée Rodríguez-Casiano, Xingyu Guo, Haoyun Li, Ryan J Deaton, Fei Mo, Maria Sverdlov, Peter H Gann, Saurabh Sinha, Sahil Sahni, Kun Wang, Kevin Van Bortle, Emad Tajkorshid, Wendy A Woodward, Wonhwa Cho, Erik R Nelson

Faculty, Staff and Student Publications

Breast and other solid tumors respond poorly to immune therapy. Myeloid cells (MCs) such as macrophages contribute to resistance. Established clinical evidence links cholesterol to cancer outcomes, with MC function being regulated by cholesterol metabolism. We screened MC-expressed regulators of cholesterol homeostasis linked to survival and identified the cholesterol efflux protein ABCA1. ABCA1 activity increases anticancer functions of macrophages: enhancing tumor infiltration, decreasing angiogenic potential, reducing efferocytosis, and improving support of CD8+ T cell activity. Mechanistically, different AKT isoforms are involved, through both PI3K-dependent and PI3K-independent mechanisms. Highlighting the clinical relevance of our findings are correlations between ABCA1 in macrophages …

Circadian-Shaped Immune Variability Predicts Infection Outcome, Jonathan Lalsiamthara, Mariko Locke, Alejandro Aballay

Faculty, Staff and Student Publications

Disease risk and severity are influenced by genetics, epigenetics, and environmental factors. However, immune responses vary even among genetically similar or related individuals, shaped by inherited and noninherited factors. Using Caenorhabditis elegans, we found that pathogen susceptibility can be predicted by preinfection biomarkers. Individuals with high-basal expression of irg-5, an infection response gene regulated by the p38 mitogen-activated protein kinase-1 (PMK-1) pathway, were more susceptible to Pseudomonas aeruginosa infection. A genome-wide screen identified the myeloid ecotropic viral integration site-1 (MEIS) homeobox protein UNC-62 as a regulator of irg-5 expression, acting through PMK-1 and GATA binding erythroid-like transcription factor …

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 …

Intra-Coronary Imaging And Transcriptomics Of Calcified Nodules Before And After Intensive Lipid-Lowering Therapy: A Yellow Iii Substudy, Pruthvi C Revaiah, Yuliya Vengrenyuk, Jiajia Liu, Keisuke Yasumura, Vemuri Krishna Santosh, Monika Karki, Ishani Bansal, Amit Hooda, Joseph K Sweeny, Sahil Khera, Vishal Kapur, Prakash Krishnan, Pedro R Moreno, Roxana Mehran, Xiaobo Zhou, Jagat Narula, Samin K Sharma, Annapoorna S Kini

Faculty, Staff and Student Publications

Aims: Calcified nodules (CNs) contribute to 3-5% of acute coronary syndromes (ACS). Identifying peri-calcific lipid-rich areas is challenging with conventional imaging but feasible using near-infrared spectroscopy (NIRS). This YELLOW III substudy investigated the impact of maximal lipid-lowering on CN morphology and lipid content over 26 weeks.

Methods and results: Patients with stable CAD and lipid-rich, non-obstructive plaques (lipid arc >90°, FCT < 120 µm on OCT) received Evolocumab (140 mg biweekly) plus maximally tolerated statins. Lesions were evaluated at baseline and 26 weeks using combined NIRS-IVUS and OCT. Exploratory endpoints were the maximum 4 mm lipid core burden index (LCBI) in segments containing CNs (maxLCBI4mm-CN) and morphological changes in CN. Linear mixed-effects models were used to evaluate temporal changes and group interactions. Peripheral blood mononuclear cell (PBMC) transcriptomics were analysed. Among 110 patients, 43 (39.1%) had CNs. A total of 73 paired CNs were analysed for morphology, of which 65 CNs were ≥4 mm. CNs with lipid signal (CNLS) demonstrated a significant reduction in maxLCBI4mm-CN from 176.8 to 113.3 (β = -63.51 ± 17.63; P < 0.001), whereas no change was observed in dense CNs (P = 0.317). Morphological parameters remained largely unchanged in both groups. A modest increase in the surrounding calcium arc was observed in CNLS (P = 0.018), while depth showed a differential change …

A Hybrid Vit-L/32-Maxvit-L Architecture With Adaptive Gated Fusion For Multiclass Gastrointestinal Disease Detection And Multi-Method Post-Hoc Explainability, Shahid Mohammad Ganie, Pijush Kanti Dutta Pramanik, Zhongming Zhao

Faculty, Staff and Student Publications

Introduction: Accurate detection of gastrointestinal diseases from endoscopic images remains challenging due to substantial inter-class similarity, intra-class variability, and heterogeneous lesion presentation. While convolutional neural networks (CNNs) effectively capture fine mucosal textures, their limited receptive field restricts global contextual reasoning. Conversely, transformer architectures model long-range dependencies but may underrepresent localized structural detail.

Methods: This study proposes a dual-branch hybrid transformer framework that integrates global token-level reasoning from ViT-L/32 with hierarchical spatial modeling from MaxViT-L. An adaptive gated fusion mechanism is introduced to dynamically regulate the relative contribution of local and global representations on a per-sample basis, enabling content-aware cross-scale integration. …

Global-Local Feature Fusion: A Robust Hybrid Deep Learning Model For Multiclass Brain Tumor Classification With Grad-Cam++ Interpretation, Kirti Pant, Pijush Kanti Dutta Pramanik, Shahid Mohammad Ganie, Anindita Saha, Zhongming Zhao

Faculty, Staff and Student Publications

Background: Accurate classification of brain tumors in MRI scans is critical for effective clinical decision making, yet manual assessment is labor-intensive and subject to variability. Although deep learning models, particularly CNNs and Transformers, have shown potential, each architecture alone has limitations: CNNs excel at local feature extraction but lack global context awareness, while Transformers capture global relationships but may overlook fine-grained details.

Objectives: To develop a hybrid Transfer Learning-Transformer model that integrates CNN-driven local feature modeling with Transformer-based global reasoning to enhance multi-class brain tumor classification.

Methods: The proposed workflow comprises three stages: (1) benchmarking standalone CNN (ResNet50, VGG19, ConvNeXtBase, …

Examining Motivators And Barriers To Meditation Practice Among Individuals With Spinal Cord Injury: Insights From A Survey Study, Radha Korupolu, Chelsea G Ratcliff, Ariana Andampour, Susan Robinson-Whelen, Shrasti Lohiya, Audrey S Cohen, Christine Bakos-Block, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Context: Meditation and mindfulness practices offer promising non-pharmacological alternatives for individuals with spinal cord injury (SCI) to improve their health and well-being, but integrating such practices into daily routines can be challenging.

Objectives: This survey study aims to identify motivators and barriers to engagement with meditation and mindfulness interventions among individuals with SCI.

Methods: A cross-sectional survey was conducted among adults with SCI (N = 94) from a single large acute rehabilitation center in the United States.

Results: Results from the survey showed a strong interest in meditation among individuals with SCI, with nearly half reporting current engagement in meditation …

Ai Privacy And Security In Healthcare: A Systematic Literature Review, Diane Dolezel, Karima Lalani, Valerie Watzlaf, Kerryn Butler-Henderson, Elise V Z Lambert, Mary Morton, Jamie Sand, David Gibbs, Susan Fenton

Faculty, Staff and Student Publications

Background: Artificial intelligence is expanding into telemedicine and telerehabilitation, yet significant privacy and security concerns persist.

Scope: To synthesize empirical evidence on privacy and security approaches in health care, particularly those relevant to distributed home care.

Methodology: A systematic review identified 80 studies (2019 to 2025), and Latent Dirichlet Allocation (LDA) topic modeling characterized the privacy and security themes.

Results: Sixty-six studies addressed privacy, only seventeen addressed security, and three studies addressed both. LDA identified four themes: patient data privacy, federated learning for medical imaging, encrypted training and secure computation, and healthcare data governance. Most studies emphasized privacy-preserving approaches, like …

Assessing The Impact Of The 2021 Vwd Guidelines On The Diagnosis/Management Of Low Vwf Patients, Michael Dong, Joanna Larson, Sepideh Saroukhani, Miguel Escobar, Lakshmi Srivaths

Faculty, Staff and Student Publications

Introduction: The 2021 ASH/ISTH/NHF/WFH VWD diagnosis guidelines recommend Type 1 VWD diagnoses for patients with (a) VWF < 0.30 IU/mL or (b) 'Low VWF' 0.30-0.50 IU/mL with the presence of abnormal bleeding. This recommendation recategorizes 'Low VWF' patients with abnormal bleeding into Type 1 VWD.

Aim: To assess the impact of the 2021 VWD guidelines on the diagnosis and management of 'Low VWF' patients.

Methods: A single centre retrospective study was conducted to review all patients presenting for VWD evaluation between January 2000 to September 2024, analyzing for clinical features, ISTH-BAT scores, VWF/FVIII levels, and management of bleeding. 149 patients, totalling 305 clinical encounters, were included in the study.

Results: Seventy five percent of patient encounters had a change in diagnosis from 'Low VWF' to Type 1 VWD …

Evaluation Of Interventions For Cognitive Symptoms In Long Covid: A Randomized Clinical Trial, David S Knopman, Deborah Koltai, Daniel T Laskowitz, Jacqueline Becker, Leigh Charvet, Juan Wisnivesky, Alex Federman, Adam Silverstein, Yuliya Lokhnygina, Giuseppina Pilloni, Michelle Haddad, Henry Mahncke, Tom Van Vleet, Rong Huang, Wendy Cox, Diana Terry, Jeannie Karwowski, Netia Mccray, Jenny J Lin, Grace A Mccomsey, Upinder Singh, Linda N Geng, Helen Y Chu, Rebecca Reece, James Moy, Zoe Arvanitakis, Sairam Parthasarathy, Thomas F Patterson, Aditi Gupta, Luis Ostrosky-Zeichner, Jeffrey Parsonnet, Elaine T Kiriakopoulos, Tamara G Fong, Janet Mullington, Sarah Jolley, Nirav S Shah, Sarah Shizuko Morimoto, Joyce K Lee-Iannotti, William D S Killgore, Brigid Dwyer, William Stringer, Carmen Isache, Jennifer A Frontera, Jerry A Krishnan, Ashley O'Steen, Melissa James, Barrie L Harper, Kanecia O Zimmerman

Faculty, Staff and Student Publications

Importance: Treatment for cognitive dysfunction due to postacute sequelae of long COVID (ie, symptoms of fatigue, malaise, weakness, confusion that persist beyond 12 weeks after an initial COVID infection) remains a significant unmet need.

Objective: To test evidence-based rehabilitation strategies for improving cognitive symptoms in persons with long COVID.

Design, setting, and participants: This was a 5-arm, multicenter, randomized clinical trial of 3 remotely delivered interventions conducted between August 17, 2023, and June 10, 2024. The study took place at 22 trial sites and included the screening of individuals with cognitive long COVID.

Interventions: Participants were randomized to 1 of …

Utilizing A Suction Catheter As A Makeshift Tracheostomy Tube In A Premature Infant: A Case Report., Ashwini V Bandi, Shaina W Gong, Gabriela G Cruz, Alicia S Lore, Kunal Shetty, Sancak Yuksel

Faculty, Staff and Student Publications

One of the most challenging aspects regarding pediatric tracheostomy tube placement is the size selection, particularly in preterm infants. We present the first reported case of a makeshift tracheostomy tube using a 6-French suction catheter in a 31-week-old premature infant in an emergent situation. This approach holds promise as a potentially life-saving intervention for extremely small preterm infants. Furthermore, this case emphasizes the size discrepancy between the premature neonatal airway and the smallest tracheostomy tubes available. Further research is warranted to allow for more diverse clinical solutions that can accommodate similar cases in acute settings.

Ventilation-Perfusion Scan: A Functional Imaging Approach To Regional Lung Disease In Primary Ciliary Dyskinesia, Gabriel Román-Ríos, Gabriel Rosario-Ortiz, Marcos J Ramos-Benitez, Ricardo A Mosquera, Wilfredo De Jesús-Rojas

Faculty, Staff and Student Publications

Introduction: As a rare genetic disorder defined by defective ciliary motility, Primary Ciliary Dyskinesia (PCD) leads to chronic respiratory complications. A founder variant in the RSPH4A [c.921+3_921+6delAAGT] gene, common in Puerto Rico, impairs ciliary function and contributes to progressive lung disease. Today, the clinical value of ventilation/perfusion (V/Q) scans in PCD has not been thoroughly investigated as well as pulmonary function tests (PFTs) and chest imaging. To explore the role and clinical utility of V/Q scans in PCD.

Methods: Retrospective evaluation of pulmonary function tests, chest imaging, and Tc-99m DTPA ventilation and Tc-99m MAA perfusion scans in ten patients with …

Racial And Ethnic Disparities In Clinical Characteristics And Outcomes In Adults With Encephalitis: A Retrospective Study, Sienna Wu, Rodrigo Hasbun, Ralph Habis, Jordan Benderoth, Ivany Patel, Ashutosh Gupta, Megan Goyal, Arun Venkatesan, John C Probasco, Paris Bean, Ashley Heck, Laya Rao, Rajesh K Gupta

Faculty, Staff and Student Publications

Background and objectives: This study aims to assess whether adult patients with encephalitis from different racial and ethnic backgrounds exhibit significant differences in clinical presentation, diagnostic findings, and outcomes.

Design and methods: A retrospective cohort study was conducted by utilizing the electronic health records of encephalitis patients in the greater Houston and Baltimore areas. Patients were categorized by race/ethnicity into White or ethnic minority (including Black, Hispanic, and Asian patients). Data was analyzed for the presence of significant differences in clinical characteristics between the two groups.

Results: Among 599 patients, 312 (52.1%) were White and 287 (47.9%) were of an …

Geospatial Disparities In Adolescent Mental Health Resources: School- And Community-Level Evidence From Travis County, Texas, Sharon V Munroe, Jingjing Gao, Gayla Ferguson, Muinat Abolore Idris, Eric C Jones

Faculty, Staff and Student Publications

Background: Adolescents in the United States face growing mental health challenges, with nearly one in three high school students reporting poor mental health in the past 30 days. Schools increasingly serve as key access points for mental health care. However, geographic disparities in access to school-based mental health services remain underexplored.

Purpose: This study examines the spatial distribution of adolescent mental health resources in Travis County, Texas, and evaluates how school- and community-level factors are associated with the presence of on-site school social workers.

Methods: School locations, enrollment data, and the presence of on-site social workers were mapped and analyzed …

Understanding Ehlers-Danlos Syndrome: A Claims-Based Analysis Of Healthcare Cost Patterns, Samson A Oyediran, Youngran Kim, Zhanna Novikov, Trudy M Krause

Faculty, Staff and Student Publications

Background: Ehlers-Danlos Syndrome (EDS) is a rare connective tissue disorder associated with substantial clinical complexity and healthcare utilization. Despite increasing recognition of EDS, little is known about its economic burden in the United States.

Objective: To assess the all-cause healthcare costs for individuals with newly diagnosed EDS during the pre-diagnosis year and the first 2 years post-diagnosis.

Methods: A retrospective cohort study was conducted using the Merative™ MarketScan® Commercial Claims and Encounters Database (2016-2022). Newly diagnosed patients were identified using ICD-10-CM codes, with the first observed diagnosis defined as the index date. Continuous enrollment for 12 months pre-index and 24 …

Latent Classification Of Time-Dependent Transition Rates In Longitudinal Binary Outcome Data, Joonha Chang, Wenyaw Chan

Faculty, Staff and Student Publications

Continuous-time Markov chain (CTMC) models and latent classification methods are commonly used to analyze longitudinal categorical outcomes in medical research. While CTMC models are popular for their simplicity and effectiveness, their assumption of constant transition rates presents limitations in capturing dynamic behaviors. To address this, non-homogeneous continuous-time Markov chains (NH-CTMCs) have been developed, incorporating time-varying transition rates to enhance model flexibility. In this study, we leverage closed-form transition probabilities for a fully ergodic two-state NH-CTMC model and propose a latent class clustering approach to identify heterogeneous transition rate patterns within the population. We emphasize the potential advantages of these models …

“If He Did It, I Can Do It, Too. I Can Change My Life Around”: The Social Model Of Recovery Within The Context Of Recovery Homes Accepting Residents Prescribed Medications For Opioid Use Disorder, Jodie M Dewey, Kathryn R Gallardo, Meenakshi S Subbaraman, Amy A Mericle

Faculty, Staff and Student Publications

Introduction: This paper provides an in-depth examination of examines four recovery residences, that serve individuals prescribed medications for opioid use disorder (MOUD). The study has two primary aims: first, to deepen understanding of how recovery residences adopt and operationalize Social Model of Recovery principles; and second, to identify gaps in staff integration of residents receiving MOUD-gaps that may either support or undermine the integrity of the social model within these settings.

Methods: We conducted semi-structured interviews with 17 residents receiving MOUD living in four participating recovery homes. The interviews were conducted between August 2022 and January 2024 using a semi-structured …

Corrigendum To 'Continuous Vital Sign Monitoring On Surgical Wards: The Cosmos Pilot, Nikola Anusic, Alper Gulluoglu, Elyad Ekrami, Edward J Mascha, Shuyi Li, René Coffeng, Alparslan Turan, Amber Clemens, Christine Perez, John W Beard, Daniel I Sessler, Cosmos Pilot Investigators

Faculty, Staff and Student Publications

Study objectives: Alerts for vital sign abnormalities seek to identify meaningful patient instability while limiting alarm fatigue. Optimal vital sign alarm settings for postoperative patients remain unknown, as is whether alerts lead to effective clinical responses reducing vital sign disturbances. We conducted a 2-phase pilot study to identify thresholds and delays and test the hypothesis that alerts from continuous monitoring reduce the duration of vital sign abnormalities.

Design: Two-phase pilot.

Patients: 250 adults having major non-cardiac surgery.

Setting: Surgical wards.

Intervention: All patients had routine vital sign monitoring by nurses at 4-h intervals. We initially continuously recorded clinician-blinded saturation, heart …

Pregnancy And Breastfeeding Are Associated With Less Later-Life Cognitive Decline In A Longitudinal, Prospective Cohort, Molly M Fox, Jennifer E Bramen, Dayoon Kwon, Mark A Espeland, Yijia Sun, Li Zhang, Aladdin H Shadyab, Ramon Casanova, Joann E Manson, Marcus Y Chang, Verna R Porter, Leslie V Farland, Qian Xiao, Robert A Wild, Prabha Siddarth, Carolyn J Crandall

Faculty, Staff and Student Publications

Introduction: The brains of female mammals evolved to undergo structural and functional changes during pregnancy and lactation, equipping them for motherhood. However, long-term cognitive health implications of these adaptations in women are poorly understood.

Methods: In the Women's Health Initiative (WHI) Memory Study (WHIMS; n = 7427) and WHI Study of Cognitive Aging (WHISCA; n = 2304), postmenopausal women completed reproductive history interviews, annual global cognitive assessment from mean age 70 for up to 13 years, and multi-domain cognitive testing for up to 8 years.

Results: Each additional month pregnant was associated with higher scores of global cognition. Each additional …

Plasma Proteomic Profile Of Dietary Potassium And Incident Ckd, Jiaqi Yang, Lauren Bernard, Jingsha Chen, Valerie K Sullivan, Bing Yu, Eugene P Rhee, Paul A Welling, Casey M Rebholz

Faculty, Staff and Student Publications

Background:: There is a need for objective biomarkers of dietary potassium. The mechanisms through which dietary potassium influences kidney health are incompletely understood.

Methods:: Atherosclerosis Risk in Communities study participants at visit 3 (1993–1995) with dietary and proteomics data were randomly divided into discovery (N=6,814) and replication (N=3,380) sets. We examined associations between dietary potassium and 4,955 aptamers using multivariable linear regression, adjusting for sociodemographic factors, health behaviors, and estimated glomerular filtration rate, with a false discovery rate of 0.05. Then, we tested the prospective associations between potassium-related proteins and incident chronic kidney disease (CKD).

Results:: …