Digital Commons Network^™

Predicting Clinically Significant Prostate Cancer With Or Without Digital Rectal Exam And Mri Data Using Claritydx Prostate Models, Robert J Paproski, Adam Kinnaird, M Eric Hyndman, Adrian Fairey, Leonard Marks, Christian P Pavlovich, Sean A Fletcher, Roman Zachoval, Vanda Adamcova, Jiri Stejskal, Armen Aprikian, Christopher J D Wallis, Desmond Pink, Catalina Vasquez, Perrin H Beatty, John D Lewis

Faculty, Staff and Student Publications

This prognostic study created optimized ensembles of calibrated random forest models to predict clinically significant prostate cancer (csPCa, grade group ≥2 PCa) using total prostate-specific antigen (PSA), free PSA, negative biopsy status, and age, with or without DRE and MRI data. Observational data were aggregated from cohorts in six organizations in Canada, the USA, and Czechia. Prostate biopsies were performed between 2009 and 2024. Risk models (ClarityDX Prostate + DRE, ClarityDX Prostate + MRI, and ClarityDX Prostate + MRI + DRE) were derived (training cohorts n = 1626 to 2191) and validated (validation cohorts n = 378 to 1318) from …

Prmt5 Inhibition Impairs Fanconi Anemia Pathway-Mediated Homologous Recombination And Enhances The Antitumor Efficacy Of Temozolomide In Glioblastoma, Shumpei Onishi, Sridharan Jayamohan, Ashis Chowdhury, Sarah Rivas, Yoshihiro Otani, Celine Ertekin, Jean-Paul Bryant, Sara A Murphy, Kimberly A Rivera-Caraballo, Stuart Walbridge, Bayu Sisay, Dragan Maric, Abdel Elkahloun, Kory Johnson, Desmond A Brown, John D Heiss, Ashish H Shah, Tae Jin Lee, Sangamesh G Kumbar, Ji Young Yoo, Andrew J Brenner, Balveen Kaur, Gangadhara R Sareddy, Yeshavanth Kumar Banasavadi-Siddegowda

Faculty, Staff and Student Publications

Despite multimodal therapy of surgical resection, radiation, and chemotherapy, glioblastoma patients show a dismal prognosis. Protein Arginine Methyltransferase 5 (PRMT5) is overexpressed in glioblastoma, and its inhibition imparts an anti-tumor effect. Tumor cells invariably develop resistance to Temozolomide (TMZ), the standard chemotherapeutic agent for glioblastoma. However, the mechanistic role of PRMT5 in treatment-resistant glioblastoma is unknown. Patient-derived glioma stem-like cells (GSCs), treated with PRMT5 inhibitor (LLY-283) or transfected with PRMT5-target-specific siRNA, were treated with TMZ and subjected to in vitro functional and mechanistic studies. The intracranial mouse xenograft model was used to test the in vivo antitumor efficacy of combination …

A Machine-Learning-Based Tool For Stroke Risk Prediction In Blunt Cerebrovascular Injury: Development And Preliminary Evaluation, Victoria Wagner, Joshua D Preston, Alejandro De Leon Castro, William F Mueller, Jonathan Nguyen, Manuel Garcia-Toca, Elizabeth R Benjamin, S Rob Todd, Jason D Sciarretta

Faculty, Staff and Student Publications

Purpose: Stroke risk correlates with the Biffl grading system in blunt cerebrovascular injury (BCVI). Although anti-thrombotic therapy is the mainstay of stroke prevention, no point-of-care clinical decision-support tool exists to guide timing for therapy. We sought to develop an interactive online calculator that incorporates patient-specific demographic and injury characteristics to estimate stroke risk and risk reduction with anti-thrombotic (AT) administration.

Methods: Data from BCVI patients (n = 1,197) at a Level I Trauma Center were retrospectively collected. Six machine learning methods were employed to predict stroke risk with and without AT therapy. Class imbalance was addressed using downsampling and/or class …

A Rare Case Of Cutaneous Extramedullary Hematopoiesis In Chronic Myeloid Leukemia, Bennett Christie-Nguyen, Hanadi El Achi, Levani Iashvili, Amer Wahed, Brenda Mai, Jacob Armstrong

Faculty, Staff and Student Publications

Cutaneous extramedullary hematopoiesis (CEH) is a rare manifestation of extramedullary hematopoiesis (EMH), a process typically associated with fetal development or myeloproliferative neoplasms. EMH most commonly involves the spleen, liver, and lymph nodes, with CEH being exceedingly rare in chronic myeloid leukemia (CML). Here, we present a 34-year-old Hispanic male with multiple bilateral lower extremity lesions, right buttock and leg pain, fatigue, and splenomegaly, who was found to have chronic-phase CML. Punch biopsy of one of the skin lesions demonstrated dermal infiltration by maturing hematopoietic elements, including granulocytes, megakaryocytes, and erythroid precursors, with fluorescence in situ hybridization (FISH) testing confirming a …

A Multidomain Peptide Hydrogel-Liposome Composite For Controlled Release Of A Cyclic Dinucleotide In Oral Cancer, Joseph W R Swain, Andrea H Molina, Gemalene M Sunga, Danielle Chew-Martinez, Neeraja Dharmaraj, Alejandra Cobos Perez, Arghadip Dey, Ephraim J Vázquez-Rosado, Simon Young, Jeffrey D Hartgerink

Faculty, Staff and Student Publications

While immunotherapy is a promising treatment strategy for cancer, the majority of head and neck squamous cell carcinoma (HNSCC) patients treated with single-agent immunotherapy do not respond. Therefore, researchers are investigating combination treatments with immunostimulatory molecules that can maximize anti-tumor responses. Cyclic dinucleotides (CDNs) are STING agonists that hold promise in combination approaches, but they require frequent intratumoral administration when used in both preclinical models of HNSCC and clinical trials. To reduce administration frequency, we have created a peptide hydrogel–liposome composite system, K2-Lip(CDN), for local and prolonged availability of CDN. We investigated the loading limits of cationic liposomes in both …

Correction: Exploiting Prmt5 As A Target For Combination Therapy In Mantle Cell Lymphoma Characterized By Frequent Atm And Tp53 Mutations, Yuxuan Che, Yang Liu, Yixin Yao, Holly A Hill, Yijing Li, Qingsong Cai, Fangfang Yan, Preetesh Jain, Wei Wang, Lixin Rui, Michael Wang

Faculty, Staff and Student Publications

No abstract provided.

An Artificial Intelligence Optimized Hepatic Differentiation Unveils Nr5a2 And Ap-1 Transcriptional Regulation In Hepatic Maturation, Zijun Huo, Jian Tu, Wei-Lei Yang, Mo-Fan Huang, Ruoyu Wang, Chih-Wei Chu, An Xu, Yao Yu, Tara N Tavakol, Mikal Kizilbash, Megan E Fisher, Yu-Wen Huang, Dandan Zhu, Trinh T T Phan, Rachel Shoemaker, Ya-Wen Chen, Yang Zhang, Chad D Huff, Shih-Yu Chen, Tien-Jen Liu, Haipeng Xiao, Dung-Fang Lee, Ruiying Zhao

Faculty, Staff and Student Publications

The generation of hepatocyte-like cells (HLCs) from human pluripotent stem cells (hPSCs) holds great promise for drug discovery and cell-based therapy for liver disease. However, current differentiation protocols are complicated and unstable, and the underlying gene regulatory mechanisms of hepatic differentiation remain incompletely defined. Here, we developed a machine learning-based artificial intelligence (AI) tool using phase-contrast images of hepatic progenitor cells (HPCs), which are essential for generating HLCs. The AI tool significantly improves the success rate of hepatic differentiation without the need for immunostaining or lineage tracing. By optimizing the methodology, we achieved an impressive purity of 90-95% for HLCs …

The Effects Of Orexin Receptor Antagonism During Early Withdrawal In Stimulant Use Disorder: Protocol For A Proof-Of-Concept Study, Heather Webber, Nikky Tran, Rita Blake, Sarah Goldman, Trevor George, Bill Bailey, Robert Suchting, Jin Yoon, Jessica Vincent, Michael Weaver, Joy Schmitz, Scott Lane

Faculty, Staff and Student Publications

Background: Stimulant use disorders (StimUDs), including cocaine and methamphetamine use disorders, remain a major public health concern in the United States with no US Food and Drug Administration (FDA)-approved pharmacological treatments. The early recovery period following stimulant use is marked by sleep disturbances, heightened stress reactivity, and dysregulated reward processing, contributing to high rates of resumption of use. Evidence from animal and human studies supports the orexin neuropeptide system as a promising therapeutic target for minimizing these disruptive mechanisms. Suvorexant, an FDA-approved dual orexin receptor antagonist for insomnia, has previously been shown to improve sleep, reduce stress, and attenuate craving …

Lgr5: From Stem Cell Marker To Therapeutic Target, Peyton C High, Maya G Cappellino, Tiffani A Blackburn, Kendra S Carmon

Faculty, Staff and Student Publications

Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) is an established marker of normal and cancer stemlike cells. LGR5 has been implicated in promoting cancer cell plasticity that drives tumorigenesis, metastasis, and therapeutic resistance. LGR5 rapidly and constitutively internalizes and potentiates Wnt (Wingless/Int-1)/β-catenin and adhesion signaling pathways, though its precise mechanisms and interacting partners remain unresolved. An improved understanding of LGR5 signaling may provide invaluable insight into its intricate and important functions in cancer progression. Moreover, several LGR5-targeting therapies, including peptibody- and antibody-drug conjugates and bispecific antibodies, are showing promising efficacy and tolerability in colorectal cancer and other tumor types. This …

A Qualitative Analysis Of Pediatricians' Perspectives Regarding Barriers, Facilitators, And Strategies For Providing Timely Autism Spectrum Disorder Screening And Diagnosis, Mallika Mathur, Jinni Tang, Christine Markham, Sandra Mckay, Ruosha Li, Deepali Ernest, Allison Marshall, Shreela Sharma

Faculty, Staff and Student Publications

Background: Autism spectrum disorder (ASD) is a developmental disorder that has increased in prevalence over the years. Diagnosis and subsequent intervention by the age of 3 is essential for development. However, recent estimates indicate that less than 50% of children receive an evaluation by age 3. Underserved populations are more likely to receive an evaluation at an older age. Several barriers in the diagnostic process have been identified; however, limited studies have aimed at understanding the specifics of these barriers among underserved populations and whether current strategies are beneficial for all children.

Objectives: The aim of this study was to …

Untangling Impacts Of Socioeconomic Position, Chronic Disease, And Low-Level Pm2.5 Exposure On Mortality Among Native American Medicare Beneficiaries, Judy Wendt Hess, Wenyaw Chan

Faculty, Staff and Student Publications

Ambient fine particulate matter (PM2.5) is associated with increased mortality at concentrations below current regulatory standards. Studies of low-level exposure often rely on large administrative cohorts whose geographic and demographic composition may influence observed associations. In a prior analysis, we observed an association between long-term PM2.5 and all-cause mortality among Native American Medicare beneficiaries living in zip codes within the lowest decile of PM2.5 exposure. The present study, a case-control analysis of 1,713,399 low-PM2.5-exposed beneficiaries enrolled in traditional Medicare during 2015-2016, evaluated whether this association could be explained by geographic context, socioeconomic position (SEP), or baseline health status. We used …

Translationally-Relevant Tumor Resection Model For Murine Preclinical Models Of Oral Squamous Cell Carcinoma, Gemalene M Sunga, Alejandra Cobos Perez, Andrea H Molina, Nourhan Hussein, Neeraja Dharmaraj, Andrew Sikora, Simon Young

Faculty, Staff and Student Publications

Currently, the first-line treatment for the most common form of head and neck squamous cell carcinoma (HNSCC), oral cavity squamous cell carcinoma (OSCC), is surgical resection, followed by risk-adapted treatments, such as chemoradiotherapy. However, with the current standard of care and even the emergence of new treatments, such as checkpoint blockade, the overall survival for advanced, recurrent disease remains high, and the prevalence of head and neck cancer is projected to continue to increase in the coming years. Thus, deeper investigation into current standard-of-care modalities, in addition to novel therapeutics, is necessary to translate potential and promising treatment options to …

Bdcd: A Comprehensive Brain Disease Cell-Cell Communication Database, Xinyi Liu, Citu Citu, Wendao Liu, Nitesh Enduru, Andi Liu, Chia-Hao Tung, Zhongming Zhao

Faculty, Staff and Student Publications

Dysregulated cell–cell communication (CCC) is increasingly recognized as a driver of brain disease pathology, contributing to neuroinflammation, synaptic dysfunction, and neurodegeneration. Nevertheless, existing resources remain limited in brain specificity, regional coverage, and functional annotation. To address this gap, we develop the Brain Disease Cell-cell communication Database (BDCD), the first comprehensive resource focused on CCC networks across major brain diseases. BDCD integrates 38 manually curated datasets, comprising 8 519 425 single cells from single-cell RNA-seq studies and 140 744 spots from spatial transcriptomic maps, spanning 14 brain regions and 13 canonical cell types covering Alzheimer’s disease, Parkinson’s disease, schizophrenia, bipolar disorder, …

Natural Language Generation In Healthcare: A Review Of Methods And Applications, Mengxian Lyu, Xiaohan Li, Ziyi Chen, Jinqian Pan, Cheng Peng, Sankalp Talankar, Yonghui Wu

Faculty, Staff and Student Publications

Objective: This study presents a systematic review of natural language generation (NLG) methods and applications in the medical domain, providing quantitative and qualitative analyses to answer four key research questions regarding methods, evaluation, applications, and challenges of NLG in healthcare.

Methods: We searched PubMed, ACM Digital Library, Web of Science, Science Direct, Scopus, Embase, and ACL Anthology for NLG-related studies in healthcare from 2018 to 2024. Out of 3,988 research articles, 113 met the inclusion criteria and were analyzed across data modality, model architecture, evaluation metrics, and application domain.

Results and conclusion: NLG in healthcare has grown substantially, with annual …

A Topic Modeling Analysis Of Stigma Dimensions, Social, And Related Behavioral Circumstances In Clinical Notes Among Patients With Hiv, Ziyi Chen, Yiyang Liu, Mattia Prosperi, Krishna Vaddiparti, Robert L Cook, Jiang Bian, Yi Guo, Yonghui Wu

Faculty, Staff and Student Publications

Objective: To characterize stigma dimensions, social, and related behavioral circumstances in people living with HIV (PLWHs) seeking care, using natural language processing methods applied to a large collection of electronic health record (EHR) clinical notes from a large integrated health system in the southeast United States.

Methods: We identified a cohort of PLWHs from the University of Florida (UF) Health Integrated Data Repository and performed topic modeling analysis using Latent Dirichlet Allocation (LDA) to uncover stigma-related dimensions and related social and behavioral contexts. Domain experts created a seed list of HIV-related stigma keywords, then applied a snowball strategy to iteratively …

Diagnostic Criteria And Management Of Melas And Stroke-Like Episodes: Consensus-Based Statements, Michelangelo Mancuso, Marcello Bellusci, Valerio Carelli, Irenaeus De Coo, Daria Diodato, Felix Distelmaier, Omar Hikmat, Michio Hirano, Rita Horvath, Amel Karaa, Thomas Klopstock, Mary Kay Koenig, Cornelia Kornblum, Chiara La Morgia, Piervito Lopriore, Mika Henrik Martikainen, Robert Mcfarland, Olimpia Musumeci, Robert D S Pitceathly, Guido Primiano, Shamima Rahman, Fernando Scaglia, Andrew Schaefer, Manuel Schiff, Luisa Semmler, Costanza Lamperti, Serenella Servidei

Faculty, Staff and Student Publications

Background and purpose: Mitochondrial Encephalomyopathy, Lactic acidosis and Stroke-like episodes (MELAS) is a rare multisystem mitochondrial disorder with clinical heterogeneity. Diagnostic criteria and management strategies for MELAS and mitochondrial stroke-like episodes (SLE) remain inconsistent. This work provides international consensus recommendations on the definition, diagnosis, and management of MELAS and SLE in pediatric and adult populations.

Methods: An international Delphi consensus process was conducted within the European Reference Network for Neuromuscular Diseases (ERN EURO-NMD), in collaboration with the US Mitochondrial Medicine Society, the ERN for Hereditary Metabolic Disorders (MetabERN), and patient representatives. Following a systematic literature review, 54 statements addressing diagnostic …

Complex Iliac Artery And Iliocaval Venous Reconstruction Using Temporary, Redundant Graft To Facilitate Resection Of Recurrent Metastatic Sex Stromal Tumor, Shah-Jahan M Dodwad, Blaz Podgorsek, Ezra Koh, Taha S Zaidi, Justin E Bird, Shalin S Patel, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Student Publications

We report a complex case of recurrent, metastatic sex cord stromal tumor involving the pelvic vasculature and spinal nerves. Posterior and anterior approaches were required with redo iliac artery reconstruction using a temporary, redundant aortoiliac to right external iliac artery graft and iliocaval venous reconstruction. After completion of tumor resection from nerve structures, reconstruction of the right iliac veins was completed and the redundant aortoiliac arterial graft was shortened. The redundant graft minimized ischemia time, enabling meticulous dissection and tumor removal. This case underscores the importance of multidisciplinary collaboration in managing rare, aggressive malignancies with complex vascular and neural involvement.

Complex Iliac Artery And Iliocaval Venous Reconstruction Using Temporary, Redundant Graft To Facilitate Resection Of Recurrent Metastatic Sex Stromal Tumor, Shah-Jahan M Dodwad, Blaz Podgorsek, Ezra Koh, Taha S Zaidi, Justin E Bird, Shalin S Patel, Thanila A Macedo, Gustavo S Oderich

Faculty, Staff and Student Publications

We report a complex case of recurrent, metastatic sex cord stromal tumor involving the pelvic vasculature and spinal nerves. Posterior and anterior approaches were required with redo iliac artery reconstruction using a temporary, redundant aortoiliac to right external iliac artery graft and iliocaval venous reconstruction. After completion of tumor resection from nerve structures, reconstruction of the right iliac veins was completed and the redundant aortoiliac arterial graft was shortened. The redundant graft minimized ischemia time, enabling meticulous dissection and tumor removal. This case underscores the importance of multidisciplinary collaboration in managing rare, aggressive malignancies with complex vascular and neural involvement.

Robo2 Variants Associated With Atrial Septal Defect Define A Novel Regulatory Element, Seong Won Kim, Michael Parfenov, Laura Rodriguez-Murillo, David A Conner, Arun Sharma, Inga Peter, Feng Xiao, Olivia Layton, Angela Tai, Tarsha Ward, Lauren K Wasson, Joshua M Gorham, Erica Mazaika, Valentina N Lagomarsino, Tracy L Young-Pearse, Elizabeth Goldmuntz, Hiroko Wakimoto, A J Agopian, David M Mckean, Steven R Depalma, William T Pu, Christine E Seidman, Bruce D Gelb, Jonathan G Seidman

Faculty, Staff and Student Publications

Background: Atrial septal defects (ASDs) are a prevalent type of congenital heart disease. Previous GWAS (Genome-Wide Association Studies) have identified common variants associated with ASDs, though their mechanisms remain unknown. We aimed to expand insights into the architecture of common variants associated with ASD risk and elucidate functional mechanisms.

Methods: We conducted a GWAS using isolated ASD cases and healthy controls and replicated findings in an independent cohort. We examined epigenetic marks within this ASD locus in human induced pluripotent stem cell-derived cardiomyocytes and fetal human hearts. We characterized the consequences of deletions introduced by CRISPR-Cas9 mutagenesis of human induced …

Developing Scenario-Based Strategies For Health, Climate, And Environmental Preparedness: The One Health, One Earth Approach, Azar M Abadi, Kyle D Brumfield, Moiz Usmani, Gemma Jiang, T C Chakraborty, Yuzhou Wang, Zhijie Zhou, Cenlin He, Minghao Qiu, Jennifer D Stowell, Douglas Fritz, Sunil Kumar, Qiang Guo, Ying Xiong, Georgia Destouni, Qian Xiao, Xindi C Hu, Kelvin C Fong, Yun Hang, John Nielsen-Gammon, Rima Habre, Jennifer R Bratburd, Christopher W Tessum, Antarpreet Jutla, Rita R Colwell, Gabriel M Filippelli, Thanh H Nguyen

Faculty, Staff and Student Publications

Climate change amplifies many threats to human health. Despite advances in understanding climate change dynamics and impacts, there remains a critical gap in translating scientific knowledge into equitable, and community‐driven health interventions. The inaugural One Earth, One Health workshop sought to explore this gap through human‐centered design exercises involving interdisciplinary researchers from climate and Earth sciences, engineering, epidemiology, microbiology, and environmental health. Although participants did not co‐develop solutions with affected communities, they used stakeholder role‐playing to guide ideation and lay groundwork for actionable plans. Through these methods, participants identified community needs and proposed prototype solutions to alleviate health threats …

The All-Payer Claims Database After The Gobeille Supreme Court Decision: Assessing The Impact On Fatal Opioid-Related Overdose Research, Jack Cordes, Cici Bauer, Dana Bernson, Marc R Larochelle, Wenjun Li, Jiahao Cao, Olaf Dammann, Thomas J Stopka

Faculty, Staff and Student Publications

Objective: To determine the consequences of the Gobeille v. Liberty Mutual Supreme Court decision on the representativeness of the Massachusetts all-payer claims database (APCD). The loss of individuals captured in the APCD may vary demographically, geographically, and in the capture of fatal opioid-related overdose (OOD).

Data sources and study setting: We used 2013-2021 data from the Massachusetts Public Health Data Warehouse (PHD), which links person-level APCD records to other datasets. The APCD includes commercially-insured health claims mandatorily reported pre-Gobeille. Post-Gobeille, reporting from self-insured plans, a subset of commercially-insured plans, became voluntary.

Study design: In a repeated cross-sectional design, we compared …

Traumatic Brain Injury And Risk Of Early-Onset Dementia: A Population-Based Cohort Study, Aishwarya Saravanan, Katherine Giorgio, Natalia Lakomski, Andrea L C Schneider, Barbara A Olson-Bullis, Behnam Sabayan, James S Pankow, Paul S De Vries, Kristine Yaffe, Alexa Beiser, Abbas Dehghan, Elizabeth A Peterson, Rachel Zmora, John J Stephen, Denise Scholtens, Maxwell Mansolf, Lenore J Launer, Richard F Maclehose, Pamela L Lutsey, Norrina B Allen, Sanaz Sedaghat

Faculty, Staff and Student Publications

Introduction: We investigated the association between traumatic brain injury (TBI) and incidence of early-onset dementia (EOD) versus late-onset dementia (LOD).

Methods: We included 501,710 UK Biobank participants (average age 56.5). Over a median 13.6 years of follow-up, 836 developed EOD (before 65) and 8947 developed LOD (after 65). We estimated hazard ratios (HRs) for TBI's association with EOD and LOD using Cox proportional hazard models with TBI as a time-varying exposure and coefficient.

Results: TBI was associated with higher risk of both EOD (HR: 4.06 [95% confidence interval: 3.13, 5.26]) and LOD (HR: 2.51 [2.31, 2.72]. Among participants included in …

Continuous Versus Bolus Norepinephrine Administration To Treat Hypotension After Induction Of General Anaesthesia In Low-To-Moderate Risk Noncardiac Surgery Patients: A Randomised Trial, Kristen K Thomsen, Finn Külls, Christina Vokuhl, Linda Krause, Dominik Müller, Max Bossemeyer, Mirja Wegge, Alina Kröker, Alina Bergholz, Christian Zöllner, Daniel I Sessler, Bernd Saugel

Faculty, Staff and Student Publications

Background: Hypotension after induction of general anaesthesia (postinduction hypotension) is common in patients undergoing noncardiac surgery and frequently requires treatment with vasopressors such as norepinephrine. We tested the hypothesis that giving norepinephrine continuously using a syringe infusion pump, compared with giving it as repeated manual boluses, reduces postinduction hypotension within 15 min after starting induction of general anaesthesia in low-to-moderate risk noncardiac surgery patients.

Methods: Patients undergoing elective noncardiac surgery were randomised to either continuous norepinephrine infusion or manual bolus norepinephrine administration intravenously during induction of general anaesthesia. In both groups, norepinephrine was administered through a peripheral venous catheter. Blood …

Fatigue Survival And Biomechanical Behavior Of Two-Piece Titanium And Zirconia Dental Implants, Jefferson David Melo De Matos, Guilherme Da Rocha Scalzer Lopes, Nathália De Carvalho Ramos, Mário Alexandre Coelho Sinhoreti, Alexandre Luiz Souto Borges, Daher Antonio Queiroz, Marco Antonio Bottino

Faculty, Staff and Student Publications

Background: Titanium implants are considered the gold standard for oral rehabilitation; however, zirconia implants have emerged as a metal-free alternative with promising esthetic and biological properties. Despite these advantages, limited evidence is available regarding their long-term fatigue behavior and fracture resistance.

Material and methods: In this in vitro experimental study conducted at São Paulo State University (UNESP), Brazil, forty implants were divided into two groups (n = 20): zirconia implants (ZZ) and titanium implants (TZ) (4.1 × 10 mm). Implants were embedded in polyurethane blocks according to ISO 14801:2016 specifications. Monolithic zirconia crowns were fabricated using CAD/CAM technology and cemented …

Bridging Gaps: Enhancing Sleep And Health Disparities In Latino Families With Young Adults With Autism Using A Culturally Adapted Intervention, Antonio F Pagán, Alejandro L Pagán, Linda Hernandez, Matthew R Cribbet, Katherine A Loveland, Ron Acierno

Faculty, Staff and Student Publications

The present study examined the effects of a culturally adapted intervention, ¡Iniciando! la Adultez, on sleep and health-related quality of life (HRQoL) in Latino young adults with autism spectrum disorder (ASD) and their Spanish-speaking parents. The intervention targeted the transition to adulthood, a period associated with increased challenges in sleep and HRQoL, particularly for underserved Latino populations. Participants included 26 young adults and 38 parents who completed assessments at baseline and post-treatment. The results indicated significant improvements in several HRQoL domains for both groups, with young adults reporting enhanced emotional well-being, social functioning, and general health. Parents experienced notable improvements …

Factors Associated With Venous Complications In Lower Extremity Free Flap Reconstruction: A Multivariate Analysis, Bora Kahramangil, Ellen Wang, Imran Rizvi, Jessica R Nye, Kylie Swiekatowski, Alexandra Dunker, Kate Liao, Michael H Haydon, Jeffrey G Trost, Mohin A Bhadkamkar

Faculty, Staff and Student Publications

Background: Due to their dependent location, lower extremity (LE) free flaps (FFs) are at increased risk for venous complications. This study analyzes risk factors of venous complications in LE FFs.

Methods: A single-center retrospective review was conducted of adult patients undergoing LE FF reconstruction from 2016 to 2025. Variables included demographics, wound and operative characteristics, and the number of venous anastomoses. The primary outcome was venous complications, defined as a composite variable encompassing venous congestion, flap loss due to venous causes, and flap hematoma.

Results: The cohort consisted of 370 patients undergoing LE FF reconstructions. Single venous anastomosis was used …

56-Year-Old Man With Dyspnea And Volume Overload, Altamish Daredia, Han Yu, Ryan Walsh, Benjamin Karfunkle

Faculty, Staff and Student Publications

No abstract provided.

Probability Of Fentanyl Adulteration In Cocaine Selectively Decreases Cocaine Demand, Cecilia Nunez, Jin H Yoon, James Mackillop, Margaret C Wardle

Faculty, Staff and Student Publications

Fentanyl-related, cocaine-overdose deaths have drastically increased, yet research on how people who use cocaine perceive fentanyl adulteration is limited. This study developed the novel Adulterated Cocaine Purchasing Task (ACocPT), a modification of the original Cocaine Purchasing Task, to quantify how people respond to fentanyl adulteration in cocaine. In the ACocPT, participants indicated how much cocaine they would purchase when cocaine had no (0%) vs. some (10%) probability of fentanyl adulteration. Study aims were: 1) determine how possible fentanyl adulteration affects cocaine demand, and 2) determine which individual characteristics predict continued demand for cocaine despite fentanyl adulteration. This Amazon Mechanical Turk …

Carotid Endarterectomy Remains A Feasible Bailout For Progressive Disease After Transcarotid Artery Revascularization: A Case Report, Aidin Baghbani, Blaz Podgorsek, Jason B Storch, Gordon H Martin, Naveed U Saqib, Daniel G Miles

Faculty, Staff and Student Publications

Carotid endarterectomy (CEA) remains the gold standard for carotid revascularization, though transcarotid artery revascularization (TCAR) has emerged as a less invasive alternative. We present a 67-year-old man with prior bilateral TCAR who developed severe right internal carotid artery restenosis 14 months after the procedure. Imaging confirmed >80% stenosis due to progressive plaque burden compressing the stent. The patient underwent successful CEA with en bloc stent explant using a standard technique. Recovery was uneventful. This case demonstrates the technical feasibility and safety of surgical stent explant after TCAR and reinforces CEA as a reliable salvage strategy when stent failure or disease …

Carotid Endarterectomy Remains A Feasible Bailout For Progressive Disease After Transcarotid Artery Revascularization: A Case Report, Aidin Baghbani, Blaz Podgorsek, Jason B Storch, Gordon H Martin, Naveed U Saqib, Daniel G Miles

Faculty, Staff and Student Publications

Carotid endarterectomy (CEA) remains the gold standard for carotid revascularization, though transcarotid artery revascularization (TCAR) has emerged as a less invasive alternative. We present a 67-year-old man with prior bilateral TCAR who developed severe right internal carotid artery restenosis 14 months after the procedure. Imaging confirmed >80% stenosis due to progressive plaque burden compressing the stent. The patient underwent successful CEA with en bloc stent explant using a standard technique. Recovery was uneventful. This case demonstrates the technical feasibility and safety of surgical stent explant after TCAR and reinforces CEA as a reliable salvage strategy when stent failure or disease …