Digital Commons Network^™

Invasive Fungal Disease In Solid Organ And Hematopoietic Cell Transplant Recipients, United States, Jeremy A W Gold, Kaitlin Benedict, Elizabeth Sajewski, Tom Chiller, Meghan Lyman, Mitsuru Toda, Jessica S Little, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Background: Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.

Methods: We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.

Results: Overall, 9143 patients received …

Trends In Contacts Made By Immigrants To The National Domestic Violence Hotline, Before And During The Covid-19 Pandemic, Sarah Treves-Kagan, Vi D Le, Liris S Berra, Colleen M Ray, Yanet Ruvalcaba, Leila Wood, Denise V D'Angelo, Tatiana M Vera, Lianne Fuino Estefan

Faculty, Staff and Student Publications

Objectives: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic.

Methods: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as …

Home-Based Transcranial Direct Current Stimulation Treatment For Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 …

Semi-Quantitative Assessment Of Surgical Navigation Accuracy During Endoscopic Sinus Surgery In A Real-World Environment, David Z Allen, Jason Talmadge, Martin J Citardi

Faculty, Staff and Student Publications

Introduction: Although surgical navigation is commonly used in rhinologic surgery, data on real world performance are sparse because of difficulties in collecting measurements for target registration error (TRE). Despite publications showing submillimeter TRE, surgeons do report TRE of >3 mm. We describe a novel method for assessing TRE during surgery and report findings with this technique.

Methods: The TruDi navigation system (Acclarent, Irving, CA) was registered using a contour-based protocol. The surgeon estimated target registration error (e-TRE) at up to 8 points (anatomic regions of interest [ROI]) during endoscopic sinus surgery (ESS). System logs were used to simulate the localization …

Efficacy And Safety Of Once-Daily Roflumilast Cream 005% In Pediatric Patients Aged 2-5 Years With Mild-To-Moderate Atopic Dermatitis (Integument-Ped): A Phase 3 Randomized Controlled Trial, Lawrence F Eichenfield, Rocco Serrao, Vimal H Prajapati, John C Browning, Lisa Swanson, Tracy Funk, Mercedes E Gonzalez, Adelaide A Hebert, Mark Lee, Mark Boguniewicz, Eric L Simpson, Melissa S Seal, David Krupa, Diane Hanna, Scott Snyder, Patrick Burnett, David H Chu, Erin Almaraz, Robert C Higham, David R Berk

Faculty, Staff and Student Publications

Background/objectives: Efficacy and safety of roflumilast cream 0.15% were demonstrated in patients aged ≥ 6 years with atopic dermatitis (AD) in two Phase 3 trials. This Phase 3 parallel-group, double-blind trial (INTEGUMENT-PED; NCT04845620) compared the efficacy and safety of roflumilast cream 0.05% and a vehicle in patients aged 2-5 years with AD.

Methods: Patients aged 2-5 years with mild-to-moderate AD were treated with once-daily roflumilast cream 0.05% or vehicle for 4 weeks. The primary efficacy endpoint was Validated Investigator Global Assessment for AD (vIGA-AD) Success (0 [Clear] or 1 [Almost Clear] plus ≥ 2-grade improvement from baseline) at Week …

Predictors For Spontaneous Pleurodesis In Patients With Indwelling Pleural Catheters For Malignant Pleural Effusion: A Safety Net Hospital Experience, Saad Farooq, Sabiha Armin, Jordan E Killingsworth, Akriti Agrawal, Adishwar Rao, Rosa M Estrada-Y-Martin, Sujith V Cherian

Faculty, Staff and Student Publications

Background: Malignant pleural effusion (MPE) affects approximately 150,000 patients in the United States each year and usually signifies advanced-stage cancer. The optimal treatment remains a challenge but indwelling pleural catheters (IPC) offer several advantages and may help achieve spontaneous pleurodesis (SP) in some patients.

Objectives: We aim to investigate the predictors of SP among patients with MPE, particularly in a resource-limited community-based safety net hospital.

Design: This is a retrospective cohort study done at a community-based safety net hospital.

Methods: Adults diagnosed with or suspected of having MPE between January 2015 and December 2023 who underwent IPC placement were included. …

Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Pilot Infection Control Lecture Series, Kayla E Ruch, Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, Eric L Brown

Faculty, Staff and Student Publications

Introduction: The Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI's Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.

Methods: Data from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to …

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 …

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 …

Effect Of Palatoplasty Technique On Otologic Outcomes In Children With Cleft Palate, Shaina W Gong, Paul Hung, Chioma G Obinero, Jose Barrera, Zi Yang Jiang, Matthew R Greives, Zhen Huang

Faculty, Staff and Student Publications

Background: In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.

Objective: We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.

Methods: A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic …

The Symptom Burden Of Women With A Known Risk Of Breast Cancer Receiving Risk Reducing Medication, Meagan S Whisenant, Jessica Treviño Jones, Anneliese O Gonzalez, Therese Bartholomew Bevers, Kelly Brassil, Darcy A Ponce, Sharvari Kamat, Emily Solis, Ann Maliackal, Hannah Warlick, Amie Walters, Chloe Denham, Loretta A Williams

Faculty, Staff and Student Publications

Background: For the estimated 10 million women in the United States who meet the high-risk criteria for breast cancer, evidence-based interventions may reduce the risk of breast cancer by 50-65 %. Even with substantial evidence supporting preventive medication for risk reduction, there is significant lack of uptake and adherence. The purpose of this study was to characterize the experience of women at high risk for breast cancer and define the content domain for a patient-reported outcomes (PRO) measure of symptom burden from breast cancer risk and risk reducing medication.

Methods: Thirty women at high risk for breast cancer and receiving …

Changes In Medication Complexity And Post-Hospitalization Outcomes In Older Adults Hospitalized For Heart Failure, Aayush Visaria, William Mcdonald, John Mancini, Andrew P Ambrosy, Min Ji Kwak, Ashkan Hashemi, Mark S Lachs, Andrew R Zullo, Monika Safford, Emily B Levitan, Parag Goyal

Faculty, Staff and Student Publications

Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

Methods: This retrospective cohort study included Reasons for Geographic and Racial Differences in Stroke (REGARDS) participants aged at least 65 years hospitalized for heart failure between 2003 and 2014. We calculated changes between hospital admission and discharge in medication count (Δcount) and …

National Landscape Of Underrepresented In Medicine Visiting Medical Student Programs In Pediatrics, Tyler K Smith, Rebecca Blankenburg, Ann E Burke, Emma A Omoruyi, Wendla Sensing, Tiffany Ruan, David D Williams, Onyi Oligbo, Lahia Yemane

Faculty, Staff and Student Publications

Objective: Underrepresented in medicine visiting medical student programs (UIM-VMSPs) have gained popularity across specialties as an intervention to diversify residency programs; however, no study has explored the national landscape of these programs in pediatrics. This study aimed to characterize program components, residency rank and match outcomes, benefits, challenges, and lessons learned about UIM-VMSPs in pediatrics nationally.

Methods: From September to December 2023, the authors conducted a national, cross-sectional, mixed methods study surveying program leaders of UIM-VMSPs identified on the Association of Pediatric Program Directors website. The authors used descriptive statistics to analyze the data and conventional content analysis for free-text …

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 …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …

Consistent Frontal-Limbic-Occipital Connections In Distinguishing Treatment-Resistant And Non-Treatment-Resistant Schizophrenia, Yijie Zhang, Shuzhan Gao, Chuang Liang, Juan Bustillo, Peter Kochunov, Jessica A Turner, Vince D Calhoun, Lei Wu, Zening Fu, Rongtao Jiang, Daoqiang Zhang, Jing Jiang, Fan Wu, Ting Peng, Xijia Xu, Shile Qi

Faculty, Staff and Student Publications

Background and hypothesis: Treatment-resistant schizophrenia (TR-SZ) and non-treatment-resistant schizophrenia (NTR-SZ) lack specific biomarkers to distinguish from each other. This investigation aims to identify consistent dysfunctional brain connections with different atlases, multiple feature selection strategies, and several classifiers in distinguishing TR-SZ and NTR-SZ.

Study design: 55 TR-SZs, 239 NTR-SZs, and 87 healthy controls (HCs) were recruited from the Affiliated Brain Hospital of Nanjing Medical University. Resting-state functional connection (FC) matrices were constructed from automated anatomical labeling (AAL), Yeo-Networks (YEO) and Brainnetome (BNA) atlases. Two feature selection methods (Select From Model and Recursive Feature Elimination) and four classifiers (Adaptive Boost, Bernoulli Naïve …

Peer Support During In Vivo Exposure Homework Increases Likelihood Of Prolonged Exposure Therapy Completion, Melba A Hernandez-Tejada, Madeline J Bruce, Wendy Muzzy, Anna Birks, Giovanni Macedo E Cordeiro, Stephanie M Hart, Stephanie Hamski, Ron Acierno

Faculty, Staff and Student Publications

Exposure-based treatments such as prolonged exposure therapy (PE) are effective for veterans with PTSD. However, dropout rates as high as 50% are common. The Department of Veterans Affairs employs peers to increase mental health treatment engagement, however peers are not routinely used to help patients complete PE homework assignments. The present study included 109 veterans who decided to drop out from exposure-based treatment after completing seven or fewer sessions and used a randomized controlled design to compare PE treatment completion rates in response to 2 forms of peer support: (1) standard weekly telephone-based peer support vs. (2) peer-assisted in vivo …

Exploring The Role Of Reward Functioning In The Overlap Of Post-Traumatic Stress And Cocaine Use Disorder, Kate Hull, Hanaan Bing-Canar, Krista Miloslavich, Christopher Holden, Aneet Ahluwalia, Scott D Lane, Joy M Schmitz, Margaret C Wardle

Faculty, Staff and Student Publications

Background: Posttraumatic stress disorder (PTSD) symptoms are common in people with cocaine use disorder (CUD), and even sub-threshold PSTD symptoms result in worse treatment outcomes. Difficulties with reward functioning may drive this comorbidity. Impairments in reward functioning are prominent in both PTSD and CUD and contribute to development of substance use problems after trauma. There are three distinct reward processes that may be involved in the PTSD/CUD overlap: consummatory reward (ability to experience pleasure), motivational reward (willingness to exert effort for rewards), and reward learning (adapting behavior based on reward history). Here we test whether impairments in these reward functions …

Consolidation Alk Tyrosine Kinase Inhibitors Versus Durvalumab Or Observation After Chemoradiation In Unresectable Stage Iii Alk-Positive Nsclc, Amin H Nassar, Ritujith Jayakrishnan, Jamie Feng, Frances Shepherd, Elio Adib, Justin M Cheung, Jessica J Lin, Yufei Liu, Steven H Lin, Kaushal Parikh, Arthi Sridhar, Purnima Shakya, Thomas J Dilling, David Kaldas, Jhanelle E Gray, Anastasiya Lobachov, Jair Bar, Heike Luders, Christian Grohe, Shruti Gupta, Ticiana Leal, Bailey Fitzgerald, Fionnuala Crowley, Yu Fujiwara, Thomas U Marron, Molly Wilgucki, Joshua Reuss, Luxi Chen, Kamya Sankar, Jacqueline V Aredo, Joel W Neal, Heather A Wakelee, Rohit Thummalapalli, Helena Yu, Ryan Whitaker, Ana Velazquez, Meera Ragavan, Alessio Cortellini, David J Kwiatkowski, Abdul Rafeh Naqash, Sarah B Goldberg, So Yeon Kim

Faculty, Staff and Student Publications

Introduction: Patients with advanced ALK-positive NSCLC typically have poor response to immunotherapy; the benefit of consolidation durvalumab in patients with unresectable stage III ALK-positive NSCLC remains unclear. Herein, we compare the efficacy and safety of consolidation ALK tyrosine kinase inhibitor (TKI) versus durvalumab or observation after concurrent chemoradiation.

Methods: We conducted a retrospective study using a multicenter study of 17 institutions globally. Patients with unresectable stage III ALK-positive NSCLC treated between 2015 and 2022 were included. Patients received ALK TKI, durvalumab, or observation after concurrent chemoradiation. Real-world progression-free survival (rwPFS) and overall survival (OS) were estimated using Kaplan-Meier method. Treatment-related …

Combining Biology-Based And Mri Data-Driven Modeling To Predict Response To Neoadjuvant Chemotherapy In Patients With Triple-Negative Breast Cancer, Casey E Stowers, Chengyue Wu, Zhan Xu, Sidharth Kumar, Clinton Yam, Jong Bum Son, Jingfei Ma, Jonathan I Tamir, Gaiane M Rauch, Thomas E Yankeelov

Faculty, Staff and Student Publications

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype associated with limited targeted treatment options, heterogeneous treatment response, and high risk of early recurrence. Artificial intelligence (AI) has rapidly emerged as a powerful tool to address key clinical challenges in TNBC across diagnosis, treatment response assessment, and prognosis. Diagnostic and staging challenges persist due to variable imaging features in TNBC and limitations in conventional modalities, increasing the risk of delayed detection. Predicting response to neoadjuvant systemic therapy remains difficult, as patient responses are heterogeneous, and existing clinical markers provide limited early predictive value. Prognostication in TNBC is similarly constrained …

Accumulated Seizure Burden Predicts Neurodevelopmental Outcome At 36 Months Of Age In Patients With Tuberous Sclerosis Complex, S Katie Z Ihnen, Samuel Alperin, Jamie K Capal, Alexander L Cohen, Jurriaan M Peters, E Martina Bebin, Hope A Northrup, Mustafa Sahin, Darcy A Krueger

Faculty, Staff and Student Publications

Objective: Epilepsy and intellectual disability are common in tuberous sclerosis complex (TSC). Although early life seizures and intellectual disability are known to be correlated in TSC, the differential effects of age at seizure onset and accumulated seizure burden on development remain unclear.

Methods: Daily seizure diaries, serial neurodevelopmental testing, and brain magnetic resonance imaging were analyzed for 129 TSC patients followed from 0 to 36 months. We used machine learning to identify subgroups of patients based on neurodevelopmental test scores at 36 months of age and assessed the stability of those subgroups at 12 months. We tested the ability of …

Real-World Outcomes Of Upfront Autologous Hematopoietic Stem Cell Transplantation In Patients With Newly Diagnosed Multiple Myeloma With Deletion 17p, Curtis Marcoux, Oren Pasvolsky, Denái R Milton, Mark R Tanner, Qaiser Bashir, Samer Srour, Neeraj Saini, Paul Lin, Jeremy Ramdial, Yago Nieto, Guilin Tang, Hans C Lee, Krina K Patel, Partow Kebriaei, Amna Ahmed, Yosra Aljawai, Sheeba K Thomas, Robert Z Orlowski, Elizabeth J Shpall, Richard E Champlin, Muzaffar H Qazilbash

Faculty, Staff and Student Publications

Despite tremendous advancements in multiple myeloma (MM) therapeutics, outcomes remain heterogeneous, heavily influenced by clinical and cytogenetic factors. Among these, deletion of the short arm of chromosome 17 (del(17p)) is a strong predictor of poor prognosis. The aim of this study was to evaluate real-world outcomes in patients with newly diagnosed MM (NDMM) with del(17p) undergoing upfront autologous hematopoietic stem cell transplantation (auto-HCT). We conducted a single-center retrospective analysis of patients with NDMM who underwent upfront auto-HCT at MD Anderson Cancer Center between 2008 and 2018. Primary endpoints were progression-free survival (PFS) and overall survival (OS), with secondary endpoints being …

Patient-Reported Outcomes, Postoperative Pain And Pain Relief After Day Case Surgery (Poppy): Methodology For A Prospective, Multicentre Observational Study*, William M. Hare, Martha Belete, Adam B. Brayne, Harriet Daykin, Matthew Everson, Anna Ratcliffe, Katie Samuel, Lexy Sorrell, Mark Rockett

Peninsula Medical School

Background: In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. Methods: This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case …

Impact Of Social Deprivation Upon The Preoperative Pathway And Early Surgical Outcomes After Pancreatoduodenectomy For Pdac And Non-Pdac Periampullary Cancer In England: The Surg-Panc-Uk Study, Surg-Panc-Uk Study Group On Behalf Of Augis, Thomas W Thorne, Siobhan C Mckay, Samir Pathak, Richard Wilkin, Jenifer Barrie, John Moir, Keith J Roberts, Somaiah Aroori

Peninsula Medical School

BACKGROUND: Socioeconomic deprivation is linked to poorer outcomes in many cancers, however the impact of social deprivation on survival in resectable pancreatic and other peri-ampullary cancers appears mixed. Moreover, no studies consider the impact of social deprivation on diagnostic pathway length.

METHODS: A retrospective observational cohort study of adults with suspected periampullary cancer undergoing pancreaticoduodenectomy in England. Following surgery, patients were stratified by cancer type (PDAC, duodenal cancer, cholangiocarcinoma and ampullary cancer) and the impact of social deprivation (IMD deprivation quintiles) upon short-term survival and diagnostic pathway length analysed.

RESULTS: 648 patients from England with social deprivation data were identified, …

Cochlear Implantation With Sporadic Inner Ear Schwannomas: Outcomes In 106 Patients From An International Multi-Institutional Study, John P. Marinelli, Torsten Rahne, James R. Dornhoffer, Christine M. Lohse, Justin Cottrell, J. Thomas Roland, Nicholas J. Thompson, Kevin D. Brown, Jacob C. Lucas, Seilesh C. Babu, Nathan R. Lindquist, Elizabeth L. Perkins, Donald Tan, John I. Lane, Jacob B. Hunter, Erin Harvey, Nicholas L. Deep, Samantha Y. Cerasiello, Matthew L. Kircher, Mana Espahbodi, Evan L. Tooker, Niels Cramer West, Per Caye-Thomasen, Matthew L. Carlson, Stefan K. Plontke

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To evaluate cochlear implant speech perception among patients with sporadic inner ear schwannoma who underwent ipsilateral implantation.

STUDY DESIGN: Retrospective multi-institutional cohort study.

SETTING: Eleven tertiary academic medical centers across Germany, Denmark, and the United States.

PATIENTS: One hundred six patients with sporadic inner ear schwannoma who received an ipsilateral cochlear implant from 2011 to 2022.

INTERVENTIONS: Ipsilateral cochlear implantation with observation, stereotactic radiosurgery, or microsurgery for tumor management.

MAIN OUTCOME MEASURES: Monosyllabic speech perception testing scores and rates of open-set speech perception.

RESULTS: Among 106 patients studied, 101 (95%) achieved open-set speech perception with a median of 24 …

Disparities In Breast Cancer Detection Modalities And Outcomes Among Geriatric Female Cancer Patients, Zhaoli Liu, Mathilda Nicot-Cartsonis, Biai D E Digbeu, Daoqi Gao, Sharon H Giordano, Yong-Fang Kuo

Faculty, Staff and Student Publications

This study examined racial and geographic disparities in breast cancer detection modalities (screening-, diagnostic-, or non-mammography) with cancer stage and mortality. A retrospective cohort study was conducted using Texas Cancer Registry-Medicare linkage data for geriatric women. Cancers detected through screening and diagnostic mammography had 43 % (95 % CI, 39 %-46 %, p < .0001) and 31 % (95 % CI, 27 %-35 %, p < .0001) lower all-cause mortality, and 49 % (95 % CI, 41 %-54 %, p < .0001) and 37 % (95 % CI, 32 %-43 %, p < .0001) lower cancer-specific mortality, respectively, compared to non-mammography-detected breast cancers. Patients from rural areas were 17 % (95 % CI, 1.06 - 1.29) more likely to be diagnosed with mid- (p = .0023) and advanced stage (p = .003) cancers compared to their urban counterparts. Racial or geographic disparities in cancer detection modalities with associated mortality no longer exist after adjusting for covariates. Healthcare professionals can leverage these findings to promote rural cancer health equity.

Improved Survival And Decreased Cancer Deaths In Young Adults With Cancer After Passage Of The Affordable Care Act Dependent Coverage Expansion, Michael Roth, Clark R Andersen, Amy Berkman, Stuart Siegel, Branko Cuglievan, J Andrew Livingston, Michelle Hildebrandt, Jaime Estrada, Archie Bleyer

Faculty, Staff and Student Publications

Background: The Patient Protection and Affordable Care Act (ACA) allowed Americans aged 19-25 years to remain on their parents' health insurance plans until age 26 years (the Dependent Care Expansion [DCE]). Have those with cancer diagnoses benefited?

Methods: The ACE DCE 7-year age range of 19-25 years was compared for changes in cancer survival and mortality before and after enactment of the ACA with groups that were younger and older (in 7-year age spans: ages 12-18 and 26-32 years, respectively). Cancer death data for the entire United States were obtained from the Centers for Disease Control and Prevention, and relative …

Correlation Of Pancreatic Laminin Alpha 5 Expression With Clinical Outcomes In Total Pancreatectomy With Islet Autotransplantation, Jayachandra Kuncha, Carly M Darden, Yang Liu, Michael Lawrence, J Sebastian Danobeitia, Bashoo Naziruddin

Faculty, Staff and Student Publications

This study examines extracellular matrix (ECM) protein (ECM) expression in chronic pancreatitis (CP) patients and its correlation with graft function after total pancreatectomy with islet autologous transplantation (TPIAT). Pancreatic sections from 29 CP patients undergoing TPIAT were analyzed for ECM including pan-laminin, laminin alpha 5 (LAMA5), collagen IV, and Perlecan by immunohistochemistry and scored by the percentage positive staining area within the whole tissue area. Graft function was monitored by blood glucose and C-peptide levels. Laminin alpha 5 levels in blood plasma were greater in CP. Laminin alpha 5 expression was significantly higher in all CP patient etiological categories including …

Combining Biology-Based And Mri Data-Driven Modeling To Predict Response To Neoadjuvant Chemotherapy In Patients With Triple-Negative Breast Cancer, Casey E Stowers, Chengyue Wu, Zhan Xu, Sidharth Kumar, Clinton Yam, Jong Bum Son, Jingfei Ma, Jonathan I Tamir, Gaiane M Rauch, Thomas E Yankeelov

Faculty, Staff and Student Publications

Purpose

To combine deep learning and biology-based modeling to predict the response of locally advanced, triple-negative breast cancer before initiating neoadjuvant chemotherapy (NAC).

Materials and Methods

In this retrospective study, a biology-based mathematical model of tumor response to NAC was constructed and calibrated on a patient-specific basis using imaging data from patients enrolled in the MD Anderson A Robust TNBC Evaluation FraMework to Improve Survival trial (ARTEMIS; ClinicalTrials.gov registration no. NCT02276443) between April 2018 and May 2021. To relate the calibrated parameters in the biology-based model and pretreatment MRI data, a convolutional neural network (CNN) was employed. The CNN …