Digital Commons Network^™

Whole-Genome Sequence-Based Association Analysis Of African American Individuals With Bipolar Disorder And Schizophrenia, Runjia Li, Sarah A Gagliano Taliun, Kevin Liao, Matthew Flickinger, Janet L Sobell, Giulio Genovese, Adam E Locke, Rebeca Rothwell Chiu, Jonathon Lefaive, Jiongming Wang, Taylor Martins, Sinéad Chapman, Anna Neumann, Robert E Handsaker, Donna K Arnett, Kathleen C Barnes, Eric Boerwinkle, David Braff, Brian E Cade, Myriam Fornage, Richard A Gibbs, Karin F Hoth, Lifang Hou, Charles Kooperberg, Ruth J F Loos, Ginger A Metcalf, Courtney G Montgomery, Alanna C Morrison, Zhaohui S Qin, Susan Redline, Alexander P Reiner, Stephen S Rich, Jerome I Rotter, Kent D Taylor, Karine A Viaud-Martinez, Tim B Bigdeli, Stacey Gabriel, Sebastian Zollner, Albert V Smith, Goncalo Abecasis, Steve A Mccarroll, Michele T Pato, Carlos N Pato, Michael Boehnke, James Knowles, Hyun Min Kang, Roel A Ophoff, Jason Ernst, Laura J Scott

Faculty, Staff and Student Publications

In studies of individuals of primarily European genetic ancestry, common and low-frequency variants and rare coding variants have been found to be associated with the risk of bipolar disorder (BD) and schizophrenia (SZ). However, less is known for individuals of other genetic ancestries or the role of rare non-coding variants in BD and SZ risk. We performed whole-genome sequencing (∼27X) of African American individuals: 1,598 with BD, 3,295 with SZ, and 2,651 unaffected controls (InPSYght study). We increased power by incorporating 14,812 jointly called psychiatrically unscreened ancestry-matched controls from the Trans-Omics for Precision Medicine (TOPMed) Program for a total of …

Risk Of Major Depression In Partners Of People With Alzheimer's Disease: A National Cohort Study, Casey Crump, Jingkai Wei, Barbara G Vickrey, Alexis C Edwards, Paul E Schulz, Weiva Sieh, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

Background: Alzheimer's disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown.

Methods: A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental …

An Ehealth Delivery Alternative For Cancer Genetic Testing For Hereditary Predisposition In Patients With Metastatic Cancers: Protocol For A Randomized Trial, Kimberley T. Lee, Briana Mcleod, Brian Egleston, Sarah Brown, Sarah Howe, Dominique Fetzer, Lauren Gutstein, Cara Cacioppo, Dana Clark, Susan M. Domchek, Jessica Ebrahimzadeh, Dana Falcone, Demetrios Ofidis, Hannah Griffin, Rajia Mim, Santina Hernandez, Linda Fleisher, Kelsey Karpink, Enida Selmani, Aysha Tahsin, Lynne Wagner, Michelle Weinberg, Kuang-Yi Wen, Elisabeth Wood, Angela R. Bradbury

Department of Medical Oncology Faculty Papers

Background: Germline BRCA1 and BRCA2 testing is a standard evidence-based practice, with established risk reduction and cancer screening guidelines for genetic carriers. With Food and Drug Administration approval for poly (adenosine diphosphate ribose) polymerase (PARP) inhibitors in patients with metastatic breast, ovarian, pancreatic, and prostate cancer, there is an additional therapeutic rationale for testing all patients with these cancers for germline BRCA1 and BRCA2 mutations. However, many at-risk patients do not have access to genetic services, leaving many genetic carriers unidentified.

Objective: The eREACH (A Randomized Study of an eHealth Delivery Alternative for Cancer Genetic Testing for Hereditary Predisposition in …

Organizational Climate And Decision Aid Sustainability In Lupus Care: Mixed Methods Study, Aizhan Karabukayeva, Larry R Hearld, Nathan W Carroll, Reena Kelly, Jasvinder A Singh

Faculty, Staff and Students Publications

Background: Digital decision aids (DAs) are increasingly used in health care to support shared decision-making and promote patient engagement. In the context of systemic lupus erythematosus (SLE), a complex autoimmune disease characterized by diverse symptoms and uncertain prognoses, DAs offer guidance to patients in navigating treatment risks and benefits. Although numerous studies have examined the initial implementation of evidence-based tools, there is limited evidence on the organizational factors that influence their long-term sustainability in clinical practice. This gap is particularly salient for digital interventions, where integration into routine workflows and ongoing use require alignment with clinic readiness and culture. This …

Multi-Ancestral Genome-Wide Association Study Of Clinically Defined Nicotine Dependence Reveals Strong Genetic Correlations With Other Substance Use Disorders And Health-Related Traits, Emma C Johnson, Jared V Balbona, Alexander S Hatoum, David A A Baranger, Louis Fox, Paul W Jeffries, Laura J Bierut, Andrew C Heath, Pamela A Madden, Elliot C Nelson, Arpana Agrawal, Et Al.

2020-Current year OA Pubs

BACKGROUND: Genetic research on nicotine dependence has utilized multiple assessments that are in weak agreement.

METHODS: We conducted a genome-wide association study (GWAS) of nicotine dependence defined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-NicDep) in 61,861 individuals (47,884 of European ancestry [EUR], 10,231 of African ancestry, and 3,746 of East Asian ancestry) and compared the results to other nicotine-related phenotypes.

RESULTS: We replicated the well-known association at the

CONCLUSIONS: Our results suggest that combining the wide availability of diagnostic EHR data with nuanced criterion-level analyses of DSM tobacco use disorder may produce new insights into the genetics …

Modeling The Importance Of Life Exposure Factors On Memory Performance In Diverse Older Adults: A Machine Learning Approach, Evan Fletcher, Marianne Chanti-Ketterl, Emily Hokett, Yi Lor, Umesh Venkatesan, Ruijia Chen, Omonigho M. Bubu, Rachel Whitmer, Paola Gilsanz, Zvinka Z. Zlatar

Moss-Magee Rehabilitation Papers

INTRODUCTION: Many health life exposure factors (LEFs) influence cognitive decline and dementia incidence, but their relative importance to episodic memory (an early indicator of cognitive decline) among diverse older adults is unclear. We used machine learning to rank LEFs for memory performance in a large and diverse US cohort.

METHODS: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR), participants underwent neuropsychological testing and answered questionnaires about multiple LEFs. XGBoost and Shapley Additive exPlanation values ranked the importance of factors influencing cross-sectional episodic memory in the full sample and by sex and …

Deep Phenotyping Of Obesity: Electronic Health Record-Based Temporal Modeling Study, Xiaoyang Ruan, Shuyu Lu, Liwei Wang, Andrew Wen, Sameer Murali, Hongfang Liu

Faculty, Staff and Student Publications

Background: Obesity affects approximately 40% of adults and 15%-20% of children and adolescents in the United States, and poses significant economic and psychosocial burdens. Currently, patient responses to any single antiobesity medication (AOM) vary significantly, making obesity deep phenotyping and associated precision medicine important targets of investigation.

Objective: This study aimed to evaluate the potential of electronic health records (EHR) as a primary data source for obesity deep phenotyping. We conducted an in-depth analysis of the data elements and quality available from obesity patients prior to pharmacotherapy and applied a multimodal longitudinal deep autoencoder to investigate the feasibility, data requirements, …

Dissatisfaction And Residual Symptoms In Younger And Older Adult Patients After Total Knee Arthroplasty, Nicholas Pohl, Parker Brush, Adrian Santana, Sebastian Fras, Eleanor Jenkins, Arjun Saxena

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Total knee arthroplasty (TKA) is an increasingly used treatment option for younger patients with osteoarthritis. Previous research has found only 66% patients < 60 years who underwent TKA postoperatively reported that their knees felt normal. However, the prior studies did not compare underlying causes for dissatisfaction based on age. This study compared the satisfaction and residual symptom rates between patients ages < 60 and ≥60 years and identified specific reasons for their dissatisfaction between the age groups.

METHODS: Patients who underwent unilateral TKA for osteoarthritis from 2014 to 2016 were electronically sent a 15-question survey pertaining to surgery satisfaction. Following patient identification and survey completion, patient demographics, medical history, surgical time, and length of stay were collected through manual review of medical records. Patients who completed surveys were grouped by age (< 60 years or ≥60 years) for analysis.

RESULTS: In total, 1189 ≥ 60-year-old patients and 388 < 60-year-old patients were included. Most patients in both cohorts reported satisfaction with overall knee function (< 60: 68.6%; ≥60: 71.8%; P = 0.175). Fewer < 60-year patients reported normal knee function (66.5% vs. 75.2%; P < 0.001). The most common residual symptom in both cohorts was continued pain.

CONCLUSION: Patients younger than 60 years reported less satisfaction with performing normal activities …

Novel Neuroactive Steroid Analogs And Voltage-Dependent Blockers Of Cav3.2 Currents, B372 And Yx23, Are Effective Anti-Nociceptives With Diminished Sedative Properties In Intact Female Mice, Benjamin Volvovitz, Rakib Miah, Kibeom Park, Jae Hun Kim, Raul Vargas, Yuanjiang Xu, Mingxing Qian, Douglas F Covey, Slobodan M Todorovic, Vesna Jevtovic-Todorovic

2020-Current year OA Pubs

Although opioids are effective in treating pain, they cause serious side effects. The use of regional anesthesia, although effective in the perioperative period, may not be suitable if mobility and lack of numbness is desired. Hence, there is a clear need for novel pain therapies. Low-voltage activated (T-type) calcium channels (Ca

Exploring Young Adults' Experiences And Beliefs In Asthma Medication Management: Pilot Qualitative Study Comparing Human And Multiple Ai Thematic Analysis, Ruth Ndarake Jeminiwa, Caroline Popielaski, Amber King

College of Pharmacy Faculty Papers

BACKGROUND: Young adults take their asthma maintenance medication 67% of the time or less. Understanding the specific needs and behaviors of young adults with asthma is essential for developing targeted interventions to improve disease self-management. Artificial intelligence (AI) has demonstrated its utility in summarizing and identifying patterns in qualitative research and may support or augment human coding efforts. However, there is pause literature to support this assertion.

OBJECTIVE: The objective of this study is to begin to explore the medication management-related needs of young adults with asthma via a pilot feasibility study. We aim to understand how to best assist …

Lipidomic And Proteomic Insights From Extracellular Vesicles In The Postmortem Dorsolateral Prefrontal Cortex Reveal Substance Use Disorder-Induced Brain Changes, Chioma M Okeoma, Wasifa Naushad, Bryson C Okeoma, Carlos Gartner, Yulica Santos-Ortega, Calvin Vary, Savio Lima-Bastos, Victor Corasolla Carregari, Martin R Larsen, Alessio Noghero, Consuelo Walss-Bass, Rodrigo Grassi-Oliveira

Faculty, Staff and Student Publications

Substance use disorder (SUD) significantly increases the risk of neurotoxicity, inflammation, oxidative stress, and impaired neuroplasticity. The activation of inflammatory pathways by substances may lead to reactive astrogliosis and chronic neuroinflammation, potentially mediated by the release of extracellular particles (EPs), such as extracellular condensates (ECs) and extracellular vesicles (EVs). These particles, which reflect the physiological, pathophysiological, and metabolic states of their cells of origin, might carry molecular signatures indicative of SUD. In particular, our study investigated neuroinflammatory signatures in SUD patients by isolating EVs from the dorsolateral prefrontal cortex (dlPFC) Brodmann's area 9 (BA9) from postmortem subjects. We isolated BA9-derived …

Gastrointestinal Fistulas-What Gastroenterologists Need To Know In 2025, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Gastrointestinal fistulas are increasingly being encountered in our clinical practice because of the increased burden of Crohn's disease, bariatric surgeries, interventional endoscopic procedures, nonsurgical trauma, and war and disaster zones worldwide. Presentation depends on the location and specific type of the fistula. Symptomatic ones can have a tremendous impact on social life and can cause dehydration, electrolyte imbalance, malnutrition, increased morbidity, and mortality. Different imaging studies and endoscopic procedures are done to establish the diagnosis. Treatment modalities to close the fistula depend on the underlying disease and the type of fistula. They include conservative treatment, medical therapy, endoscopic interventions, and …

Shared And Distinct Alterations In Brain Structure Of Youth With Internalizing Or Externalizing Disorders: Findings From The Enigma Antisocial Behavior, Adhd, Mdd, And Anxiety Working Groups, Sophie Townend, Marlene Staginnus, Yidian Gao, Nina Alexander, Volker Arolt, Tobias Banaschewski, Mark A Bellgrove, Vivek Benegal, Robert J Blair, Laura Blanco-Hinojo, Ole Jonas Boeken, Joscha Böhnlein, Sven Bölte, Linda M Bonnekoh, Daniel Brandeis, Rodrigo A Bressan, Fabian Breuer, Willem B Bruin, Jan K Buitelaar, Katie L Burkhouse, Monica E Calkins, Marta Cano, Narcis Cardoner, Hui Chen, Xianliang Chen, David R Coghill, Olivier F Colins, Colm G Connolly, Michael C Craig, Kathryn R Cullen, Udo Dannlowski, Christopher G Davey, Andrea Dietrich, Daifeng Dong, Christine M Freitag, Thomas Frodl, Liesbet Goossens, Dominik Grotegerd, Raquel E Gur, Ruben C Gur, Jan Haavik, Cindy C Hagan, Tim Hahn, Alfons O Hamm, Ben J Harrison, Catharina A Hartman, Martin J Herrmann, Tiffany C Ho, Pieter J Hoekstra, Bharath Holla, Karim Ibrahim, Andrea Jackowski, Hamidreza Jamalabadi, Yali Jiang, Tilo Kircher, Kerstin Konrad, Anna Kraus, Jonna Kuntsi, Till Langhammer, Luisa Lazaro, Elisabeth J Leehr, Ulrike Lueken, Ren Ma, Frank P Macmaster, Gisele G Manfro, Anne Martinelli, Hannah Meinert, Susanne Meinert, Jarosław M Michałowski, Qingsen Ming, Robert Moeck, Lilianne R Mujica-Parodi, Benson Mwangi, Janina Neufeld, Joel T Nigg, Ruth L O'Gorman Tuura, Hyuntaek Oh, Jaap Oosterlaan, Yannis Paloyelis, Pedro M Pan, Luca Passamonti, Wenceslao Peñate, K Luan Phan, Kerstin J Plessen, Jesus Pujol, Karl Lundin Remnélius, Francisco Rivero, Katya Rubia, Ramiro Salas, Giovanni A Salum, Theodore D Satterthwaite, Anne Schienle, Elisabeth Schrammen, Koen R J Schruers, Gunter Schumann, Arjun Sethi, Tim Silk, Norbert Skokauskas, Jordan Smoller, Jair C Soares, Lin Sørensen, Christina Stadler, Michael C Stevens, Benjamin Straube, Thomas Straube, Andreas Ströhle, Gustavo Sudre, Denis G Sukhodolsky, Kate Sully, Xiaoqiang Sun, Chad M Sylvester, Nicola Toschi, Steven J A Van Der Werff, Alasdair Vance, Robert Vermeiren, Albert Wabnegger, Xiaoping Wang, Julia Wendt, Sarah Whittle, Julian Wiemer, Anderson M Winkler, Hans U Wittchen, Mon-Ju Wu, Qiong Wu, Tony T Yang, Yunbo Yang, Shuqiao Yao, Jibiao Zhang, Jiansong Zhou, Andre Zugman, Giovana B Zunta-Soares, Peter M Zwanzger, Sophia I Thomopoulos, Neda Jahanshad, Paul M Thompson, Kevin Hilbert, Arielle Baskin-Sommers, Charlotte A M Cecil, Moji Aghajani, Daniel S Pine, Nic J A Van Der Wee, Dan J Stein, Nynke A Groenewold, Janna Marie Bas-Hoogendam, Laura K M Han, Elena Pozzi, Lianne Schmaal, Barbara Franke, Martine Hoogman, Esther Walton, Stephane A De Brito, Graeme Fairchild, Enigma Antisocial Behavior, Anxiety, Adhd, And Mdd Working Groups

Staff and Researcher Publications

BACKGROUND: Externalizing and internalizing disorders are common in youth but are often studied separately, preventing researchers from identifying shared (i.e., transdiagnostic) alterations in brain structure. Using data from the ENIGMA Consortium, we conducted a mega-analysis to identify shared and distinct cortical and subcortical brain alterations across internalizing (anxiety disorders and depression) and externalizing disorders (attention-deficit/hyperactivity disorder [ADHD] and conduct disorder [CD]) in youth.

METHODS: 3D T1-weighted MRI data from youth (aged 4-21 years) with anxiety disorders (n=1,044), depression (n=504), ADHD (n=1,317), and CD (n=1,172), along with healthy controls (n=4,743) were analyzed. We assessed group differences in regional cortical thickness, surface …

Non-Isolated Tetralogy Of Fallot (Tof+): Exome Sequencing Efficacy And Phenotypic Expansions, Julia Volpi, Xiaonan Zhao, Nichole Owen, Tia Evans, Muriel Holder-Espinasse, Nayana Lahiri, Eleanor Sherlock, Gemma Poke, Jeroen Breckpot, Koen Devriendt, Bjorn Cools, Alfredo Brusco, Giovanni Battista Ferrero, Enrico Grosso, Pradeep Vasudevan, Sara Loddo, Antonio Novelli, Maria Cristina Digilio, Aafke Engwerda, Marrit Hitzert, Alison Male, Lucy Bownass, Ruth Newbury-Ecob, Zosia Miedzybrodzka, Ruth Armstrong, Sally Ann Lynch, Gunnar Houge, Shiyi Xiong, Seema R Lalani, Jill A Rosenfeld, Pamela N Luna, Chad A Shaw, Daryl A Scott

Faculty, Staff and Students Publications

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect (CHD). TOF may present in isolation or in conjunction with one or more non-cardiac congenital anomalies or neurodevelopmental disorders (TOF+). Uncertainty regarding the efficacy of various genetic testing strategies, and an incomplete understanding of the genetic causes of TOF+, may lead to hesitancy in recommending genetic testing, particularly, clinical exome sequencing (cES). Here, we analyzed cES data from 131 individuals with TOF+. A definitive or probable diagnosis was made for 31 individuals, yielding a diagnostic rate of 23.6% (31/131). One individual received three diagnoses. Commercially available CHD panels …

Effects Of Treatment Integrity Level And Error Type On Dro Efficacy: A Parametric And Comparative Analysis, Paige O'Neill

Theses & Dissertations

Differential reinforcement of other behavior (DRO) is a strategy commonly used in applied contexts to address challenging behavior but can be difficult to implement with high treatment integrity. Previous research has shown that DRO may be robust despite marginal errors of commission, but the impact of differing degrees of errors and different error types during DRO is still unclear. The purpose of the current study was to conduct a parametric evaluation of treatment integrity level (100%, 80%, 60%, 40%, 20%) in DRO when implemented with combined errors (Experiment 1) and to directly compare error types (commission errors, omission errors, combined …

Amputation Trends Among People Who Use Drugs In The Context Of Philadelphia’S Increasingly Xylazine Adulterated Drug Supply, Rose Laurano, Monika Pogorzelska-Maziarz, Traci C. Green, Sara Beachy, Kristin L. Rising, Jeffrey K. Hom, Megan K. Reed

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Xylazine-adulterated fentanyl has rapidly spread across the United States and has been increasingly detected in overdose deaths in Philadelphia, PA through medical examiner reports, clinical testing, and widescale drug checking. Xylazine use has been associated with wounds which may lead to amputation, but the extent of this outcome has not been explored.

METHODS: Utilizing the 10th revision of the International Classification of Diseases (ICD-10) codes, we conducted a de-identified retrospective analysis of data for patients identified with opioid related disorders (ICD-10 code F11) admitted to four different hospitals in Philadelphia, PA between 2018 and 2023. Exposure to xylazine use …

Discontinuation Rates And Predictors Of Medical Cannabis Cessation For Chronic Musculoskeletal Pain, Mohammad Khak, Sina Ramtin, Juliet Chung, Asif M. Ilyas, Ari Greis

Rothman Institute Papers

Medical cannabis (MC) is increasingly used as a treatment for chronic musculoskeletal pain, but there is limited data on factors influencing its discontinuation. This study aims to investigate the rates of MC discontinuation and explore factors influencing it in patients with chronic musculoskeletal pain. A retrospective analysis was conducted on 78 patients certified for medical cannabis over a 2 year period. Patient demographics, pain origin, and Global Physical Health (GPH) and Global Mental Health (GMH) scores were collected before intervention. Discontinuation rates were measured at three-month and one-year follow-up. Statistical analyses, including Fisher's Exact Test and two-sample t-tests, were performed …

Enhancing Digital Health Development Through Speech Act Theory: Application To Peripartum Depression Management, Alexandra Zingg, Tavleen Singh, Michael Truong, Sahiti Myneni

Faculty, Staff and Student Publications

The peripartum period is a time of complex transition into motherhood when women may develop peripartum depression (PPD). Digital information sources can help prevent and monitor symptoms through social support and mental health knowledge. However, few studies have characterized the content and form of peer interactions in PPD online forums to inform interventions. In this paper, we present preliminary work using a dataset of 55,301 interactions to inform our digital health development. We combine manual coding for speech acts, behavioral theory mapping, and user engagement modeling to conceptualize dynamic digital education modules for PPD. Results reveal "Expressive" speech act, where …

Feasibility And Preliminary Efficacy Of A Lymphedema And Fibrosis Self-Management Program For Head And Neck Cancer Survivors: A Pilot Randomized Controlled Trial, Jie Deng, Barbara Murphy, Lucy Andersen, Erin Mcmenamin, John Lukens, Joy Cohn, Karthik Rajasekaran, Ryan Quinn, Bryan Spinelli, Alexander Lin

Department of Physical Therapy Faculty Papers

OBJECTIVES: Survivors of head and neck cancer (HNC) are at high risk for developing lymphedema and fibrosis (LEF). Once diagnosed with LEF, survivors must engage in a lifelong program of self-care to minimize long-term adverse effects. However, evidence-based LEF self-management (SM) programs are lacking. To fill this void, we developed and pilot-tested a LEF-SM program for HNC survivors.

MATERIALS AND METHODS: The LEF-SM Program was developed using the Information-Motivation-Behavioral Skills model of health behavior change as a framework. The program was pilot tested in a three-group randomized controlled trial evaluating feasibility and preliminary efficacy. Fifty-nine participants were randomized to: Usual …

Applying The Practical, Robust, Implementation And Sustainability Model (Prism) To A Community-Based Youth Participatory Action Research Program, Nicholas Szoko, Tyia K Wilson, Ebonie Slade, Ti'yanna Risher, Marquise Wheeler, Elizabeth Miller, Alison J Culyba

2020-Current year OA Pubs

BACKGROUND: Youth participatory action research (YPAR) represents an empowerment-based process in which youth identify and address issues in their schools and communities. YPAR has been applied in diverse settings, but evaluations of YPAR implementations using an implementation and dissemination science (IDS) framework are limited. Our goal was to use the Practical, Robust, Implementation & Sustainability Model (PRISM) to evaluate a multisite community-based YPAR program.

METHODS: We identified three community sites to implement Youth Leadership in Action (YLIA+), an eight session YPAR intervention. Any youth aged 13 and older was eligible to participate. Guided by PRISM, we collected data using: (1) …

Real-Time Experiences Of Racism And Stress In Association With Postpartum Weight Retention: A Longitudinal Ecological Momentary Assessment Study, Dara M Méndez, Amanda L Tapia, Sarah A Sanders, Andrea D Casas, Marquita Smalls, Esa M Davis, Stephen L Rathbun, Tiffany L Gary-Webb, Lora E Burke, Serwaa S Omowale, Linda A Adodoadji, John J Gianakas, Y Lai, Maisa Feghali, Meredith L Wallace

Faculty, Staff and Student Publications

Racial inequities in postpartum weight have been documented with limited studies on the influences of racism and other forms of discrimination. In a prospective longitudinal study applying ecological momentary assessment (EMA) and ambulatory assessment of weight, we measured the association between discrimination, stress, and postpartum weight change. The Postpartum Mothers Mobile Study is a cohort of 313 pregnant and birthing individuals who were followed during their second and third trimesters through 1 year postpartum. They were recruited in clinical settings between 2017 and 2020 in a major city center in Pennsylvania. Measures of racism and gender-based discrimination were collected via …

Association Between Allostatic Load And Accelerated White Matter Brain Aging: Findings From The Uk Biobank, Li Feng, Zhenyao Ye, Zewen Du, Yezhi Pan, Travis Canida, Hongjie Ke, Song Liu, Shuo Chen, L Elliot Hong, Peter Kochunov, Jie Chen, David K Y Lei, Edmond Shenassa, Tianzhou Ma

Faculty, Staff and Student Publications

White matter (WM) brain age, a neuroimaging-derived biomarker indicating WM microstructural changes, helps predict dementia and neurodegenerative disorder risks. The cumulative effect of chronic stress on WM brain aging remains unknown. In this study, we assessed cumulative stress using a multi-system composite allostatic load (AL) index based on inflammatory, anthropometric, respiratory, lipidemia, and glucose metabolism measures, and investigated its association with WM brain age gap (BAG), computed from diffusion tensor imaging data using a machine learning model, among 22 951 European ancestries aged 40 to 69 (51.40% women) from UK Biobank. Linear regression, Mendelian randomization, along with inverse probability weighting, …

Genetic Overlap Between Functional Impairment And Depression And Anxiety Symptom Severity: Evidence From The Glad Study, Megan Skelton, Jessica Mundy, Abigail Ter Kuile, Brett Adey, Cherie Armour, Joshua Buckman, Jonathan Coleman, Molly Davies, Colette R. Hirsch, Matthew Hotopf, Ian Jones, Gursharan Kalsi, Georgina Krebs, Sang Hyuck Lee, Yuhao Lin, Andrew M. Mcintosh, Alicia J. Peel, Christopher Rayner, Katharine Rimes, Daniel J. Smith, Katherine N. Thompson, David Veale, James T.R. Walters, Christopher Hübel, Gerome Breen, Thalia C. Eley

School of Psychology

BACKGROUND: Functional impairment in daily activities, such as work and socializing, is part of the diagnostic criteria for major depressive disorder and most anxiety disorders. Despite evidence that symptom severity and functional impairment are partially distinct, functional impairment is often overlooked. To assess whether functional impairment captures diagnostically relevant genetic liability beyond that of symptoms, we aimed to estimate the heritability of, and genetic correlations between, key measures of current depression symptoms, anxiety symptoms, and functional impairment.

METHODS: In 17,130 individuals with lifetime depression or anxiety from the Genetic Links to Anxiety and Depression (GLAD) Study, we analyzed total scores …

Alternative To The Statistical Mass Confusion Of Testing For "No Effect", Josh L Morgan

2020-Current year OA Pubs

In cell biology, statistical analysis means testing the hypothesis that there was no effect. This weak form of hypothesis testing neglects effect size, is universally misinterpreted, and is disastrously prone to error when combined with high-throughput cell biology. The solution is for analysis of measurements to start and end with an interpretation of effect size. In this manuscript, I walk through some of the common critiques of significance testing and how they relate to experimental cell biology. I argue that careful consideration of effect size should be returned to its central position in the planning and discussion of cell biological …

Pain Acceptance In Chronic Postoperative Pain: Concept Analysis, Sajini M Thekkel, Constance M Johnson, Meagan Whisenant, Deniz Dishman

Faculty, Staff and Student Publications

Purpose: Chronic postoperative pain (CPOP) is a potential outcome of otherwise successful surgery that can persist for months, with its prevalence varied by surgical type, genetic predispositions, and psychosocial factors. Pain acceptance offers better outcomes to these patient populations by fostering a willingness to experience pain without resistance. This analysis examines how pain acceptance contributes to psychological well-being, helps reduce opioid misuse, and enhances quality of life, even in the presence of CPOP.

Design: The concept analysis approach follows Walker and Avant's framework (2019).

Methods: A literature search across PubMed, Web of Science, and CINAHL yielded 276 articles, of which …

Lack Of Relationships Between Ketamine Treatment And Peripheral Neurotrophic And Inflammatory Factors In A Randomized Controlled Ketamine Trial Of Major Depressive Disorder, Manivel Rengasamy, Benjamin Panny, Zakary Hutchinson, Anna Marsland, Tessa Kovats, Angela Griffo, Crystal Spotts, Robert H Howland, Meredith L Wallace, Sanjay J Mathew, Shabnam Hossein, Rebecca B Price

Staff and Researcher Publications

Background: Ketamine is a rapid-acting treatment for treatment-resistant depression (TRD), though mechanisms related to ketamine's effects remain unclear. Blood-based neurotrophic and inflammatory factors (NIFs; e.g., brain-derived neurotrophic factor, interleukin-6) have emerged as markers potentially linked to ketamine and ketamine treatment response.

Methods: In this secondary analysis of a randomized controlled trial (RCT), 133 adults with TRD received a single-dose infusion of ketamine (n = 89; 0.5 mg/kg) or saline (n = 44) and provided measures of peripheral blood NIF levels and depression severity across a five-day post-infusion period. Differences between ketamine and saline groups were examined for (1) NIF levels, …

Use Of Cognitive-Behavioral Therapy In A Nation-Wide Veterans Health Administration Sample: The Role Of Clinic, Therapist, And Patient Factors., Alan Mcguire, Mindy Flanagan, Madison E Stout, Jessica Coffing, Marina Kukla, Morgan Traylor, Laura Myers, Nancy Henry, Jessica Carter, Marianne Matthias

Health Services and Informatics Research

OBJECTIVE: To examine the use of CBT-CP (Cognitive-behavioral therapy for chronic pain) by CBT-CP-trained therapists to treat patients with pain over a five-year period (October 2015-February 2020).

DATA SOURCES AND STUDY SETTING: CBT-CP is a core evidence-based practice that is central to multidisciplinary chronic pain care. However, research suggests that CBT-CP is underused. The current study used national Veterans Health Administration data to examine the use of CBT-CP by CBT-CP-trained therapists to treat patients with pain over a five-year period.

STUDY DESIGN: Multilevel modeling was used to evaluate clinic, therapist, and patient-level factors as predictors of CBT-CP receipt.

DATA COLLECTION: …

Safety And Efficacy Of Deep Tms For Adolescent Depression Based On Large Real-World Data Analysis, Yiftach Roth, Aron Tendler, Gaby S Pell, Teejay Tripp, Philip Yam, Dianne Dekeyser, Mah Mekolle, Jayson Tripp, Aaron J Dahl, Owen S Muir, Carlene M Macmillan, Kevin R Rosi, Steven A Harvey, Teresa Poprawski, Kevin M Kinback, Oluremi Adefolarin, Alexander Rohr, Mark E Blair, Diana Ghelber, Raymond Y Cho, Hannah R Kelly, Raymond C Garcia, Amita Jha, Richard A Bermudes, Colleen A Hanlon

Staff and Researcher Publications

Adolescent major depressive disorder (MDD) is a prevalent and serious mental health condition. Pharmacological treatments are commonly used but often have poor tolerability and severe side effects, such as suicidal ideation. Deep transcranial magnetic stimulation (TMS) is currently cleared treating MDD in individuals 22-86 years old. This post-marketing surveillance study was designed to evaluate the safety and efficacy of using this tool as a treatment for MDD in younger patients. Data were collected from 56 sites, resulting in 1257 patients that met inclusion criteria (e.g. 11-21 years old, H1 coil, 18 Hz or iTBS, treatment-resistant MDD). Treatment was well tolerated …

Longer Scans Boost Prediction And Cut Costs In Brain-Wide Association Studies, Leon Qi Rong Ooi, Scott Marek, Nico U F Dosenbach, Timothy O Laumann, Evan M Gordon, Et Al.

2020-Current year OA Pubs

A pervasive dilemma in brain-wide association studies

Barriers And Facilitators To Accessing Healthcare For People With Parkinson's Disease In Latin America: A Qualitative Study, Christine Jeyachandran, Catherine Spooner, Ana Margarita Rodriguez Salgado, Matthew Prina, Joel Rhee, Jorge Jesus Llibre-Guerra, Dani Kim, Juan J Llibre-Rodriguez, Mark F Harris

2020-Current year OA Pubs

AIMS: The aim of the study was to identify the barriers and facilitators to healthcare access for people with Parkinson's disease (PWP) in Spanish-speaking Latin American countries (LAC) in Central and South America, to understand their drivers and consider the implications for health systems in LAC.

METHODS: Four online semi-structured focus groups were conducted with 25 PWP who provide education and/or support to PWP. The study was designed and implemented by a person with lived experience of PD. Data were mapped to an existing model of access to healthcare that incorporates provider and consumer abilities.

FINDINGS: There were multiple provider …