Digital Commons Network^™

An Integrated Analysis Of Three Medulloblastoma Clinical Trials Refines Risk-Stratification Approaches For Reducing Toxicity And Improving Survival, Kyle S Smith, Jeff M Michalski, Et Al.

2020-Current year OA Pubs

BACKGROUND: The identification of clinical and molecular heterogeneity in medulloblastoma has produced risk-stratified therapy, but establishing the most effective yet least toxic regimens has remained elusive owing to numerous treatment options. To improve risk-stratification, we performed an integrated analysis from three clinical trials.

METHODS: Medulloblastoma patients from ACNS0331/NCT00085735, ACNS0332/NCT00392327, and SJMB03/NCT00085202 were included if they had methylation profiling. Molecular groups [WNT, SHH, Group 3 (G3), and Group 4 (G4)], subgroups, and copy number variations were procured from methylation profiles and mutations from next-generation sequencing. Data was assembled into an interactive portal to capture patient characteristics. Cross-trial comparisons, univariable, and multivariable …

Identifying Disparities In Same-Day Surgery Cancellations: Impact Of Race And Socioeconomic Factors In A Pediatric Health System, Nicole M Santucci, Daniel Alligood, Amanda Maytin-Hevia, Danyi Wang, Kelly Chilson, Jesse Vrecenak, Andrew Yeh, Colin A Martin

2020-Current year OA Pubs

PURPOSE: Same-day surgery (SDS) cancellations have significant implications on patients and hospitals. This study aimed to identify demographic and socioeconomic factors that impact SDS cancellations across a single pediatric health system.

METHODS: A case-control retrospective review captured patients (age < 18) who underwent SDS procedures from July 2022 to August 2024. Patients were included if they underwent any procedure at three operative sites: a tertiary pediatric academic hospital (PAH) and two outpatient surgery centers (OSC). Patients whose SDS was cancelled (n = 2,034) were compared to those whose surgeries proceeded as scheduled (n = 25,573). Patient zip codes were matched to Child Opportunity Index (COI) 2.0 data.

RESULTS: The overall SDS cancellation rate was 7.37 %, with a significantly higher rate observed at the PAH compared to OSC (11.4 % vs 53 %, p < 0.001). Patients with cancelled cases were more likely to identify as Black and have the lowest quintile COI (p < 0.001). Cancelled in preop and no shows were two reasons with the most racial disparities. In a sub-analysis comparing cancelled cases between operating sites, PAH cancelled patients tended to be Black (23.8 % vs 11.7 %, p < 0.001) and have very low COI (20.1 % vs. 10.6 %, p < 0.001).

CONCLUSION: SDS cancellation rates are significantly higher amongst patients who identify as Black and reside in low opportunity neighborhoods. Disparities in cancellation rate are more significant in patients scheduled at the urban PAH compared …

Beyond Restless Sleep: A Cross-Sectional Study Of Obstructive Sleep Apnea Risk, Aging Biomarkers, And Chronic Low Back Pain, Khalid W Freij, Fiona Bat Agbor, Philemon Domoyeri, Kiari R Kinnie, Asia M Wiggins, Demario S Overstreet, Tammie L Quinn, Shivraj S Grewal, S Justin Thomas, Walid W Freij, Shameka L Cody, Michael A Owens, Robert E Sorge, Burel R Goodin, Edwin N Aroke

2020-Current year OA Pubs

This secondary data analysis aimed to determine the nature of the relationship between obstructive sleep apnea (OSA) risk, biological age acceleration, and nonspecific chronic low back pain (CLBP). In total, 199 adults aged 18-82 years who filled both STOPBANG and pain questionnaires subsetted for secondary analysis. Based on the STOPBANG questionnaire, 104 had a low OSA risk and 95 had an intermediate or high OSA risk. Dunedin Pace of Aging Computed from the Epigenome (DunedinPACE), Horvath's, Hannum's, PhenoAge, and GrimAge clocks were used to determine biological age and pace of biological aging. Individuals with low OSA risk reported increased DunedinPACE …

Psychometric Properties Of A Novel Affective Bias Task And Its Application In Clinical And Nonclinical Populations, Prathik Kalva, Kourtney Kanja, Brian A Metzger, Xiaoxu Fan, Brian Cui, Bailey Pascuzzi, John Magnotti, Madaline Mocchi, Raissa Mathura, Kelly R Bijanki

Faculty, Staff and Students Publications

To mitigate limitations in self-reported mood assessments, we introduce a novel affective bias task (ABT). The task quantifies instantaneous emotional state by leveraging the phenomenon of affective bias, in which people interpret external emotional stimuli in a manner consistent with their current emotional state. This study establishes task stability in measuring and tracking depressive symptoms in clinical and non-clinical populations. Initial assessment in a large non-clinical sample established normative ratings. Depressive symptoms were tracked relative to task performance in a non-clinical sample, as well as in a clinical cohort undergoing surgical evaluation for severe epilepsy. In both cohorts, a stronger …

Suicidal Ideation In Spinocerebellar Ataxia, Levi Peppel, Ruo-Yah Lai, Christian Rummey, Puneet Opal, Jeremy D Schmahmann, Christopher M Gomez, Henry Paulson, Theresa A Zesiewicz, Susan Perlman, George Wilmot, Sarah H Ying, Chiadi U Onyike, Khalaf O Bushara, Michael D Geschwind, Karla P Figueroa, Stefan M Pulst, Sub H Subramony, Antoine Duquette, Tetsuo Ashizawa, Ali G Hamedani, Marie Y Davis, Sharan R Srinivasan, Matthew R Burns, Nadia Amokrane, Lauren R Moore, Vikram G Shakkottai, Liana S Rosenthal, Sheng-Han Kuo, Chi-Ying R Lin

Faculty, Staff and Students Publications

Objective: Suicidal ideation has not been extensively studied in spinocerebellar ataxias (SCAs). The authors examined whether individuals with SCAs have increased suicidal ideation and related factors.

Methods: The authors studied patients with genetically confirmed SCAs enrolled in the Clinical Research Consortium for the Study of Cerebellar Ataxia cohort, examining the percentages of patients with SCA subtypes 1, 2, 3, and 6 who reported suicidal ideation and comparing findings with nationally representative data from the National Survey on Drug Use and Health (NSDUH). Clinical characteristics that may contribute to suicidal ideation in SCAs, including age, disease duration, sex, ataxia severity, depression, …

Exploring The Acceptability Of Integrating Dietitians Into Primary Care Dental Services For Children, Lauren Hallewell, Raul Bescos, Zoe Brookes, Tracey Parkin, Robert Witton, Patricia Casas-Agustench

School of Health Professions

BACKGROUND: Dental caries is a common childhood non-communicable disease strongly associated with high sugar intake. Beyond oral health, a poor diet can affect children's growth, development, and overall well-being. While dietary advice is central to preventive dental care, some primary care dental clinics have introduced body mass index (BMI) assessments and further dietary advice to address wider nutritional concerns in children. However, these efforts are often constrained by limited nutrition training, time constraints and concerns about sensitivity. Integrating dietitians into primary dental care may help overcome these barriers by enhancing dietary guidance, supporting broader nutritional needs and facilitating structured BMI …

Dampened Social Motivation In Dysphoria: The Role Of Negative Social Expectancies And Internal Causal Attribution Style, Julie L Ji, Nilly Mor, Colin Macleod

School of Psychology

Dysphoria is associated with dampening of social interaction intention, but the cognitive mechanisms that underpin this relationship are under-investigated. This study tested the hypothesis that heightened negative social expectancies mediate the association between dysphoria and dampened social motivation. Additionally, it tested the hypothesis that the association between dysphoria and negative social expectancies is mediated by an attribution style bias that attributes negative, but not positive, outcomes to internal causes. University students (N = 271) with varied levels of dysphoria read vignettes describing hypothetical situations where they initiate a social interaction that results in positive or negative outcomes. Participants rated their …

Picturing The Past: The Role Of Photo Cue Visual Perspective On Positive Autobiographical Memory Recall In Dysphoria, Sarah Snow, Zachary Adolph Niese, Julie L Ji

School of Psychology

Positive autobiographical memory plays a key role in emotional well-being and is distorted by cognitive processing biases in dysphoria. This experiment investigated how the visual perspectives (first-person vs. third-person) of personal photographs influence recall of positive memories depending on dysphoria. Eighty-five participants (42 low dysphoria, 43 high dysphoria) submitted photos of positive events from both perspectives. Later, participants recalled these events while viewing either a first- or third-person photo before rating and describing their memory. While first-person photos promoted more recall from an own-eyes vantage point regardless of dysphoria level, dysphoria was still associated with greater observer-like recall, reduced mental …

Conventional Versus Advanced Imaging Selection For Endovascular Treatment Of Basilar Artery Occlusion Strokes, Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Sami Al Kasab, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Edgar A Samaniego, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Jonathan A Grossberg, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Travis Dumont, Ergun Daglioglu, Richard Williamson, Pedro Navia, Reade De Leacy, Shakeel Chowdhry, David J Altschul, Alejandro M Spiotta, Peter Kan

Faculty, Staff and Students Publications

Introduction: Endovascular thrombectomy (EVT) is an effective treatment for basilar artery occlusion (BAO) stroke in select patients. While there is a growing body of literature suggesting that advanced imaging modalities such as computed tomography perfusion (CTP) and magnetic resonance (MR) may not be necessary for selecting anterior circulation large vessel occlusion stroke patients for EVT, whether advanced imaging may be superior to conventional imaging (non-contrast CT and CT angiography) in identifying good treatment candidates among BAO patients is less clear.

Patients and methods: This was a multicenter retrospective cohort study of BAO EVT patients treated from 2013 to 2022 in …

Non-Congenital Hsv-1 Keratitis In An Immunocompetent 9-Month-Old Infant, Caleb A Casanova, Stephanie Trejo Corona, Stephen F Pflugfelder

Faculty, Staff and Students Publications

Isolated, non-congenital herpes simplex virus type 1 (HSV-1) keratitis in immunocompetent infants is exceedingly rare and may be easily misdiagnosed, leading to delays in appropriate antiviral therapy. This case is unique in that it describes HSV-1 keratitis in a healthy 9-month-old infant presenting without systemic illness, initially treated as bacterial conjunctivitis. The patient presented with unilateral eye pain, redness, and corneal opacification. Subsequent evaluation revealed HSV-1 keratitis, and the patient was treated with intravenous acyclovir in combination with topical moxifloxacin and topical ganciclovir, resulting in complete resolution of symptoms within one week. This case adds to the limited literature on …

Comparing Rotational Thromboelastometry And Standard Coagulation Assays For Predicting Intraoperative Bleeding In Pediatric Liver Transplantation, Kirby Deshotels, Trung Nguyen, Jun Teruya, Muhammed Umair M Mian, Kelby Fuller, Sanjiv Harpavat, Anna Banc-Husu, Amir Navaei, John Goss, Moreshwar Desai, Arun Saini

Faculty, Staff and Students Publications

Background: Utility of preoperative rotational thromboelastometry (ROTEM) over standard coagulation assays (SCAs) in predicting intraoperative bleeding during orthotopic liver transplantation (OLT) in children with liver failure (LF) remains unclear.

Methods: In this single-center retrospective cohort of pediatric OLT recipients, we compared the predictive values of preoperative ROTEM parameters (intrinsic pathway (INTEM) maximum clot firmness (MCF), extrinsic pathway (EXTEM) clotting time (CT), INTEM CT, and fibrinogen-based (FIBTEM) MCF) and the corresponding SCAs (platelet count, international normalized ratio (INR), activated partial thromboplastin time (aPTT), and fibrinogen level, respectively) for significant intraoperative bleeding (blood loss of > 22 mL/kg; i.e., ≥ 85th percentile for …

Frontline Aspiration Versus Stent Retriever Thrombectomy For M2 Occlusions: Insights From The Star Registry, Michael Gaub, Joshua Osbun, Et Al.

2020-Current year OA Pubs

BACKGROUND: Recent trials have furthered uncertainty regarding the endovascular benefit for medium vessel occlusions (MeVO). Stent retrievers (SR) were employed in the first attempt in most interventional arm participants. We sought to compare outcomes in acute MCA M2 occlusions between frontline aspiration and SR, and to delineate procedural and anatomical covariates associated with differential treatment effect.

METHODS: Retrospective analysis of a multicenter stroke thrombectomy cohort identified cases of MT for M2 occlusions. Unmatched and propensity score-matched (PSM) cohorts were generated comparing frontline aspiration to standalone and combined SR. The primary outcome was functional independence (mRS 0-2) at 90 days. Recanalization, …

Diverse Misfolding Mutant Digestive Enzymes Cause Chronic Pancreatitis Through Common Pathways, Steven J Wilhelm, Grace E Curry, Neel Matiwala, Jianguo Lin, Tran Quach, Mark E Lowe, Miklós Sahin-Tóth, Xunjun K Xiao

2020-Current year OA Pubs

BACKGROUND & AIMS: Increasing evidence suggests that protein misfolding and proteotoxicity is an important mechanism of chronic pancreatitis (CP) in patients with genetic variants. Two mouse models carrying misfolding digestive enzyme variants, CPA1 N256K and PNLIP T221M, recapitulate the human CP phenotype. We hypothesized that both models develop CP through similar disease mechanisms.

METHODS: We conducted a comprehensive analysis of mice aged 1 to 6 months using histology, immunohistochemistry, protein immunoblotting, quantitative polymerase chain reaction (qPCR), transmission electron microscopy (TEM), and RNA sequencing (RNA-seq) analysis to characterize pancreatic pathological changes.

RESULTS: Both homozygous models exhibited CP hallmarks, including progressive acinar …

Foot-Specific Exercise Intervention For Forefoot Deformity In Individuals With Type 2 Diabetes And Peripheral Neuropathy: A Randomized Controlled Clinical Trial With 3-Year Follow-Up, J A Zellers, K Steger-May, P K Commean, H-J Jeong, E M Bullard, M J Mueller, M K Hastings

2020-Current year OA Pubs

BACKGROUND: Diabetes with peripheral neuropathy can lead to metatarsophalangeal joint (MTPJ) deformity. The purpose of this study was to estimate the effect of a foot-specific intervention on MTPJ deformity. Secondary aims were determining MTPJ deformity progression over 3 years and predictors of MTPJ deformity progression.

METHODS: Sixty people with type 2 diabetes and peripheral neuropathy were recruited for this randomized controlled clinical trial. Participants were assessed at baseline, 6 months (post-intervention), 1.5 years, and 3 years. A 6-month, foot-specific intervention in the experimental group was compared to a shoulder intervention in the control group. The primary outcome was change in …

Identification Of Distinct Subtypes In Immune Tolerance After Hematopoietic Cell Transplantation Using The Prospective Able1.0 Pediatric Study Cohort, Bernard Ng, Shalini Shenoy, Et Al.

2020-Current year OA Pubs

The lack of immune tolerance after hematopoietic cell transplantation (HCT) can result in chronic graft-versus-host disease (cGvHD), which is the primary nonrelapse limitation of successful HCT. To date, immune tolerance has been considered a single biological entity, but we hypothesized that post-HCT immune tolerance could develop through multiple pathways. Using the ABLE network database, which comprises measurements of 75 cell populations, 10 cytokines and chemokines, lymphocyte population telomere length, KRECs and TRECs, and 132 metabolites from the largest pediatric cGvHD cohort (n = 241), we applied clustering analysis to patients with primary immune tolerance (PIT; no acute GvHD [aGvHD] or …

Phase I Trial Of Adp-A2afp Tcr T-Cell Therapy In Patients With Advanced Hepatocellular Or Gastric Hepatoid Carcinoma, Tim Meyer, Benjamin R Tan, Et Al.

2020-Current year OA Pubs

BACKGROUND & AIMS: Patients with advanced hepatocellular carcinoma (HCC) generally experience poor outcomes despite current therapies, necessitating the development of alternative treatments. ADP-A2AFP is an investigational autologous T-cell therapy with an affinity-enhanced T-cell receptor (TCR) targeting alpha-fetoprotein (AFP).

METHODS: We describe a phase I, open-label, first-in-human clinical trial of ADP-A2AFP (NCT03132792) in human leukocyte antigen-eligible participants with AFP-expressing HCC (or other tumor) not amenable to transplant/resection who progressed on, were intolerant to, or refused prior systemic therapy. Participants received lymphodepletion chemotherapy (cyclophosphamide 500 mg/m

RESULTS: Twenty-one participants, 20 with advanced HCC and one with gastric hepatoid carcinoma received ≥1 ADP-A2AFP …

Genome-Wide Gene-Sleep Interaction Study Identifies Novel Lipid Loci In 732,564 Participants, Raymond Noordam, Karen Schwander, Lisa De Las Fuentes, Mary F Feitosa, Anh Do, C Charles Gu, Changwei Li, Michael A Province, Dabeeru C Rao, Et Al.

2020-Current year OA Pubs

BACKGROUND AND AIMS: Deviations from the population mean in sleep duration have been associated with increased risk for developing dyslipidemia and atherosclerotic cardiovascular disease, but the mechanism of effect is poorly characterized. We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets.

METHODS: We collected data from 55 cohorts with a combined sample size of 732,564 participants (87 % European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) …

Excellent Outcomes In Feasibility Study Of Radiation-Free Conditioning And Transplant In Pediatric Severe Aplastic Anemia, Mithra Lakshmi Narasimhan, Irem Eldem, Jeffrey J Bednarski, Ginny L Schulz, Robert J Hayashi, Shalini Shenoy

2020-Current year OA Pubs

Severe aplastic anemia (SAA) is treated with a hematopoietic cell transplant (HCT) in the presence of an HLA-matched sibling donor (MSD) with disease-free survival (DFS) of >90%. In the absence of an MSD, immunosuppressive therapy (IST) can induce remission but concerns for relapsed/refractory disease and clonal hematopoiesis persist. IST failure is an indication for HCT. Modern HCT approaches target barriers such as graft rejection (GR), graft-versus-host disease (GVHD), and transplant-related toxicities. Traditionally, total body irradiation (TBI) inclusive HCT conditioning helps decrease GR, but the use of TBI in children increases concerns for late effects such as malignancies. To describe outcomes …

Perceived Hiv Risk, Barriers, And Preferences For Hiv Testing In Structurally Vulnerable Communities In St. Louis: A Best-Worst Scaling Survey, Emmanuel K Tetteh, Noelle Le Tourneau, Gregory Gross, Mckenzie Swan, Tyrell Manning, Justin Cole, Katie Wolf, Lawrence Hudson-Lewis, Julia D López, Todd Combs, Virginia R Mckay

2020-Current year OA Pubs

BackgroundPersistent gaps in efforts to end the HIV epidemic in the United States highlight the need for community-specific, evidence-based HIV testing strategies. This study investigated barriers and preferences around HIV testing among underserved populations, including Black, queer, and young adults in the St. Louis, Missouri area.MethodsWe conducted a Best-Worst Scaling (BWS) survey with adults (16+ years) recruited at community events, collecting responses electronically and providing a $25 incentive. The survey assessed the relative importance of 13 potential barriers to HIV testing such as stigma, structural barriers, and perceived HIV risk, chosen based on literature review and community input. Mean preference …

A Single-Cell Atlas Characterizes Dysregulation Of The Bone Marrow Immune Microenvironment Associated With Outcomes In Multiple Myeloma, William C Pilcher, Lijun Yao, Yizhe Song, Kazuhito Sato, Julia T Wang, Reyka G Jayasinghe, Jennifer A Foltz, Mark A Fiala, Chiang I-Ling, Julie Fortier, Michael Slade, Stephen T Oh, Michael P Rettig, John F Dipersio, Shaji Kumar, Ravi Vij, Li Ding, Et Al.

2020-Current year OA Pubs

Multiple myeloma (MM) remains incurable despite advances in treatment options. Although tumor subtypes and specific DNA abnormalities are linked to worse prognosis, the impact of immune dysfunction on disease emergence and/or treatment sensitivity remains unclear. We developed an Immune Atlas of MM by generating profiles of 1,397,272 single cells from the bone marrow (BM) of 337 newly diagnosed participants and characterized immune and hematopoietic cell populations. Cytogenetic risk-based analysis revealed heterogeneous associations with T cells of BM, with 17p13 deletion showing distinct enrichment of a type 1 interferon signature. The disease progression-based analysis revealed the presence of a proinflammatory immune …

Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Stacey House, Et Al.

2020-Current year OA Pubs

OBJECTIVES: We evaluated Mycoplasma genitalium (MG) positivity and co-infection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG), based on results from a trial assessing clinical performance of the Cobas® Liat CT/NG/MG point-of-care test.

METHODS: A prospective, US, multicenter, noninterventional study assessed MG positivity in prospective urine samples (male) and clinician-collected vaginal swabs (female) from symptomatic/asymptomatic patients aged ≥14 years attending various clinical settings. Participants were designated positive or negative for MG, CT, and NG based on combined results from three US Food and Drug Administration-approved assays and one laboratory-developed test. MG co-infection with CT and/or NG was assessed.

RESULTS: Among …

Influence Of Obesity And Insulin Resistance With Hepatic Steatosis On The Human Plasma Lipidome, Max C Petersen, Gordon I Smith, Aaron M Armando, Xiong Su, Oswald Quehenberger, Edward A Dennis, Samuel Klein

2020-Current year OA Pubs

Insulin resistance accompanied by hepatic steatosis is a common complication of obesity. In an effort to identify plasma lipids that could be biomarkers or causes of insulin resistance with steatosis in people with obesity, we evaluated the plasma lipidome in three distinct groups separated by adiposity, hepatic steatosis, and insulin sensitivity, assessed by using the hyperinsulinemic-euglycemic clamp procedure: i) insulin-sensitive lean (ISL, n = 13); ii) insulin-sensitive obese (ISO, n = 14); and iii) insulin-resistant obese with hepatic steatosis (IROS, n = 13). We evaluated 759 complex lipid species in 16 subclasses (including phospholipids, glycerolipids, sphingolipids, acylcarnitines, and cholesteryl esters) …

Advancing Inter-Brain Synchrony Measurement: A Comparative Hyperscanning Study Of Diffuse Optical Tomography And Functional Near-Infrared Spectroscopy, Shuo Guan, Yuhang Li, Yingbo Geng, Dongyun Li, Qiong Xu, Peisong Niu, Dalin Yang, Adam Eggebrecht, Yingchun Zhang, Rihui Li

2020-Current year OA Pubs

Inter-brain synchrony (IBS), measured by hyperscanning, refers to the synchronization of multiple individuals' brain activities during social interactions. Traditional fNIRS-based hyperscanning suffers shortcomings like low spatial resolution and high susceptibility to superficial interference, causing imprecise estimation of IBS in complex social tasks. This study aims to fill the knowledge gap by comprehensively assessing diffuse optical tomography (DOT), an enhanced alternative to fNIRS, can benefit hyperscanning studies of complex social interactions. Sixteen dyads were engaged in both collaborative and individual tangram puzzle tasks, and their brain activities were recorded simultaneously using DOT and fNIRS. We found that DOT demonstrated significantly stronger …

Abnormalities In Sensorimotor Brain Function Are Related To Chronicity Of Low Back Pain, Jo Armour Smith, Rongwen Tain, Kelli G Sharp, Laura M Glynn, Linda R Van Dillen, Jesse V Jacobs, Steven C Cramer

2020-Current year OA Pubs

Maladaptive plasticity in the brain may contribute to chronic low back pain (LBP) and underlie the altered postural control of the lumbopelvic musculature that is evident in some individuals with LBP. We recently described an MRI-compatible leg-raise paradigm to measure brain activity associated with lumbopelvic postural control. The objective of this study was to compare brain function in young adults with and without a history of LBP and to determine relationships between brain function, pain, and postural control characteristics. We recruited 55 participants with a history of LBP, who were asymptomatic when studied, and 30 healthy controls. Postural control during …

Clinical Outcomes Following Mechanical Thrombectomy In Pulmonary Embolism Response Team-Consulted Patients: A Retrospective Analysis, Ryan Nolan, Maanasi Samant, Suresh Vedantham, Westley Ohman, Nathan Droz, Kristen Sanfilippo, Pavan Kavali

2020-Current year OA Pubs

PURPOSE: To determine if use of mechanical thrombectomy (MT) impacts survival and additional outcomes in patients with acute intermediate-high-risk and high-risk pulmonary embolism (PE) who were evaluated by a Pulmonary Embolism Response Team (PERT).

METHODS: This retrospective, single-center study included patients with intermediate-high-risk and high-risk PE who received PERT evaluation over 3.5 years and were treated with anticoagulation (AC) alone or MT + AC. The primary outcome was 30-day all-cause mortality, measured with inverse probability of treatment weighting. Exploratory outcomes included survival during the study period, PE-associated/caused mortality, hospital length of stay (LOS), supplemental oxygen at discharge, and MT-related metrics. …

Modeling Clinical Relevance And Risk In Yttrium-90 Radioembolization Of The Liver: Lung Shunt Fraction Variability According To Imaging Modality, Cancer Type, And Tumor Size, M Allan Thomas, Tharun Alamuri, Ryan C Lee, Dan Giardina, John Karageorgiou, Naganathan Mani, Daniel A Braga, Christopher D Malone

2020-Current year OA Pubs

PURPOSE: To test the hypothesis that lung shunt fraction (LSF) in yttrium-90 (

MATERIALS AND METHODS: This was a retrospective analysis of 354 consecutive cases from a 34-month period at a single institution. Cancer type (hepatocellular carcinoma [HCC] vs non-HCC) and maximum tumor size were tracked. LSF was computed from planar imaging (LSF

RESULTS: Median LSF was significantly different (all P < .001) among LSF

CONCLUSIONS: Despite significant variations with imaging modality and correction methods, consistent trends in LSF magnitude with cancer type and tumor size were still uncovered. The relative risk of observing clinically relevant LSF can be modeled for different liver tumor …

Knowledge, Interest, And Willingness Of Hematologists And Oncologists To Care For Adults With Vascular Anomalies, Bryan A Sisk, Anna M Kerr, Sally Cohen-Cutler, Margaret T Lee, Katie Harmoney, Alexandra Borst, Shelley E Crary, Shelbie Fishman, Stephanie Chen, Danielle Cicka, Stephanie Milam, Christine Bereitschaft, Kristen M Sanfilippo

2020-Current year OA Pubs

BACKGROUND: Vascular anomalies (VAs) are rare diseases that cause significant morbidity. Adults with VAs struggle to access expert care. Hematologists and oncologists in adult medicine are positioned to provide expert care, but no prior studies have characterized their openness to this role.

OBJECTIVES: This study characterized the experience, confidence, willingness, and motivating factors for hematologists/oncologists to care for adults with VAs.

METHODS: We surveyed United States hematologists and oncologists in adult medicine between October 2024 and March 2025. The questionnaire assessed knowledge, experience, confidence, and willingness to care for adults with VAs, as well as open-ended questions assessing factors influencing …

Mouse Alport Podocytes Are Susceptible To Aav9 Transduction In Vivo, Meei-Hua Lin, Kohei Omachi, Joshua F Begin, Jennifer L Richardson, Jeffrey H Miner

2020-Current year OA Pubs

INTRODUCTION: Alport syndrome features a defective glomerular basement membrane (GBM) due to variants in COL4A3, COL4A4, and COL4A5. The most severe forms, which lack the GBM's collagen α3α4α5(IV) network, progress from hematuria in early childhood to proteinuria, chronic kidney disease, and kidney failure by the age of ∼30. As a monogenic disease without specific treatments, and with podocytes being the only glomerular cells that synthesize collagen α3α4α5(IV), the ability to efficiently deliver genes to Alport podocytes could open up new possibilities for treatment.

METHODS: As a proof-of-concept study, we investigated whether podocytes in X-linked Alport mice were susceptible to transduction …

Cgrp Expression And Signaling Sensitization In A Mouse Model Of Chronic Oxaliplatin-Induced Peripheral Neuropathy, Junwei Du, Leland C Sudlow, Margaret H Johnson, Kanishk Satish, Abraham Villagomez, Hongzhen Hu, Mikhail Y Berezin

2020-Current year OA Pubs

Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and dose-limiting side effect of oxaliplatin treatment, yet its molecular mechanisms remain incompletely understood. Calcitonin gene-related peptide alpha (CGRPα, encoded by

Psychological And Clinical Risk Factors For Substance Use In People With And Without Hiv, Joanna M Hobson, Shameka L Cody, Shannon R Gilstrap, Michael A Owens, Myles D Moody, Dyan M White-Gilliam, Stephen Justin Thomas, Emily J Bartley, Burel R Goodin

2020-Current year OA Pubs

BackgroundDespite growing concerns, limited research has demonstrated how psychological factors influence substance use in people with HIV (PWH). Therefore, we examined the association between heightened vigilance and substance use outcomes in people with (PWH) and without HIV (PWoH), while accounting for key risk factors.MethodsParticipants (n = 138) were recruited from an HIV clinic and the surrounding community, completing a urine drug screener (UDS) and questionnaires.ResultsPWH reported greater insomnia (