Digital Commons Network^™

Middle Meningeal Artery Embolization Does Not Confer Protection Against Symptomatic Recurrence In Patients With Early Antithrombotic Therapy Following Surgery For Chronic Subdural Hematomas, Hussein A Zeineddine, Bryden H Dawes, William W Wroe, Bronson Ciavarra, Salvatore A D'Amato, Hyun Woo Kim, Nimer Adeeb, Gabriel Galan Castro, Michael I Nahhas, Peng Roc Chen, Spiros L Blackburn, Sunil A Sheth, Ching-Jen Chen, Ryan S Kitagawa, Mark J Dannenbaum, Juan Carlos Martinez-Gutierrez

Faculty, Staff and Student Publications

Objective: Middle meningeal artery embolization (MMAE) has emerged as a promising treatment, both as an adjunct to surgery and as a primary treatment for chronic subdural hematoma (cSDH). Here, we evaluate the efficacy of MMAE following surgery in reducing the likelihood of reoperation in patients requiring early introduction of antithrombotics.

Methods: From our prospectively collected registry of patients with cSDH, we identified patients treated with surgical evacuation, either in combination with or without MMAE. Patients were included if they had a clinical indication requiring early antithrombotics within 7 days of surgery. The primary outcome was the rate of reoperation. The …

The Future Of Parkinson’S Care: A Need To Expand Access, Sana Aslam, Anjail Z Sharrief, Samantha K Holden, Michelle Fullard, Jodi S Holtrop, Anna M Maw, Amy W Amara

Faculty, Staff and Student Publications

Parkinson's disease (PD) affects over one million Americans, with prevalence expected to double by 2040, creating rising challenges for healthcare systems. While neurologist-led care, particularly by movement disorder specialists (MDS), is associated with improved patient outcomes, only a small fraction of PD patients access this level of expertise. Many, various, barriers lead to delays or missed opportunities for advanced treatments such as deep brain stimulation and infusion therapies. This Perspective article issues a call to action for improving referral pathways and care coordination in PD, addressing both clinical and systems-level gaps. We propose several pragmatic strategies, including the development of …

Predictors And Outcomes Of Hematoma Expansion And Neurological Decline In Intracerebral Hemorrhage: A Multisite Mobile Stroke Unit Study, Asish K Gulati, Tianwen Ma, Isaiah Rolle, Ryan Peterson, Bianca Pirlog, Justine Chen, Megan Heckathorn, Jonathan Ratcliff, Nicolas Bianchi, Carol Fleming, Michael Frankel, James Grotta, Ritvij Bowry, Stephanie Parker, William Hicks, Digvijaya Navalkele

Faculty, Staff and Student Publications

Background: Hemorrhagic stroke, particularly intracerebral hemorrhage, is one of the leading causes of permanent disability worldwide. Early hematoma expansion (HE) is a key factor in neurological deterioration (ND) and functional outcomes post intracerebral hemorrhage. This observational cohort study examines the predictors and outcomes of HE and ND in spontaneous intracerebral hemorrhage patients using data from 3 Mobile Stroke Units (MSUs) in the United States.

Methods: Patients diagnosed with spontaneous intracerebral hemorrhage within 4 hours of last known well were included. Data collection involved initial and follow-up non-contrast (computerized tomography) CT scans from MSUs and emergency departments, from which the rate …

Editorial: Understanding The Mechanism Of Dynamic Cell Communications: A Much Needed Angle For Cell Motility And Barrier Functions, Virag Vas, Zhen Xu, Pasquale Cervero

Faculty, Staff and Student Publications

No abstract provided.

Intrapartum Glycemic Control And Clinical Outcomes, Ghamar Bitar, Michal Fishel Bartal

Faculty, Staff and Student Publications

Current recommendations encourage strict intrapartum glycemic control for individuals with diabetes in pregnancy to optimize maternal and neonatal outcomes. However, established evidence is limited in providing a strong association between strict maternal blood glucose control and neonatal outcomes.

Helping Everyone Achieve A Lifetime Of Health - Future Addiction Scientist Training Program Outcomes, Asfand B Moosa, Christina M Segura, Ammar D Siddiqi, Hinal Patel, Tzuan A Chen, Anastasia Rogova, Marcy Zere, Ezemenari M Obasi, Lorraine R Reitzel

Faculty, Staff and Student Publications

Objectives: Addiction to alcohol, tobacco, and/or other drugs (ATOD) remains a leading cause of cancer and a contributor to diabetes and cardiovascular diseases, disproportionately affecting marginalized and minoritized groups. Social and structural inequities including limited healthcare access, employment instability, inadequate housing, and environmental stressors increase these risks. A diverse scientific workforce is necessary to mitigate ATOD-related health disparities; yet underrepresentation persists in ATOD research. Helping Everyone Achieve a LifeTime of Health-Future Addiction Scientist Training (HEALTH-FAST) is a NIDA funded research education program that aims to reduce ATOD-related disparities by training future scholars in addiction science and health equity.

Methods: From …

New Anhydramnios After 22 Weeks And Pulmonary Hypoplasia, Aaron W Roberts, Margaret Clement, Suzanne Marie Lopez, Rita Swinford, Percy Pacora Portella, Edgar Hernandez-Andrade, Matthew Rysavy, Anthony Johnson

Faculty, Staff and Student Publications

Introduction: Anhydramnios due to renal failure prior to 22 weeks of gestational age (WGA) is associated with lethal pulmonary hypoplasia but after 22 WGA outcomes are less clear. We evaluated whether these fetuses, with new anhydramnios after 22 WGA, incur significant risk of severe neonatal pulmonary morbidity.

Methods: This retrospective study of singleton pregnancies diagnosed with new-onset renal anhydramnios after 22 WGA following verifiable normal AFI on ultrasound before 22 WGA from 2021 to 2023. Cases with bilateral renal agenesis, premature rupture of membranes, and nonrenal malformations were excluded.

Results: During the study period 53,698 s trimester ultrasound examinations were …

Palliative Care In Acute Care Surgery: Research Challenges And Opportunities, Amelia W Maiga, Vanessa Ho, Rachel S Morris, Lisa M Kodadek, Thaddeus J Puzio, Gail T Tominaga, Masami Tabata-Kelly, Zara Cooper

Faculty, Staff and Student Publications

Palliative care includes effective communication, relief of suffering and symptom management with an underlying goal of improving the quality of life for patients with serious illness and their families. Best practice palliative care is delivered in parallel with life-sustaining or life-prolonging care. Palliative care affirms life and regards death as a normal process, intends neither to hasten death nor to postpone death and includes but is not limited to end-of-life care. Palliative care encompasses both primary palliative care (which can and should be incorporated into the practice of acute care surgery) and specialty palliative care (consultation with a fellowship-trained palliative …

Latent Classes Of Adolescent Trauma Exposure, Posttraumatic Stress Disorder Symptoms, And Substance Use Predict Clinical Diagnoses At 12-Month Follow-Up, John Leri, Josh M Cisler, Shaunna L Clark, Cody G Dodd, Saman Siddiqui, Leslie Taylor, Alexa Ayala, Sunita Stewart, Robyn Richmond, Jeffrey D Shahidullah, Justin F Rousseau, John M Hettema, D Jeffrey Newport, Karen D Wagner, Charles B Nemeroff

Faculty, Staff and Student Publications

BACKGROUND: Trauma exposure, posttraumatic stress disorder (PTSD), and substance use commonly co-occur among youth. Identifying specific subgroups of youth based on unique constellations across these domains may provide a novel way to identify and target youth at prospective risk for specific types of negative clinical outcomes.

METHODS: Trauma exposed youth completed structured clinical assessments as part of a longitudinal study (

RESULTS: Four latent classes were identified which differentiated participants based on the type of trauma exposure, the number of PTSD symptoms endorsed, and the propensity to be engaged in polysubstance use. Latent classes which were characterized by exposure to …

Risk Factors For Diagnostic Change From Glaucoma Suspect To Primary Open-Angle Glaucoma And Vice Versa Over 2 Years, Lillian K To, Nicole V Carrabba, Chaitanya G Kalathuru, Alice Z Chuang, Logan Smith, Robert M Feldman

Faculty, Staff and Student Publications

Objective: This study investigates the incidence and causes of diagnostic changes from primary open-angle glaucoma suspect (POAGS) to primary open-angle glaucoma (POAG), and vice versa, in clinical practice.

Design: This is a retrospective, single-site, case-control study.

Participants: It includes patients > 40 years of age diagnosed with either POAG or POAGS between 2013 and 2020. Controls had a minimum of 24 months of follow-up without a diagnostic change, whereas cases underwent a diagnostic change from glaucoma to suspect (POAG to POAGS) or from suspect to glaucoma (POAGS to POAG) within 2 years.

Methods: At initial and follow-up visits, diagnosis, treatment, type …

Serum Metabolome Profiling In Patients With Mild Cognitive Impairment Reveals Sex Differences In Lipid Metabolism, Rocio Diaz Escarcega, Vijay Kumar M J, Vasilia E Kyriakopoulos, Guadalupe J Ortiz, Aaron M Gusdon, Huihui Fan, Pedram Peesh, Maria P Blasco Conesa, Gabriela Delevati Colpo, Hilda W Ahnstedt, Lucy Couture, Stella H Kim, Miriam Hinojosa, Christine M Farrell, Sean P Marrelli, Akihiko Urayama, Bhanu P Ganesh, Paul E Schulz, Louise D Mccullough, Andrey S Tsvetkov

Faculty, Staff and Student Publications

Alzheimer's disease (AD) affects more women than men. Although women live longer than men, it is not longevity alone, but other factors, including metabolic changes, that contribute to the higher risk of AD in women. Metabolic pathways have been implicated in AD progression, but studies to date examined targeted pathways, leaving many metabolites unmeasured. Sex is often a neglected biological variable, and most metabolomic studies were not designed to investigate sex differences in metabolomic profiles. Here, we performed untargeted metabolomic profiling of sera from male and female patients with mild cognitive impairment (MCI), a common precursor to AD, and matched …

The Deceleration Dilemma: Leveraging The Relationship Between Quadriceps Function And Deceleration To Optimize Return To Sport, Steven Higbie, Christopher Gallina, Russ Paine, Lane Bailey, Walter R Lowe

Faculty, Staff and Student Publications

Decelerations frequently occur during sport and are often associated with non-contact knee injury mechanisms. Though decelerations place a high eccentric demand on the quadriceps, little is known about the relationship between quadriceps function and deceleration performance. Traditional functional testing batteries often over-estimate quadriceps function and lack assessments of deceleration performance, while current deceleration testing is often heavily reliant on technology and performed at shallow angles. The purpose of this clinical commentary is to describe the relationship between deceleration and quadriceps function, suggest two clinical tests to assess deceleration performance, and provide exercise suggestions for improving deceleration performance. The authors believe …

Impact Of Preoperative And Residual Alpha Angle On Outcomes After Hip Arthroscopy, Jasmine Puria, Daniel Puczko, Christopher S Frey, James L Rogers, Alicia M Hymel, Candler G Mathews Iii, Thomas M Spears, Jaron Paul Sullivan

Faculty, Staff and Student Publications

Purpose: Femoroacetabular impingement syndrome (FAIS) can lead to pain, decreased mobility, and difficulty in performing activities of daily living. Symptoms can improve with surgery, often hip arthroscopy with osteoplasty. Radiological parameters such as the alpha angle can be utilized to determine the degree of cam morphology and assess resection after surgery. This study sought to evaluate the relationship between pre-operative alpha angle and the change in alpha angle on patient satisfaction post-surgical correction using the 12-item International Hip Outcome Tool (iHOT-12).

Patients and methods: Patients that underwent primary or revision hip arthroscopy with osteoplasty for FAIS by a single fellowship-trained …

Analyzing Practice Pattern In Treating Partial-Thickness Rotator Cuff Tears: A Dual Perspective From National Database And American Shoulder And Elbow Surgeons Parcial Research Group, H Mike Kim, Emily Leary, Champ L Baker, Leslie A Barnes, R Alexander Creighton, Frances Cuomo, Matthew J Dipaola, Abdullah Foad, James M Gregory, Brian F Grogan, Scott G Kaar, Eitan M Kohan, Sumant G Krishnan, Eddie Y Lo, John T Moor, Parcial Group Contributors

Faculty, Staff and Student Publications

Background: Partial-thickness rotator cuff tears (PTRCTs), often considered less severe than full-thickness rotator cuff tears (FTRCTs), can be equally symptomatic. Despite the prevalence of PTRCTs, scholarly attention has predominantly focused on FTRCTs, resulting in a relative neglect of PTRCTs. This study aimed to assess the incidence of surgical repairs for PTRCTs in the United States (U.S.) using the Nationwide Ambulatory Surgery Sample (NASS) database and delineate practice patterns among a group of American Shoulder and Elbow Surgeons (ASES) members.

Methods: The NASS database, representing approximately 67% of U.S. ambulatory surgical encounters, was queried to obtain the incidence of PTRCT and …

Information Seeking Behaviors And Attitudes Of Wives Of Former Football Players Regarding Chronic Traumatic Encephalopathy, Summer D Ott, Sukhnandan K Cheema, Alexa Ryder, Philip Schatz, Lorie A Gonzalez, Jecenia Duran, Paul E Schulz

Faculty, Staff and Student Publications

This study examines CTE-related knowledge and information-seeking behaviors of caregivers of persons who are at high risk of CTE. Online survey responses were collected from 64 females, ages 18-74, who were married to former college, semiprofessional, or professional football players and were fluent in English. Ranging from 0 to 18, a score was calculated to represent level of CTE knowledge. Participants were classified into groups based on their spouse's reported symptoms and diagnosis. Approximately 87% of participants reported that their spouses have been diagnosed with a football-related concussion and were significantly more likely to seek out information from a healthcare …

Professional Baseball Pitchers Use Of Weighted Ball Training, Injury Incidence, And Time Loss: A Preliminary Study, Ellen Shanley, Thomas J Noonan, Michael J Kissenberth, Daniel Kline, Charles A Thigpen, Garrett S Bullock

Faculty, Staff and Student Publications

Background: Little is known about the injury risk associated with weighted ball use by professional baseball pitchers. The purpose of this study was to describe weighted ball training and injuries and compare injury rates between those professional pitchers using weighted ball training and those that did not use weighted ball training during the 2023 pre- and regular season.

Methods: This study, intended as a multi-year project, serves as an interim safety analysis after one year of follow up. Pitchers underwent routine physical examination and injury screening and were surveyed about their use of weighted baseball training. Throughout spring training and …

Using Content Validity Index Methodology For Cross-Cultural Translation Of A Patient-Reported Outcome Measure For Head And Neck Cancer, Janet H Van Cleave, Alizendie Guerra, Eva Liang, Carolina Gutiérrez, Ron J Karni, Marcely Tsikis, Geanise Pearl C Nguyen, Allison P Squires

Faculty, Staff and Student Publications

Introduction: Translations of patient-reported measures may not account for structural and cultural differences in shared languages spoken in multiple countries, such as English, Spanish, Arabic, or Russian. The objective of this research was to create a cross-cultural Spanish translation of the New York University (NYU) Electronic Patient Visit Assessment (ePVA)© for head and neck cancer (HNC), a patient-reported symptom measure available only in English.

Methods: Using the Content Validity Index (CVI) methodology, an expert panel of nurses (n = 6) proficient in Spanish and English independently reviewed and rated a forward translation of the ePVA, a measure consisting of …

Transnasal Humidified Rapid Insufflation Ventilatory Exchange (Thrive) For The Operative Management Of Retrograde Cricopharyngeus Dysfunction, Amy B Leming, Dylan G Vance, Andrew G Tritter, Zao Mike Yang

Faculty, Staff and Student Publications

Objective: Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is a method of apneic oxygenation gaining popularity in upper aerodigestive surgery. Retrograde cricopharyngeus muscle dysfunction (RCPD) is characterized by the inability to belch, managed by intraoperative injection of botulinum toxin to the cricopharyngeus muscle (CPBI), often performed under general anesthesia with endotracheal intubation. We sought to assess the safety and efficacy of THRIVE when performing CPBI for RCPD.

Study design: We conducted a retrospective review of adult RCPD patients undergoing CPBI under general anesthesia with THRIVE.

Setting: The study was conducted at both the University of Texas Health Science Centers in …

Sarcomatoid Carcinoma Arising In The Gallbladder Of A 58-Year-Old Female: Case Report, Ahmed A Ahmed, Yan Gao, Rossana Kazemimood

Faculty, Staff and Student Publications

Sarcomatoid carcinoma of the gallbladder is a rare malignancy with no specific clinical manifestation. It is characterized by the presence of malignant epithelial and mesenchymal components intermingled with each other. This disease usually presents at an advanced stage, and its final diagnosis needs to be confirmed by histopathological and immunohistochemical examination. Sarcomatoid carcinoma is characterized by early metastasis through lymphatics, rapid progression, a high recurrence rate, and a worse prognosis than usual gallbladder adenocarcinoma. Herein, we report the case of a 58-year-old female patient, who underwent laparoscopic cholecystectomy, with sarcomatoid carcinoma of the gallbladder. Histologically, the epithelial component of the …

Molecular, Histologic, And Clinical Characterization Of Methylation Class Pleomorphic Xanthoastrocytoma: An Analysis Of 469 Tumors, Christopher H Dampier, Niharika Shah, Kristyn Galbraith, Azadeh Ebrahimi, Osorio Lopes Abath Neto, Zied Abdullaev, Sanda Alexandrescu, Felipe Andreiuolo, Terri Armstrong, Tiffany Baker, Sahara Cathcart, Hye-Jung Chung, Patrick J Cimino, Kyle S Conway, Jennifer Cotter, Felipe D'Almeida Costa, Karen Dazelle, Nima Etminam, Sima Esther Ferman, Igor Fernandes, Christina K Ferrone, Ahmed Gilani, Mark Gilbert, Jason Gregory, Courtney Ketchum, Han Sung Lee, Ina Lee, Maria Beatriz S Lopes, Qinwen Mao, Michael S Marshall, Matthew Mccord, Stewart G Neill, Jeffrey J Nirschl, Byram H Ozer, Werner Paulus, Marta Penas-Prado, Marco Prinz, Peter Pytel, Martha Quezado, Mark Raffeld, Sharika Rajan, Miriam Ratliff, Guido Reifenberger, Lorraina Robinson, Jens Schittenhelm, Daniel Schrimpf, Omkar Singh, Christian Thomas, Diana Thomas, Jaiyeola Thomas-Ogunniyi, Angus Toland, Rust Turakulov, Rachael Vaubel, Nitin Wadhwani, Jing Wu, Caterina Giannini, Matija Snuderl, Sebastian Brandner, Andreas Von Deimling, Kenneth Aldape

Faculty, Staff and Student Publications

Background: Methylation class pleomorphic xanthoastrocytoma (mcPXA) comprises tumors with the DNA methylation signature of classical PXA but with a wider histologic spectrum, including overlap with glioblastoma (GBM).

Methods: To clarify the histologic and molecular scope of mcPXA and characterize its clinical behavior, a cohort of 469 tumor samples from 458 patients matching to mcPXA by the DKFZ classifier (v12.6 score ≥0.85) was interrogated.

Results: Patient median age was 23 years (range 1-73 years) with a female predominance (259 female/199 male). CDKN2A/B homozygous deletion was observed in 406 of 469 (87%) samples. In samples tested for BRAF p.V600E mutations (n …

Safety Of Indocyanine Green Microdosing For Clinical Imaging Of Csf Ventricular Dynamics And Extracranial Outflow, Miriam Zamorano, Banghe Zhu, Ahmed T Massoud, Jonathan Hendricks, H Alex Choi, Pedram Peesh, Brandon A Miller, Xinhai Robert Zhang, Manish N Shah, Eva M Sevick-Muraca

Faculty, Staff and Student Publications

Background and purpose: Intravenous administration of indocyanine green (ICG) has been approved in brain surgeries for decades, yet concerns about neurotoxicity prevent its direct administration into the cerebrospinal fluid (CSF). Armed with prior animal studies demonstrating the feasibility of using ICG microdosing into the CSF, we sought to evaluate its nonclinical safety profile and obtain surrogate measures in adults prior to its use in human neonates.

Methods: Evaluation of ICG toxicity was conducted in mixed primary CNS cell cultures and in an extended safety study of juvenile rat pups deploying intraventricular injections of saline (as control) or ICG. Analysis of …

Advancing Randomized Clinical Trials In Surgery: Role Of Exception From Informed Consent, Central Institutional Review Board, And Bayesian Approaches, Amelia W Maiga, Rebecca A Snyder, Lillian S Kao, Mehul V Raval, Mayur B Patel, Martin L Blakely

Faculty, Staff and Student Publications

No abstract provided.

Neutrophils Unveiled In Chronic Lymphocytic Leukemia, Sheighlah Mcmanus, Priyanka Khare, Maria Teresa S Bertilaccio

Faculty, Staff and Student Publications

This review explores neutrophils' roles in chronic lymphocytic leukemia (CLL), highlighting their functions within the immune system. While neutrophils are known for fighting infections, their altered behavior in CLL significantly impacts disease progression. This review notes the reduced phagocytic abilities of neutrophils and the increased formation of neutrophil extracellular traps (NETs) in patients with CLL. It also examines the effects of CLL treatments, including chemotherapy, immunotherapy and targeted therapies, on neutrophils' count and function, stressing the need for improved strategies to manage therapy-induced immune dysfunction. This review also provides detailed information about the interactions between neutrophils and other immune elements …

Microbial Imprints On Colorectal Cancer: The Epigenetic Silencing Of Phlpp1 As A Prognostic Nexus, Xiangsheng Huang, Faraz Bishehsari

Faculty, Staff and Student Publications

No abstract provided.

Editorial: Protein Regulation By Lipids, Mikhail V Bogdanov, Elena G Govorunova

Faculty, Staff and Student Publications

No abstract provided.

Micrornas As Key Regulators Of Cancer Drug Resistance: Insights And Future Directions In Chemotherapy, Targeted-Therapy, Radiotherapy, And Immunotherapy, Michael Attathikhun, Ancuta Jurj, George A Calin

Faculty, Staff and Student Publications

Cancer therapy remains an active field of investigation, particularly in understanding and overcoming therapy resistance. Small non-coding RNAs, such as microRNAs (miRNAs), are emerging as key regulators of cancer survival, progression, proliferation, invasion, migration, and metastasis. Although many studies have linked miRNAs to cancer therapy outcomes, significant questions remain regarding their precise molecular and cellular roles in therapy resistance. Increasing evidence shows that miRNAs influence critical pathways such as apoptosis, immune evasion, and other signaling cascades. However, there have been many setbacks because of the limitations in knowledge of each specific miRNA's function. A deeper understanding of miRNA expression and …

Disulfidptosis And Its Emerging Relevance In Cancer And Immunity, Qidong Li, Shengrong Wu, Li Zhuang, Boyi Gan

Faculty, Staff and Student Publications

Disulfidptosis is a recently identified form of regulated cell death (RCD) triggered by disulfide stress when cystine uptake via solute carrier family 7 member 1 (SLC7A11) overwhelms the cell's reducing capacity. Unlike apoptosis or other "cell suicide" pathways, disulfidptosis likely represents a "cell sabotage" mechanism, defined by aberrant disulfide bonding and catastrophic actin cytoskeleton collapse. In this Perspective, we examine the paradoxical role of SLC7A11 as both a ferroptosis protector and a disulfidptosis trigger, and the mechanistic hallmarks of disulfidptosis. We highlight emerging therapeutic strategies to target disulfidptosis in cancer, including glucose transporter inhibition, redox-targeting agents, and nanomaterial-based approaches, and …

Racial And Ethnic Disparities In Longitudinal Trajectories Of Cardiovascular Risk Factors In Us Middle-Aged And Older Adults, Matthew E Dupre, Radha Dhingra, Hanzhang Xu, Scott M Lynch, Qing Yang, Cassie Ford, Michael D Green, Ying Xian, Ann Marie Navar, Eric D Peterson

Faculty, Staff and Student Publications

Background: Racial and ethnic disparities in cardiovascular disease (CVD) risk factors are well-documented. However, racial and ethnic differences in the longitudinal changes among multiple CVD risk factors are unknown.

Methods: We used prospective cohort data of U.S. adults aged ≥50 in the 2006-2016 Health and Retirement Study. Group-based multi-trajectory models characterized age-related trajectories of systolic blood pressure ([BP] mmHg), non-HDL cholesterol (mg/dL), diabetes mellitus (DM), and smoking. Racial and ethnic differences in the multi-trajectory profiles were examined using multinomial logistic regression. Karlson-Holm-Breen methods were used to assess factors contributing to these associations.

Results: Among 10,292 participants (median age: 61), approximately …

Case Report: Successful Delivery Following Chemotherapy In A Pregnant Patient With Metastatic Smarcb1-Deficient Renal Medullary Carcinoma, Panayiotis D Kontoyiannis, Adam Kuykendal, Chad Tang, Jessica P Cheng, Beei Chan, Susan S Thomas, Priya Rao, Bora Lim, Pavlos Msaouel

Faculty, Staff and Student Publications

SMARCB1-deficient renal medullary carcinoma (RMC) is a rare and aggressive kidney cancer defined by the loss of SMARCB1 tumor suppressor and primarily affecting adolescents and young adults with sickle hemoglobinopathies. Approximately 7% of RMC cases, known as renal cell carcinoma unclassified with medullary phenotype (RCCU-MP), lack sickle hemoglobinopathy. RMC does not respond to immune checkpoint inhibitors and antiangiogenic tyrosine kinase inhibitors, with chemotherapy being the main treatment. Here we present the first documented case of RMC diagnosed during pregnancy. A 24-year-old woman presented with right-sided back pain, leading to the discovery of a 6-cm right renal mass. Pathology confirmed RCCU-MP …

Comb-Boin12: A Utility-Based Bayesian Optimal Interval Design For Dose Optimization In Cancer Drug-Combination Trials, Mengyi Lu, Jingyi Zhang, Ying Yuan, Ruitao Lin

Faculty, Staff and Student Publications

Drug combinations are increasingly utilized in cancer treatment to enhance drug effectiveness through synergistic therapeutic effects. However, determining the optimal biological dose combination (OBDC) in small-scale drug combination trials presents challenges due to the increased complexity of the dose space. To effectively optimize the dose combination of combined drugs, we propose a model-assisted design by extending the single-agent Bayesian optimal interval phase I/II (BOIN12) design. Our approach incorporates a utility function to balance the trade-off between risk and benefit and directly models the utility of each dose by constructing a quasi-beta-binomial model. A key advantage of our design is the …