Digital Commons Network^™

Which Aspects Of Abortion Care Do Healthcare Practitioners In Britain Think Nurses/Midwives Should Provide? Findings From The Sacha Study, Rebecca French Sacha Study Team, Alice Fulton, Ona Mccarthy, Jill Shawe, Rebecca Meiksin, Maria Lewandowska, Melissa Palmer, Rachel Scott, Kaye Wellings, Patricia Lohr, Geoffrey Wong, Sally Sheldon, Annette Aronsson, Paula Baraitser, Sharon Cameron, Louise Keogh, Clare Murphy, Wendy V. Norman, Jennifer Reiter, Natasha Salaria

School of Nursing and Midwifery

Aim: To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion. Design: An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022). Methods: Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression. Results: Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, …

Theatre And Dance As Divine Purpose: Liberating The Christian Performer In Pursuit Of Artistic Worship, Abby Owen

Dance (MFA) Theses

This study examines the historical relevance of theatre and dance alongside religious forms of worship, with a particular emphasis on their integration into Christian churches of the Middle Ages, in comparison to the current Western era. Beginning with their origin, this research examines the creation of theatre and dance in Ancient Greece as a means of connecting with spiritual deities, tracing their recorded transition into accepted acts of everyday worship by Christian leadership. At the same time, this research scrutinizes contemporary congregations’ lack of artistic incorporation, denouncing the rise of restricted worship in response to present-day condemnation of the female …

Safety And Effectiveness Of Emicizumab In People With Haemophilia A Enrolled In The Athn 7 Haemophilia Natural History Study., Tyler W. Buckner, Shannon L. Carpenter, Nabil Daoud, Christine L. Kempton, Lucy Lee, Lynn Malec, Thomas W. Mclean, Paul Morton, Carrie O'Neill, Janice M. Staber, Michael Wang, Stacy E. Croteau, Michael Recht

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Natural History Study of the Safety, Effectiveness, and Practice of Treatment for People with Haemophilia (ATHN 7) monitors use of contemporary haemophilia therapies, including emicizumab, a bispecific antibody substituting for activated factor (F)VIII in people with haemophilia A (HA).

AIM: To report participant characteristics and real-world safety and effectiveness of emicizumab in ATHN 7.

METHODS: ATHN 7 is a prospective observational cohort study conducted across 26 American Thrombosis and Haemostasis Network (ATHN)-affiliated sites. People with HA receiving emicizumab were eligible for inclusion in this analysis. Clinical information was collected quarterly through participant interview and medical record review. Safety …

Pharmacogenetic Hslco1b1*14-Guided Dosing Of Methotrexate In Transgenic Arthritic Mice Normalizes Exposure And Response., Felicia Gooden, Brennan D. Meier, Griffin D. Shaffer, Kim Gibson, Paul Toren, Nieko C. Punt, Sandhya Subash, Dilip K. Singh, Bhagwat Prasad, Laura Ramsey, Zachary L. Taylor

Manuscripts, Articles, Book Chapters and Other Papers

Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease that negatively affects ~100,000 children under the age of 16 in the United States. About ~30% of these patients fail first-line drug therapy with low-dose methotrexate (MTX) due to poor tolerability or lack of efficacy. The SLCO1B1*14 allele is associated with increased MTX clearance and has been linked to reduced overall drug exposure and nonresponse to MTX in JIA patients. Herein, we describe transgenic hSLCO1B1*14 and hSLCO1B1*1 DBA1/J mSlco1b2 knock-out mice, which we used to assess arthritic response to MTX using the collagen-induced arthritis model. Mass spectrometry-based proteomics analysis revealed that …

Greater Body Dissatisfaction At Admission Is Associated With Lower Bmi At Discharge In Anorexia Nervosa: Predictive Validity Of The Eating Pathology Symptoms Inventory., Danielle A N Chapa, Marianna L. Thomeczek, Brianne N. Richson, Alan Duffy, Kara A. Christensen Pacella, Kelsie T. Forbush, Renee D. Rienecke, Dan V. Blalock, Sara R. Gould, Victoria L. Perko, Philip S. Mehler

Manuscripts, Articles, Book Chapters and Other Papers

People with anorexia nervosa (AN) engage in dietary restriction and other weight loss behaviors that result in dangerously low body weight, leading to an increased risk for mortality and medical complications. Weight gain is one of the most important indicators of treatment progress and recovery for AN. There are limited predictors of weight gain for patients with AN, making it difficult for clinicians to anticipate which patients are likely to respond favorably to treatment. Thus, there is a need to identify additional, potentially modifiable predictors of weight gain within a higher level of care for AN. This study tested the …

Steroid Hormone Metabolites And Mammographic Breast Density In Premenopausal Women, Ghazaleh Pourali, Kayode A Matthew, Myung Sik Jeon, Chongliang Luo, Gary J Patti, Jingqin Luo, Adetunji T Toriola

2020-Current year OA Pubs

BACKGROUND: Steroid hormones influence breast morphology and cellular proliferation and are associated with breast carcinogenesis. However, their associations with mammographic breast density (MBD) are less studied, particularly in premenopausal women. We, therefore, investigated the associations of steroid hormone metabolites with MBD in premenopausal women.

METHODS: Our study included 700 premenopausal women scheduled for screening mammograms. We analyzed 54 steroid hormone metabolites (Metabolon®) and assessed volumetric measures of MBD including volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV) using Volpara. We investigated associations using linear regression modeling to estimate the covariate-adjusted means of VPD, NDV, and DV, corresponding …

Clinical Test Cases For Commissioning, Qa, And Benchmarking Of Model-Based Dose Calculation Algorithms In 1⁹2ir Hdr Gynecologic Tandem And Ring Brachytherapy, Vasiliki Peppa, Maude Robitaille, Fatemeh Akbari, Shirin Enger, Rowan Thomson, Firas Mourtada, Gabriel Fonseca

Department of Radiation Oncology Faculty Papers

PURPOSE: To develop clinically relevant test cases for commissioning Model-Based Dose Calculation Algorithms (MBDCAs) for ¹⁹²Ir High Dose Rate (HDR) gynecologic brachytherapy following the workflow proposed by the TG-186 report and the WGDCAB report 372.

ACQUISITION AND VALIDATION METHODS: Two cervical cancer intracavitary HDR brachytherapy models were developed based on a real patient, using either uniformly structured regions or realistic segmentation. The patient's computed tomography (CT) images were processed, converted to a series of digital imaging and communications in medicine (DICOM) CT images, and imported into two treatment planning systems (TPSs), the Oncentra Brachy and BrachyVision. The original segmentation …

Expanding The Genetic And Phenotypic Spectrum Of Polrmt-Related Mitochondrial Disease., Mahmoud R. Fassad, Sebastian Valenzuela, Monika Oláhová, Jack J. Collier, Charlotte V Y Knowles, Eleni Mavraki, Miriam Elbracht, Nergis Güzel, Thomas Herberhold, Ingo Kurth, Andrea Maier, Larissa Mattern, Carol J. Saunders, Helen Mccullagh, Katrin Õunap, Saskia B. Wortmann, Andre Reis, Lei Zhang, Claes M. Gustafsson, Robert Mcfarland, Robert W. Taylor

Manuscripts, Articles, Book Chapters and Other Papers

Mitochondrial diseases are a complex group of conditions exhibiting significant phenotypic and genetic heterogeneity. Genomic testing is increasingly used as the first step in the diagnostic pathway for mitochondrial diseases. We used next-generation sequencing followed by bioinformatic data analysis to identify potentially damaging variants in the POLRMT gene (NM_005035.4) in six new affected individuals. Structural protein analysis predicted the detrimental impact of variants on POLRMT protein structure. Patients show extended phenotypic abnormalities often presenting early in life with features including global developmental delay, cognitive impairment, short stature and muscular hypotonia. This study expands the genetic and phenotypic landscape of mitochondrial …

Widening Participation In Dentistry: A Quantitative Study Of Changing Demographics At A South West Uk Dental School (2014-2021)., Sally Hanks, Ian Mills, Marie Bryce, Daniel Zahra, Rebecca Glanville

Peninsula Dental School

Introduction: Access to National Health Service (NHS) dental care in the UK, particularly in rural and coastal regions such as the South West, remains a significant concern. Increasing socio-economic diversity in the dental workforce has previously been reported to improve access to care in underserved areas. Widening Participation (WP) initiatives aim to address this by encouraging applications from underrepresented groups. Methods: This study analysed admissions data from the University of Plymouth's Bachelor of Dental Surgery (BDS) programme for cohorts between 2014 and 2021. Metrics included entry qualifications, age, gender, ethnicity, disability and socio-economic markers. Statistical analyses included chi-squared tests and …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …

Refining Aicardi Syndrome Diagnostic Criteria: An Expert-Based Consensus Using A Modified Delphi Approach, Silvia Masnada, Valentina De Giorgis, Umberto Carugo, Nadia Bahi-Buisson, Mara Cavallin, Mark Corbett, Manuela Formica, Jozef Gecz, Natalia Petros, Emilio Perucca, Anna Pichiecchio, Paolo Fusar Poli, Elliott H Sherr, Ignatia B Van Den Veyver, Federico Zara, Martin Geroldinger, Pierangelo Veggiotti, Alexis Arzimanoglou

Duncan NRI Faculty and Staff Publications

Background and objectives: Aicardi syndrome (AIC) is a rare neurodevelopmental disorder historically characterised by the presence of chorioretinal lacunae, corpus callosum agenesis, infantile spasms and several supporting features that aid in diagnosis. However, the unclear aetiology and evolving diagnostic tools have led to ongoing reconsideration of the criteria, based on individual approaches. Our study aimed to establish, for the first time, an expert-based consensus on diagnostic criteria for AIC by integrating both existing and novel ones.

Methods: A geographically diverse and multidisciplinary group of expert physicians was invited to participate in a modified Delphi study, to achieve consensus on major, …

Does Dexmedetomidine Affect Opioid Consumption Following Orthognathic Surgery?, Allen F. Champion, Jung-Me Lee, Daniel Taub, Yu Jin Lee

Department of Oral and Maxillofacial Surgery Faculty Papers

BACKGROUND: Despite its purported analgesic effects, controversy exists regarding dexmedetomidine's efficacy as an opioid-sparing anesthetic adjunct.

PURPOSE: The purpose of this study is to measure the association between dexmedetomidine (DEX) administration during orthognathic surgery and postoperative opioid consumption.

STUDY DESIGN, SAMPLE, AND SETTING: A single-blind randomized prospective cohort study was implemented. Patients consenting for orthognathic surgery at Thomas Jefferson University from January 2022 to October 2024 were screened. American Society of Anesthesiologists physical status I to III individuals aged ≥14 years were included. Exclusion criteria were revision surgery, recreational drug use, opioid prescription within 2 years, and chronic pain.

PREDICTOR …

Behavioral And Psychological Financial Hardship Among Caregivers Of Pediatric Cancer Patients, Josiane Kabayundo, Cheng Zheng, Edward S. Peters, Don W. Coulter, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Financial hardship encompasses material, behavioral, and psychological domains; however, most research among caregivers of pediatric cancer patients has focused on material hardship. This study examined factors associated with behavioral and psychological financial hardship among caregivers of pediatric cancer patients in Nebraska.

METHODS: We conducted a cross-sectional survey of caregivers of children diagnosed within the past 5 years and treated at two pediatric oncology specialty clinics. Behavioral hardship was defined as delaying medical or mental healthcare due to cost, while psychological hardship was measured by worry about ability to pay medical bills. Descriptive statistics and poisson regression with robust variance …

“Shaking The Ladder” Reveals How Analytic Choices Can Influence Associations In Nutrition Epidemiology: Beef Intake And Coronary Heart Disease As A Case Study, Colby J Vorland, Lauren E O'Connor, Beate Henschel, Cuiqiong Huo, James M Shikany, Carlos A Serrano, Robert Henschel, Stephanie L Dickinson, Keisuke Ejima, Aurelian Bidulescu, David B Allison, Andrew W Brown

Children’s Nutrition Research Center Staff Publications

Nutrition epidemiological models involve many analytic decisions, such as defining exposures, selecting which covariates to include, or configuring variables in different ways. We explored the impact of analytical decisions on conclusions in nutrition epidemiology using self-reported beef intake and incident coronary heart disease as a case study. We used REasons for Geographic and Racial Differences in Stroke (REGARDS) data, and selected covariates and their configurations from published literature to recapitulate common models used to assess associations between meat intake and health outcomes. Three model sets were designed: sets one and two used continuous and quintile-defined beef intakes, respectively, each with …

The Underdiagnosis Of Neurodevelopmental Disorders In Women: Recognizing A Spectrum Of Symptoms, Taylor D. Bloomhuff

Psychology Doctoral Specialization Projects

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have long been viewed as predominantly male diagnoses. Based on foundational studies for these disorders, not only are they more prevalent in male children, but symptom severity is also higher in male children. In attention-deficit/hyperactivity disorder in particular, it has become a common assumption that hyperactive/impulsive and combined types are ‘male’ ADHD presentations, while the inattentive type corresponds to the few female children who meet diagnostic criteria. However, emerging research looking at the decrease in autism spectrum disorder and attention-deficit/hyperactivity disorder prevalence rates between gender in adulthood suggests that these neurodevelopmental disorders …

Redrawing Anatomy: Addressing Female Genital Underrepresentation In Educational Texts, Clara E. Krohn

Williams Honors College, Honors Research Projects

The fight for female equality in the historically male dominated medical field is an ongoing battle. This project focuses primarily on the underrepresentation of female genitalia in undergraduate academic textbooks. A dissected pelvis of a female cadaver was initially examined. Pictures were obtained with scale bars to accurately depict size of the structures included. Underrepresented structures such as the clitoris and the broad ligament were closely examined along with the reproductive system as a whole. The pictures compiled along with further research were used to design a portfolio of diagrams and a survey to be later administered. The survey was …

Mucin 5ac Modulates Cancer-Associated Fibroblast Heterogeneity Through Epigenetic Reprogramming Of Precursor Cells, Rachel J. Kehrberg, Namita Bhyravbhatla, Zahraa Wajih Alsafwani, Xiaoqi Li, Gopalakrishnan Natarajan, Imran Khan, Randall E. Brand, Maneesh Jain, Surinder K. Batra, Sushil Kumar

Journal Articles: Biochemistry & Molecular Biology

Pancreatic cancer (PC) is characterized by extensive desmoplasia, with heterogeneous cancer-associated fibroblasts (CAFs) as a major component. However, the contribution of distinct precursor cells to CAF heterogeneity remains poorly defined. This study investigated the role of Muc5ac in modulating CAF heterogeneity by maturing precursor cells, including adipose-derived mesenchymal stem cells (AD-MSCs), bone marrow-derived MSCs (BM-MSCs), and pancreatic stellate cells (PSCs), into different CAF subsets. RNA sequencing of precursor cells treated with conditioned media from Muc5ac-proficient or -deficient cancer cells revealed distinct transcriptional profiles. Muc5ac significantly modulated the expression of Dnmts and Tets in AD-MSCs, promoting the acquisition of extracellular matrix …

Pancreatic Cancer Detection Consortium Biomarker Bakeoff: A Phase Ii Blinded Biomarker Validation And Panel Discovery Study, Ann L. Oberg, William R. Bamlet, Grant Izmirlian, Seetharaman Balasenthil, Surinder K. Batra, Masataka Hayashi, Daniel S. Herman, Michael A. Hollingsworth, Maneesh Jain, Ann M. Killary, Brianna M. Krusen, Suyu Liu, Shounak Majumder, Gopalakrishnan Natarajan, Subrata Sen, Lynette M. Smith, Sudhir Srivastava, Brian M. Wolpin, Kenneth S. Zaret, Michael G. Goggins

Journal Articles: Biochemistry & Molecular Biology

PURPOSE: The Pancreatic Cancer Detection Consortium (PCDC) performed a blinded Early Detection Research Network-defined phase II biomarker bakeoff study of blood-based biomarker panels. The aims were to evaluate panel performance, to compare the panels' performance with that of cancer antigen 19-9 (CA19-9) alone, and to evaluate the performance of new combinations of the individual biomarkers.

EXPERIMENTAL DESIGN: Ten biomarkers representing eight biomarker panels and CA19-9 were evaluated using plasma, serum, and germline DNA from 140 stage I to IV pancreatic ductal adenocarcinoma (PDAC) cases and 140 controls from three tertiary care institutions, with controls frequency matched to cases on age …

35 Individuals With Huwe1-Related Neurodevelopmental Disorder And Suggested Clinical Evaluations, Mindy H. Li, Deziree L. Coleman, Kelsey Hogan, Danielle Luz, Lindsay Bhandari, Newell Belnap, Tiffany Busa, Charles Coutton, Klaus Dieterich, Svetlana Gorokhova, Clara Hildebrandt, Rachel Logan, Milena Mariani, Manuela Morleo, Vincenzo Nigro, John Pappas, Rachel Rabin, Kelly Schoch, Angelo Selicorni, Vandana Shashi, Rebecca Spillman, Jennifer Sullivan, Charlotte Tardy, Samantha A. Schrier Vergano, Brock Grill, Kristin Baranano

Department of Pediatrics Faculty Publications

HUWE1 (HECT, UBA, and WWE Domain Containing E3 Ubiquitin Protein Ligase1, OMIM 300697), located at Xp11.22, encodes a ubiquitin ligase that is highly conserved across species. Genetic variants in HUWE1 described in multiple independent studies cause X-linked intellectual disability, including in the patients identified by Juberg, Marsidi, and Brooks. This report describes 35 additional cases of individuals with variants in HUWE1 and suggested guidelines for clinical management. Our study includes several female cases, which have not been widely reported previously. Our findings confirm earlier reported clinical features including developmental delay, autism, hypotonia, short stature, and dysmorphic facial features as well …

Estrogen Deprivation During Primate (Papio Anubis) Pregnancy: Impact On Systemic Microvascular Flow And Cardiovascular Development And Function After Birth In Offspring, Sifa Turan, Jeffery S. Babischkin, Graham W. Aberdeen, Gerald J. Pepe, Eugene D. Albrecht

Department of Biomedical and Translational Sciences Faculty Publications

Background

Suppressing estradiol (E₂) during baboon pregnancy lowers offspring skeletal muscle capillary density, vital for insulin-mediated glucose uptake, and induces insulin resistance. We examined whether E₂ deprivation also impairs microvascular flow and cardiac function.

Methods

Offspring of untreated baboons, letrozole-treated baboons, or letrozole plus E₂ (maternal s.c. injections during the second half of gestation) underwent contrast-enhanced microbubble ultrasonography to quantify microvessel flow and echocardiography to assess cardiac performance.

Results

Letrozole reduced maternal serum E₂ by 95% (p <  0.01). In letrozole offspring, microbubble flux rate (β) fell 55% (p <  0.02), replenishment was 5 s slower (p <  0.03), and microvessel flow declined 40% (p = 0.05); all were restored by added E₂. Indices of systolic (isovolumic contraction), diastolic (isovolumic relaxation), global performance (Tei index), and cardiac output were unchanged.

Conclusion

Prolonged gestational E₂ deprivation programs a reduction in microvascular flow without altering cardiac function; maternal E₂ prevents this, supporting E₂'s role in …

Oxytocin Dosing During Trial Of Labor After Cesarean To Minimize The Risk Of Uterine Rupture: A Systematic Review And Meta-Analysis, Pierpaolo Nicolì, Moti Gulersen, Jordan Beacham, Hila Hochler, Alessandra Familiari, Anna Locatelli, Cynthia Abraham, Ettore Cicinelli, Amerigo Vitagliano, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Oxytocin remains the mainstay for induction and for the management of labor arrest during trial of labor after cesarean (TOLAC). Therefore, the clinical question should be not whether to use oxytocin, but how to optimize its administration. This meta-analysis aimed to assess which oxytocin protocol, in terms of initial dose, amount of increase, timing to next increase, and maximum dose, may minimize the risk of uterine rupture (UR) during TOLAC.

DATA SOURCES: PubMed, Embase and Clinicaltrials.gov were searched up to September 21, 2024.

STUDY ELIGIBILITY CRITERIA: Randomized and nonrandomized studies evaluating the association between induction and/or augmentation with oxytocin …

Impact Of Prophylactic Oral Azithromycin During Labor On Azithromycin Resistance (Amr) In Nasal Staphylococcus Aureus And Streptococcus Pneumoniae In Women And Infants In The Multi-Country Azithromycin Prevention In Labor Use Study (A-Plus)., Patricia L. Hibberd, Jean H. Kim, Marissa Trotta, Sixto M. Leal, Anna Aceituno, Doyle V. Ward, Archana Patel, Akila Subramaniam, Waldemar A. Carlo, Imran Ahmed, Sarah Saleem, Sk Masum Billah, Rashidun Haque, Manolo Mazariegos, Fabian Esamai, Manjunath S. Somannavar, Shivaprasad S. Goudar, Elwyn Chomba, Muska Mwenchanya, Adrien Lokangaka, Antoinette Tshefu, Robert L. Goldenberg, Melissa Bauserman, Nancy F. Krebs, Sherri Bucher, Richard J. Derman, William A. Petri, Marion Koso-Thomas, Denise C. Babineau, Elizabeth M. Mcclure, Alan T. N. Tita

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Prophylactic oral azithromycin vs. placebo reduced maternal, but not neonatal, mortality/sepsis in the A-PLUS Randomized Trial. While prophylactic intrapartum azithromycin reduces maternal mortality/sepsis, it may promote antimicrobial resistance (AMR) in commensal bacteria,.

METHODS: Randomly selected women and their infants participating in A-PLUS were enrolled in a longitudinal cross-sectional sub-study to assess the presence of azithromycin resistance in selected bacteria in nasal cultures. Staphylococcus aureus and Streptococcus pneumoniae were cultured on selective agar, then azithromycin-containing agar to select for azithromycin resistant bacteria, identified biochemically. Azithromycin susceptibility was assessed by E-test. Nasal cultures were collected from women and infants between August …

The Mediating Effect Of Socioeconomic Status And Persistent Poverty On Racial And Ethnic Disparities In Pediatric Cancer Mortality In The United States, Josiane Kabayundo, Apu Das, Cheng Zheng, Emma Hymel, Krishtee Napit, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Socioeconomic (SE) factors have been shown to mediate racial and ethnic disparities in adult cancer mortality. However, evidence in pediatric cancer is limited, especially at finer geographic levels.

OBJECTIVE: Evaluate the mediating effect of socioeconomic status (SES) and persistent poverty in racial and ethnic disparities in childhood cancer mortality using census tract-level data.

METHODS: Data were obtained from the 2006-2020 SEER Incidence Data with Census Tract Attributes Database and included children 0-19 years. Neighborhood-level SES was measured using a composite variable with five categories. Census tracts were classified as persistently poor if 20% or more of the population lived …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Trends In Hypertension Prevalance And Control In The United States Over 25 Years, Omar Saleh, Neda Rehan, Saleh Mostafa, Rehan Qayyum

Department of Medicine Faculty Publications

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear …

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

The 2025 American Society Of Pediatric Otolaryngology Workforce And Compensation Survey: Current State And Future Directions, Lyndy J. Wilcox, Cristina M. Baldassari, Amy C. Brenski, Emily Boss, John Carter, David H. Chi, William O. Collins, Charles A. Elmaraghy, Andrew J. Tompkins, Craig S. Derkay, The Aspo 2025 Workforce And Compensation Committee

Department of Otolaryngology (ENT) Faculty Publications

Objective

To provide an updated comprehensive assessment of the Pediatric Otolaryngology workforce in the United States inclusive of compensation, productivity, practice patterns, and on-call burden.

Study Design

Cross-sectional electronic survey.

Methods

A structured electronic survey was developed by members of the American Society of Pediatric Otolaryngology (ASPO) Workforce and Compensation Committee. The survey evaluated six domains: demographics, compensation, workforce dynamics, productivity, on-call burden, and future priorities, and was distributed to all 480 presumedly actively-practicing, domestic ASPO members.

Results

The survey response rate was 68% (327/480). Ninety-one percent of respondents held an academic appointment with relatively equal percentages of each rank …

Associations Between Contralesional Neuroplasticity And Motor Impairment Through Deep Learning-Derived Mri Regional Brain Age In Chronic Stroke (Enigma): A Multicohort, Retrospective, Observational Study, Gilsoon Park, Mahir Khan, Justin Andrushko, Nerisa Banaj, Michael Borich, Lara Boyd, Amy Brodtmann, Truman Brown, Cathrin Buetefisch, Adriana Conforto, Steven Cramer, Michael Dimyan, Martin Domin, Miranda Donnelly, Natalia Egorova-Brumley, Elsa Ermer, Wuwei Feng, Fatemeh Geranmayeh, Colleen Hanlon, Brenton Hordacre, Neda Jahanshad, Steven Kautz, Mohamed Salah Khlif, Jingchun Liu, Martin Lotze, Bradley Macintosh, Feroze Mohamed, Jan Nordvik, Fabrizio Piras, Kate Revill, Andrew Robertson, Christian Schranz, Nicolas Schweighofer, Na Jin Seo, Surjo Soekadar, Shraddha Srivastava, Bethany Tavenner, Gregory Thielman, Sophia Thomopoulos, Daniela Vecchio, Emilio Werden, Lars Westlye, Carolee Winstein, George Wittenberg, Jennifer Ferris, Chunshui Yu, Paul Thompson, Sook-Lei Liew, Hosung Kim

Department of Radiology Faculty Papers

BACKGROUND: Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.

METHODS: …

Prognostic Factors For Patients Under 45 Undergoing Surgery For Colorectal Liver Metastases: A Seer Population-Based Study, Gabrielle Grob, Fang Fang, Matvey Karpov, Eric Feliberti, Marybeth Hughes, Rachel Burke, Winifred Lo

Department Surgery Faculty Publications

Background and Objectives: Colorectal cancer (CRC) has been on the rise in adults younger than 50. Surgical resection is a potentially curative treatment option for patients with colorectal liver metastases (CRLM). The aim of this study was to describe patient and tumor characteristics associated with disease-specific survival in young patients (<  45 years) versus older patients (≥ 45 years) with isolated CRLM.

Methods: The SEER database was queried for patients with CRLM who underwent colon and liver resection from 2010 to 2021. Patients under age 20, with metastases beyond the liver, or who had not had surgery for liver metastases were excluded. Cox regression was used to analyze demographic factors, tumor …

Advancing Models Of Ptsd-Aud Comorbidity: Protocol For A Multimethod Framework Using Genetics And Ecological Momentary Assessment, Elizabeth A. Stinson, Samhita Lellapalli, Sage E. Hawn, Natalie Merrill, Lance M. Rappaport, Christina M. Sheerin, Vasiliki Michopoulos, Silviu-Alin Bacanu, Roseann E. Peterson, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and …