Digital Commons Network^™

Regional Vulnerability Indices In Youth With Persistent And Distressing Psychoticlike Experiences, Nicole R Karcher, Hailey Modi, Peter Kochunov, Si Gao, Deanna M Barch

Faculty, Staff and Student Publications

IMPORTANCE: Distressing and persistent psychoticlike experiences (PLEs) in youth are associated with greater odds of developing psychiatric conditions in adulthood. Despite this risk, it is unclear whether early PLEs show similar brain patterns compared with adults with psychiatric and neurologic conditions.

OBJECTIVE: To examine the degree to which persistent and distressing PLEs exhibit neural metrics that show similarity to adults with chronic psychiatric and neurologic conditions.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used Adolescent Brain Cognitive Development (ABCD) Study examining the persistence and distress associated with PLEs across the first 3 waves of data with baseline structural magnetic resonance …

Pancreatic Replacement Therapy For Maladaptive Behaviors In Preschool Children With Autism Spectrum Disorder, Deborah A Pearson, Robert L Hendren, Matthew F Heil, William R Mcintyre, Shane R Raines

Faculty, Staff and Student Publications

IMPORTANCE: There is an urgent unmet need for a treatment addressing the core symptoms and associated maladaptive symptoms of autism spectrum disorder (ASD), especially in preschool populations.

OBJECTIVES: To evaluate whether treatment of children with ASD aged 3 to 6 years treated with high-protease pancreatic therapy produces long- and short-term improvements in autism-associated maladaptive behaviors.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study at 32 sites across the US used a double-blind parallel group, delayed-start design comprising a 2-week blinded placebo run-in, and a double-blind, randomized, placebo-controlled segment (12 weeks). Children were recruited into the study in 2015, with data collection …

Severe Lupus Enteritis Complicated By Intractable Gastrointestinal Hemorrhage, Austin Thomas, Clay Smithhart, Maneera Chopra, Athira Jayan, Faisal Ali, Karim Doughem, Asmeen Bhatt, Joanna Scoon, Scott Larson

Faculty, Staff and Student Publications

Lupus enteritis (LE) is a rare presentation of systemic lupus erythematosus manifesting with nonspecific symptoms, laboratory derangements, and imaging findings. Rarely, LE may progress to bowel perforation, hemorrhage, and even death. Treatment with systemic glucocorticoids often results in rapid clinical improvement, but patients may require further immunosuppression. We present a case of severe LE complicated by life-threatening intractable gastrointestinal hemorrhage and warm autoimmune hemolytic anemia refractory to glucocorticoids and ultimately requiring massive transfusions, intravenous immunoglobulin, and plasmapheresis. This case illustrates the importance of early specialist involvement and treatment with intravenous immunoglobulin and plasmapheresis for severe, life-threatening LE.

Diverse Clinical Manifestations And Challenges Of Mucormycosis: Insights From Serial Cases, Marisa C Nielsen, Filipe M Cerqueira, Sri Bharathi Kavuri, Caitlin M Raymond, Aeman Muneeb, Andrzej S Kudlicki, Shafaq Tariq, Mingru Liu, Andrew L Routh, Suimin Qiu, Ping Ren

Faculty, Staff and Student Publications

Mucormycosis is a severe and potentially life-threatening infection caused by a group of fungi classified as mucormycetes within the scientific order Mucorales. These infections are characterized by rapid and invasive fungal growth, presenting significant treatment challenges. Here we present 5 cases encountered from 2018 to 2022 at the University of Texas Medical Branch in Galveston, Texas, including a novel Apophysomyces species. These cases illustrate the diverse clinical manifestations of mucormycosis, including pulmonary, rhino-cerebral, gastrointestinal, and soft tissue involvement. Our investigation incorporates information provided by a multidisciplinary team of clinical collaborators, emphasizing the findings from radiology, histopathology, and microbiology. Given the …

Comparison Between Viral Vector And Mrna Based Covid-19 Vaccination In Prevalence And Severity Of Regional Immune Reactions, And 18f-Fdg Pet/Ct Features, Narjess Ayati, Scott Evans, S Rasoul Zakavi, Simon M Gruenewald

Faculty, Staff and Student Publications

Objective(s):

The coronavirus pandemic caused by SARS-CoV-2 commenced in late 2019, and global wide vaccination appears to be the only reasonable solution to fight this dreadful virus. There are two main types of COVID-19 immunization using viral vector and mRNA-based vaccines. However, the impact of each of type on 18F-FDG PET/CT needs to be accurately assessed. This study aimed to compare the 18F-FDG PET/CT features of these two types of COVID-19 vaccines.

Methods:

A total of 188 patients referred for 18F-FDG PET/CT with a recent history of either BioNTech/Pfizer or AstraZeneca COVID-19 vaccination, and a control group of 40 patients …

Deep Learning-Based Dose Prediction To Improve The Plan Quality Of Volumetric Modulated Arc Therapy For Gynecologic Cancers, Mary P Gronberg, Anuja Jhingran, Tucker J Netherton, Skylar S Gay, Carlos E Cardenas, Christine Chung, David Fuentes, Clifton D Fuller, Rebecca M Howell, Meena Khan, Tze Yee Lim, Barbara Marquez, Adenike M Olanrewaju, Christine B Peterson, Ivan Vazquez, Thomas J Whitaker, Zachary Wooten, Ming Yang, Laurence E Court

Faculty, Staff and Student Publications

Background: In recent years, deep‐learning models have been used to predict entire three‐dimensional dose distributions. However, the usability of dose predictions to improve plan quality should be further investigated.

Purpose: To develop a deep‐learning model to predict high‐quality dose distributions for volumetric modulated arc therapy (VMAT) plans for patients with gynecologic cancer and to evaluate their usability in driving plan quality improvements.

Methods: A total of 79 VMAT plans for the female pelvis were used to train (47 plans), validate (16 plans), and test (16 plans) 3D dense dilated U‐Net models to predict 3D dose distributions. The models received the …

Hypofibrinogenemia Following Injury In 186 Children And Adolescents: Identification Of The Phenotype, Current Outcomes, And Potential For Intervention, Justin Gerard, Jan-Michael Van Gent, Jessica Cardenas, Christian Gage, David E Meyer, Charles Cox, Charles E Wade, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVES: Recent studies evaluating fibrinogen replacement in trauma, along with newly available fibrinogen-based products, has led to an increase in debate on where products such as cryoprecipitate belong in our resuscitation strategies. We set out to define the phenotype and outcomes of those with hypofibrinogenemia and evaluate whether fibrinogen replacement should have a role in the initial administration of massive transfusion.

METHODS: All patients/17-4/21 were reviewed. We then evaluated all patients who received emergency-release and massive transfusion protocol (MTP) products. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen(r-TEG) angleHYPOFIB, the impact on outcomes, and whether early replacement improved mortality. …

Immune Cell Identity Behind The Ktrans Mapping Of Mouse Glioblastoma, Yanrong Zhang, Olivier Keunen, Anna Golebiewska, Marco Gerosa, Jing Wang, Sara Natasha Ghobadi, Ai Huang, Qingyi Hou, Frezghi G Habte, Ningrui Li, Gerry Grant, Ramasamy Paulmurugan, Kevin S Lee, Max Wintermark

Faculty, Staff and Student Publications

Dynamic contrast-enhanced MR imaging (DCE-MRI) can assess the integrity of the blood brain barrier (BBB) and has been used in GBM patients to determine glioma grade, predict prognosis, evaluate treatment response, and differentiate treatment-induced effect from recurrence. The volume transfer constant Ktrans is the most frequently used metric in tumor assessment. Based on previous studies that a higher WHO grade of brain tumor was associated with greater impairments of immunity and and that Ktrans value was associated with the pathological grading, the relationship between differential composition of immune cells in GBM tissue and dynamic changes in Ktrans mapping was anticipated …

Real-Time Liver Motion Estimation Via Deep Learning-Based Angle-Agnostic X-Ray Imaging, Hua-Chieh Shao, Yunxiang Li, Jing Wang, Steve Jiang, You Zhang

Faculty, Staff and Student Publications

Background: Real-time liver imaging is challenged by the short imaging time (within hundreds of milliseconds) to meet the temporal constraint posted by rapid patient breathing, resulting in extreme under-sampling for desired 3D imaging. Deep learning (DL)-based real-time imaging/motion estimation techniques are emerging as promising solutions, which can use a single X-ray projection to estimate 3D moving liver volumes by solved deformable motion. However, such techniques were mostly developed for a specific, fixed X-ray projection angle, thereby impractical to verify and guide arc-based radiotherapy with continuous gantry rotation.

Purpose: To enable deformable motion estimation and 3D liver imaging from individual X-ray …

Biomechanics In The Onset And Severity Of Spondyloarthritis: A Force To Be Reckoned With, Priyanka Iyer, Mark Hwang, Lauren Ridley, Michael M Weisman

Faculty, Staff and Student Publications

Increasing evidence suggests that there is a pivotal role for physical force (mechanotransduction) in the initiation and/or the perpetuation of spondyloarthritis; the review contained herein examines that evidence. Furthermore, we know that damage and inflammation can limit spinal mobility, but is there a cycle created by altered spinal mobility leading to additional damage and inflammation?Over the past several years, mechanotransduction, the mechanism by which mechanical perturbation influences gene expression and cellular behaviour, has recently gained popularity because of emerging data from both animal models and human studies of the pathogenesis of ankylosing spondylitis (AS). In this review, we provide evidence …

Compound Muscle Action Potential (Cmap) Scan Examination Of Paretic And Contralateral Muscles Reveals Motor Unit Alterations After Stroke, Maoqi Chen, Zhiyuan Lu, Xiaoyan Li, Ya Zong, Qing Xie, Sheng Li, Ping Zhou

Faculty, Staff and Student Publications

This study presents a novel compound muscle action potential (CMAP) examination of motor unit changes in paretic muscle post stroke. CMAP scan of the first dorsal interosseous (FDI) muscle was performed bilaterally in 16 chronic stroke subjects. Various parameters were derived from the CMAP scan to examine paretic muscle changes, including CMAP amplitude, D50, step index (STEPIX) and amplitude index (AMPIX). A significant decrease in CMAP amplitude and STEPIX was observed in paretic muscles compared with contralateral muscles (CMAP amplitude: paretic (9.0±0.5) mV, contralateral (11.3±0.9) mV, P=0.024; STEPIX: paretic 101.2±7.6, contralateral 121.9±6.5, P=0.020). No significant difference in D50 and AMPIX …

Blood-Based Migration Signature Biomarker Panel Discriminates Early Stage New Onset Diabetes Related Pancreatic Ductal Adenocarcinoma From Type 2 Diabetes, Seetharaman Balasenthil, Suyu Liu, Jianliang Dai, William R Bamlet, Gloria Petersen, Suresh T Chari, Anirban Maitra, Nanyue Chen, Subrata Sen, Ann Mcneill Killary

Faculty, Staff and Student Publications

Background and aims: While type 2 diabetes is a well-known risk factor for pancreatic ductal adenocarcinoma (PDAC), PDAC-induced new-onset diabetes (PDAC-NOD) is a manifestation of underlying PDAC. In this study, we sought to identify potential blood-based biomarkers for distinguishing PDAC-NOD from type 2 diabetes (T2DM) without PDAC.

Materials and methods: By ELISA analysis, a migration signature biomarker panel comprising tissue factor pathway inhibitor (TFPI), tenascin C (TNC-FNIII-C) and CA 19-9 was analyzed in plasma samples from 50 PDAC-NOD and 50 T2DM controls.

Results: Both TFPI (area under the curve (AUC) 0.71) and TNC-FNIII-C (AUC 0.69) outperformed CA 19-9 (AUC 0.60) …

Review Of Generic Scenario Environmental Release And Occupational Exposure Models Used In Chemical Risk Assessment, William M Barrett, David E Meyer, Raymond L Smith, Sudhakar Takkellapati, Michael A Gonzalez

Faculty, Staff and Student Publications

Under the Toxic Substances Control Act (TSCA), the United States Environmental Protection Agency (USEPA) is required to determine whether a new chemical substance poses an unreasonable risk to human health or the environment before the chemical is manufactured in or imported into the United States. This manuscript provides a review of the process used to evaluate the risk associated with a chemical based on the scenarios and models used in the evaluation. Specifically, the Generic Scenarios and Emission Scenario Documents developed by the USEPA were reviewed, along with background documentation prepared by USEPA to identify the core elements of the …

Acaa2 Is A Novel Molecular Indicator For Cancers With Neuroendocrine Phenotype, Michelle Shen, Shiqin Liu, Angus Toland, En-Chi Hsu, Alifiani B Hartono, Busola R Alabi, Merve Aslan, Holly M Nguyen, Conner J Sessions, Rosalie Nolley, Chanjuan Shi, Jiaoti Huang, James D Brooks, Eva Corey, Tanya Stoyanova

Faculty, Staff and Student Publications

BACKGROUND: Neuroendocrine phenotype is commonly associated with therapy resistance and poor prognoses in small-cell neuroendocrine cancers (SCNCs), such as neuroendocrine prostate cancer (NEPC) and small-cell lung cancer (SCLC). Expression levels of current neuroendocrine markers exhibit high case-by-case variability, so multiple markers are used in combination to identify SCNCs. Here, we report that ACAA2 is elevated in SCNCs and is a potential molecular indicator for SCNCs.

METHODS: ACAA2 expressions in tumour xenografts, tissue microarrays (TMAs), and patient tissues from prostate and lung cancers were analysed via immunohistochemistry. ACAA2 mRNA levels in lung and prostate cancer (PC) patients were assessed in published …

Arginase Deficiency Masked By Cerebral Palsy And Coagulopathy-Three Varied Presentations Of Latin American Origin, Shelby L Mills, Paige Roberts, Myla Ashfaq, Kathryn Leal, Hope Northrup, Deborah L Brown, David Rodriguez-Buritica, Laura S Farach

Faculty, Staff and Student Publications

Arginase deficiency (ARG1‐D) is an autosomal recessive inborn error of metabolism that is often misdiagnosed. Classic presentation of ARG1‐D includes progressive symptoms of spasticity, delayed development, cognitive impairment, protein avoidance, and seizures. Patients who present atypically may evade diagnosis and require a thoughtful diagnostic workup. Here, we discuss three females of Latin American origin with differing clinical presentations, but who all have the same intronic pathogenic variant in ARG1. Importantly, we found that each case included elevated coagulopathy on laboratory testing and discussed one case in particular with manifestation of bleeding. When diagnosed early, treatment is favorable and can …

Egfr Tyrosine Kinase Inhibitors For The Treatment Of Metastatic Non-Small Cell Lung Cancer Harboring Uncommon Egfr Mutations: A Podcast, Xiuning Le, Eric Nadler, Daniel B Costa, John Victor Heymach

Faculty, Staff and Student Publications

See the video and supplementary file.

Germline Sequencing Analysis To Inform Clinical Gene Panel Testing For Aggressive Prostate Cancer, Burcu F Darst, Ed Saunders, Tokhir Dadaev, Xin Sheng, Peggy Wan, Loreall Pooler, Lucy Y Xia, Stephen Chanock, Sonja I Berndt, Ying Wang, Alpa V Patel, Demetrius Albanes, Stephanie J Weinstein, Vincent Gnanapragasam, Chad Huff, Fergus J Couch, Alicja Wolk, Graham G Giles, Tu Nguyen-Dumont, Roger L Milne, Mark M Pomerantz, Julie A Schmidt, Ruth C Travis, Timothy J Key, Konrad H Stopsack, Lorelei A Mucci, William J Catalona, Beth Marosy, Kurt N Hetrick, Kimberly F Doheny, Robert J Macinnis, Melissa C Southey, Rosalind A Eeles, Fredrik Wiklund, David V Conti, Zsofia Kote-Jarai, Christopher A Haiman

Faculty, Staff and Student Publications

Importance: Germline gene panel testing is recommended for men with advanced prostate cancer (PCa) or a family history of cancer. While evidence is limited for some genes currently included in panel testing, gene panels are also likely to be incomplete and missing genes that influence PCa risk and aggressive disease.

Objective: To identify genes associated with aggressive PCa.

Design, setting, and participants: A 2-stage exome sequencing case-only genetic association study was conducted including men of European ancestry from 18 international studies. Data analysis was performed from January 2021 to March 2023. Participants were 9185 men with aggressive PCa (including 6033 …

Considerations For Intensity Modulated Total Body Or Total Marrow And Lymphoid Irradiation, David Parsons, Tze Yee Lim, Jose R Teruel, Paulina Galavis, Stefano Agostinelli, Jieming Liang, Pietro Mancosu, Amanda Cherpak, Dennis N Stanley, Kang-Hyun Ahn, Bingqi Guo, Yesenia Gonzalez, Jay Burmeister, Jeffrey Y C Wong, Xuejun Gu, Grace Gwe-Ya Kim

Faculty, Staff and Student Publications

We compiled a sampling of the treatment techniques of intensity-modulated total body irradiation, total marrow irradiation and total marrow and lymphoid irradiation utilized by several centers across North America and Europe. This manuscript does not serve as a consensus guideline, but rather is meant to serve as a convenient reference for centers that are considering starting an intensity-modulated program.

Circulating Micrornas And Cytokines As Prognostic Biomarkers For Doxorubicin-Induced Cardiac Injury And For Evaluating The Effectiveness Of An Exercise Intervention, Prince Jeyabal, Anchit Bhagat, Fei Wang, Michael Roth, J Andrew Livingston, Susan C Gilchrist, Jose Banchs, Michelle A T Hildebrandt, Joya Chandra, Anita Deswal, Efstratios Koutroumpakis, Jian Wang, Najat C Daw, Theresa A Honey, Eugenie S Kleinerman

Faculty, Staff and Student Publications

Purpose: To define a set of biomarkers that can be used to identify patients at high risk of developing late doxorubicin (DOX)-induced cardiac morbidity with the goal of focused monitoring and early interventions.

Experimental design: Mice received phosphate buffered saline or DOX 2.5 mg/kg 2x/week for 2 weeks. Blood samples were obtained before and after therapy for quantification of miRNAs (6 and 24 hours), cytokines (24 hours), and troponin (24 hours, 4 and 6 weeks). Cardiac function was evaluated using echocardiography before and 24 hours after therapy. To assess the effectiveness of exercise intervention in preventing DOX-induced cardiotoxicity blood samples …

The Androgen Receptor Does Not Directly Regulate The Transcription Of Dna Damage Response Genes, Joshua D Samuels, Katelyn A Moore, Hannah E Ennerfelt, Alexis M Johnson, Adeline E Walsh, Richard J Price, John R Lukens

Faculty, Staff and Student Publications

INTRODUCTION: Mutations in INPP5D, which encodes for the SH2-domain-containing inositol phosphatase SHIP-1, have recently been linked to an increased risk of developing late-onset Alzheimer's disease. While INPP5D expression is almost exclusively restricted to microglia in the brain, little is known regarding how SHIP-1 affects neurobiology or neurodegenerative disease pathogenesis.

METHODS: We generated and investigated 5xFAD Inpp5d

RESULTS: SHIP-1 deletion in microglia led to substantially enhanced recruitment of microglia to Aβ plaques, altered microglial gene expression, and marked improvements in neuronal health. Further, SHIP-1 loss enhanced microglial plaque containment and Aβ engulfment when compared to microglia from Cre-negative 5xFAD Inpp5d

DISCUSSION: …

Importance Of Health Policy And Systems Research For Strengthening Rehabilitation In Health Systems: A Call To Action To Accelerate Progress, Walter R Frontera, Wouter Degroote, Abdul Ghaffar, Health Policy & Systems Research For Rehabilitation Group

Faculty, Staff and Student Publications

No abstract provided.

Use Of Term Reference Infants In Assessing The Developmental Outcome Of Extremely Preterm Infants: Lessons Learned In A Multicenter Study, Charles E Green, Jon E Tyson, Roy J Heyne, Susan R Hintz, Betty R Vohr, Carla M Bann, Abhik Das, Edward F Bell, Sana Boral Debsareea, Emily Stephens, Marie G Gantz, Carolyn M Petrie Huitema, Karen J Johnson, Kristi L Watterberg, Ricardo Mosquera, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Tarah T Colaizy, Nathalie L Maitre, Stephanie L Merhar, Ira Adams-Chapman, Janell Fuller, Michelle E Hartley-Mcandrew, William F Malcolm, Sarah Winter, Andrea F Duncan, Gary J Myer, Stephen D Kicklighter, Myra H Wyckoff, Sara B Demauro, Anna Maria Hibbs, Barbara J Stoll, Waldemar A Carlo, Krisa P Van Meurs, Matthew A Rysavy, Ravi M Patel, Pablo J Sánchez, Abbot R Laptook, C Michael Cotten, Carl T D'Angio, Michele C Walsh, Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital.

STUDY DESIGN: Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age.

RESULTS: We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting …

Automated Large Vessel Occlusion Detection Software And Thrombectomy Treatment Times: A Cluster Randomized Clinical Trial, Juan Carlos Martinez-Gutierrez, Youngran Kim, Sergio Salazar-Marioni, Muhammad Bilal Tariq, Rania Abdelkhaleq, Arash Niktabe, Anjan N Ballekere, Ananya S Iyyangar, Mai Le, Hussain Azeem, Charles C Miller, Jon E Tyson, Sandi Shaw, Peri Smith, Mallory Cowan, Isabel Gonzales, Louise D Mccullough, Andrew D Barreto, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

Importance

The benefit of endovascular stroke therapy (EVT) in large vessel occlusion (LVO) ischemic stroke is highly time dependent. Process improvements to accelerate in-hospital workflows are critical.

Objective

To determine whether automated computed tomography (CT) angiogram interpretation coupled with secure group messaging can improve in-hospital EVT workflows.

Design, Setting, and Participants

This cluster randomized stepped-wedge clinical trial took place from January 1, 2021, through February 27, 2022, at 4 comprehensive stroke centers (CSCs) in the greater Houston, Texas, area. All 443 participants with LVO stroke who presented through the emergency department were treated with EVT at the 4 CSCs. Exclusion …

Cell-Autonomous Effects Of Apoe4 In Restricting Microglial Response In Brain Homeostasis And Alzheimer’S Disease, Chia-Chen Liu, Na Wang, Yuanxin Chen, Yasuteru Inoue, Francis Shue, Yingxue Ren, Minghui Wang, Wenhui Qiao, Tadafumi C Ikezu, Zonghua Li, Jing Zhao, Yuka Martens, Sydney V Doss, Cassandra L Rosenberg, Suren Jeevaratnam, Lin Jia, Ana-Caroline Raulin, Fangfang Qi, Yiyang Zhu, Alla Alnobani, Joshua Knight, Yixing Chen, Cynthia Linares, Aishe Kurti, John D Fryer, Bin Zhang, Long-Jun Wu, Betty Y S Kim, Guojun Bu

Faculty, Staff and Student Publications

Microglial involvement in Alzheimer's disease (AD) pathology has emerged as a risk-determining pathogenic event. While apolipoprotein E (APOE) is known to modify AD risk, it remains unclear how microglial apoE impacts brain cognition and AD pathology. Here, using conditional mouse models expressing apoE isoforms in microglia and central nervous system-associated macrophages (CAMs), we demonstrate a cell-autonomous effect of apoE3-mediated microglial activation and function, which are negated by apoE4. Expression of apoE3 in microglia/CAMs improves cognitive function, increases microglia surrounding amyloid plaque and reduces amyloid pathology and associated toxicity, whereas apoE4 expression either compromises or has no effects on these outcomes …

Stratification Of Alpha Ganglion Cells And On/Off Directionally Selective Ganglion Cells In The Rabbit Retina, Xinruo Zhang, Katherine Brind'amour, Kelly E King, Susan Hartmaier, Katherine Harris, David A Weinstein, Cynthia J Girman

Faculty, Staff and Student Publications

Introduction

Neurodegenerative diseases cause developmental delays and loss of milestones in infants and children. However, scalable outcome measures that quantify features meaningful to parents/caregivers (P/CGs) and have regulatory precedence are lacking for assessing the effectiveness of treatments in clinical trials of neurodegenerative disorders. To address this gap, we developed an innovative, blinded strategy for single-arm trials with external controls using expert panel review of home video.

Method

We identified meaningful, observable, and objective developmental milestones from iterative interviews with P/CGs and clinical experts. Subsequently, we standardized video recording procedures and instructions to ensure consistency in how P/CGs solicited each activity. …

The Need For Space To Plan The Future For Spondyloarthritis, Louise D Mccullough

Faculty, Staff and Student Publications

A new study indicates that although men and women are equally likely to experience cognitive impairment after acute ischaemic stroke, there are sex differences in particular cognitive domains. Whether these differences are directly linked to biological sex is uncertain, as many factors, including age and pre-stroke factors, could contribute to cognitive outcomes.

A Tale Of 2 Tics: Endoscopic Treatment Of Perforated Periampullary Diverticulum Within A Giant Duodenal Diverticulum, Suchapa Arayakarnkul, Ekin Inal, Amit Mehta, Saowanee Ngamruengphong

Faculty, Staff and Student Publications

Periampullary diverticulum presenting with severe complications, such as perforations, is associated with high morbidity and mortality. Traditionally, only surgical or conservative management has been warranted. In this case, we present a 76-year-old woman with a spontaneously perforated periampullary diverticulum, located within a larger duodenal diverticulum, who achieved complete recovery with endoscopic closure after an initial unsuccessful attempt at surgical management. This case report highlights the role of endoscopy in the treatment of complicated diverticulum perforation.

Surface Charge Effects For The Hydrogen Evolution Reaction On Pt(111) Using A Modified Grand-Canonical Potential Kinetics Method, Mihir Patel, Matthias Franzen, Camille D Hawkins, Matthew Brown, Samir Patel

Faculty, Staff and Student Publications

Supraventricular tachycardia (SVT) is the most common tachyarrhythmia of pregnancy. Catecholamine surges, the use of vasoactive agents during delivery, and increased cardiac output during pregnancy are the most common contributing factors to developing SVT. SVT is usually benign in presentation but can lead to more serious arrhythmias in patients with a history of mitral stenosis secondary to rheumatic heart disease. When an SVT is detected, organic heart causes should be ruled out first. Symptoms of SVT include shortness of breath, palpitations, syncope, sweating, chest pain, and dizziness. In patients who are refractory to pharmacologic management and hemodynamically unstable, electrical cardioversion …

Comprehensive Evaluation And New Recommendations In The Use Of Gafchromic Ebt3 Film, Kevin Liu, Patrik Gonçalves Jorge, Ramesh Tailor, Raphaël Moeckli, Emil Schüler

Faculty, Staff and Student Publications

BACKGROUND: Gafchromic film's unique properties of tissue-equivalence, dose-rate independence, and high spatial resolution make it an attractive choice for many dosimetric applications. However, complicated calibration processes and film handling limits its routine use.

PURPOSE: We evaluated the performance of Gafchromic EBT3 film after irradiation under a variety of measurement conditions to identify aspects of film handling and analysis for simplified but robust film dosimetry.

METHODS: The short- (from 5 min to 100 h) and long-term (months) film response was evaluated for clinically relevant doses of up to 50 Gy for accuracy in dose determination and relative dose distributions. The dependence …

Investigate The Possibility Of Using Phosphorescence In Clinical Oncology As An Early Prognostic Test In Detecting Brain Carcinogenesis, Yuriy O Vinnyk, Igor A Kryvoruchko, Valeriy V Boyko, Yulia V Ivanova, Svetlana Gramatiuk, Karine Sargsyan

Faculty, Staff and Student Publications

Phosphorescence is considered one of the non-invasive glioblastoma testing methods based on studying molecular energy and the metabolism of L-tryptophan (Trp) through KP, which provides essential information on regulating immunity and neuronal function. This study aimed to conduct a feasibility study using phosphorescence in clinical oncology as an early prognostic test in detecting Glioblastoma. This study was conducted on 1039 patients who were operated on with follow-up between January 1, 2014, and December 1, 2022, and retrospectively evaluated in participating institutions in Ukraine (the Department of Oncology, Radiation Therapy, Oncosurgery, and Palliative Care at the Kharkiv National Medical University). Method …