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Incisionless Targeted Adeno-Associated Viral Vector Delivery To The Brain By Focused Ultrasound-Mediated Intranasal Administration, Dezhuang Ye, Jinyun Yuan, Yaoheng Yang, Yimei Yue, Zhongtao Hu, Siaka Fadera, Hong Chen Oct 2022

Incisionless Targeted Adeno-Associated Viral Vector Delivery To The Brain By Focused Ultrasound-Mediated Intranasal Administration, Dezhuang Ye, Jinyun Yuan, Yaoheng Yang, Yimei Yue, Zhongtao Hu, Siaka Fadera, Hong Chen

2020-Current year OA Pubs

BACKGROUND: Adeno-associated viral (AAV) vectors are currently the leading platform for gene therapy with the potential to treat a variety of central nervous system (CNS) diseases. There are numerous methods for delivering AAVs to the CNS, such as direct intracranial injection (DI), intranasal delivery (IN), and intravenous injection with focused ultrasound-induced blood-brain barrier disruption (FUS-BBBD). However, non-invasive and efficient delivery of AAVs to the brain with minimal systemic toxicity remain the major challenge. This study aims to investigate the potential of focused ultrasound-mediated intranasal delivery (FUSIN) in AAV delivery to brain.

METHODS: Mice were intranasally administered with AAV5 encoding enhanced …


From World War Ii To Covid-19: A Historical Perspective On The American Medical Supply Chain, Hunter D Bechtold, Andrea T Cruz, Brent D Kaziny Oct 2022

From World War Ii To Covid-19: A Historical Perspective On The American Medical Supply Chain, Hunter D Bechtold, Andrea T Cruz, Brent D Kaziny

Faculty, Staff and Students Publications

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.


Azithromycin Use Increases The Risk Of Sudden Cardiac Death In Patients With Hemodialysis-Dependent Kidney Failure, Magdalene M Assimon, Patrick H Pun, Lily Wang, Sana M Al-Khatib, M Alan Brookhart, David J Weber, Wolfgang C Winkelmayer, Jennifer E Flythe Oct 2022

Azithromycin Use Increases The Risk Of Sudden Cardiac Death In Patients With Hemodialysis-Dependent Kidney Failure, Magdalene M Assimon, Patrick H Pun, Lily Wang, Sana M Al-Khatib, M Alan Brookhart, David J Weber, Wolfgang C Winkelmayer, Jennifer E Flythe

Faculty, Staff and Students Publications

Azithromycin is an antibiotic with QT-prolonging potential commonly prescribed to individuals receiving hemodialysis. Hemodialysis patients have a high prevalence of clinical conditions, such as structural heart disease, that can enhance the pro-arrhythmic effects azithromycin, but were excluded from prior investigations evaluating the cardiac safety of azithromycin. Using data from the United States Renal Data System (2007–2017), we conducted two cohort studies to examine the cardiac safety of azithromycin relative to amoxicillin-based antibiotics (amoxicillin, amoxicillin/clavulanic acid) and levofloxacin (a fluoroquinolone antibiotic known to prolong the QT-interval) in the hemodialysis population. The primary outcome was five-day sudden cardiac death. Using inverse probability …


Public Health Information Seeking, Trust, And Covid-19 Prevention Behaviors: Cross-Sectional Study, Emmanuel Kwabena Tetteh, Todd Combs, Elvin Hsing Geng, Virginia Ruth Mckay Sep 2022

Public Health Information Seeking, Trust, And Covid-19 Prevention Behaviors: Cross-Sectional Study, Emmanuel Kwabena Tetteh, Todd Combs, Elvin Hsing Geng, Virginia Ruth Mckay

2020-Current year OA Pubs

BACKGROUND: Preventative health measures such as shelter in place and mask wearing have been widely encouraged to curb the spread of the COVID-19 disease. People's attitudes toward preventative behaviors may be dependent on their sources of information and trust in the information.

OBJECTIVE: The aim of this study was to understand the relationship between trusting in COVID-19 information and preventative behaviors in a racially and politically diverse metropolitan area in the United States.

METHODS: We conducted a web-based cross-sectional survey of residents in St. Louis City and County in Missouri. Individuals aged ≥18 years were eligible to participate. Participants were …


Assessment And Diagnostic Practices Relating To Autism Spectrum Disorder In The United States And Mexico, Maria Valdez, Jessica R. Stewart, Wan-Lin Chang, Ruth Crutchfield, Ralph Carlson Sep 2022

Assessment And Diagnostic Practices Relating To Autism Spectrum Disorder In The United States And Mexico, Maria Valdez, Jessica R. Stewart, Wan-Lin Chang, Ruth Crutchfield, Ralph Carlson

Internet Journal of Allied Health Sciences and Practice

Purpose: The present study examined and compared professional assessment and diagnostic practices relating to autism spectrum disorder (ASD) in Mexico and the United States (U.S.). This information is of great importance because there is an extremely limited amount of information pertaining the assessment and diagnostic practices for ASD in Mexico and little is known about how these practices compare to those in the U.S. Methods: Archival data from a survey investigating ASD in the U.S. and Mexico was used for this study. Participants included 29 professionals from the U.S. and 7 professionals from Mexico. Professionals were from a variety of …


Veterans’ Ambulatory Care Experience During Covid-19: Veterans’ Access To And Satisfaction With Primary Care Early In The Pandemic, Brice Thomas, Aanchal Thadani, Patricia V Chen, Israel C Christie, Lisa M Kern, Mangala Rajan, Himabindu Kadiyala, Drew A Helmer Sep 2022

Veterans’ Ambulatory Care Experience During Covid-19: Veterans’ Access To And Satisfaction With Primary Care Early In The Pandemic, Brice Thomas, Aanchal Thadani, Patricia V Chen, Israel C Christie, Lisa M Kern, Mangala Rajan, Himabindu Kadiyala, Drew A Helmer

Faculty, Staff and Students Publications

BACKGROUND: The COVID-19 pandemic caused widespread changes to healthcare, but few studies focus on ambulatory care during the early phase of the pandemic. We characterize veterans' ambulatory care experience, specifically access and satisfaction, early in the pandemic.

METHODS: We employed a semi-structured telephone interview to capture quantitative and qualitative data from patients scheduled with a primary care provider between March 1 - June 30, 2020. Forty veterans were randomly identified at a single large urban Veterans Health Administration (VHA) medical center. The interview guide utilized 56 closed and open-ended questions to characterize veterans' perceptions of access to and satisfaction with …


Invasive Group A Streptococcal Penicillin Binding Protein 2× Variants Associated With Reduced Susceptibility To Β-Lactam Antibiotics In The United States, 2015-2021, Sopio Chochua, Benjamin Metcalf, Zhongya Li, Saundra Mathis, Theresa Tran, Joy Rivers, Katherine E Fleming-Dutra, Yuan Li, Lesley Mcgee, Bernard Beall Sep 2022

Invasive Group A Streptococcal Penicillin Binding Protein 2× Variants Associated With Reduced Susceptibility To Β-Lactam Antibiotics In The United States, 2015-2021, Sopio Chochua, Benjamin Metcalf, Zhongya Li, Saundra Mathis, Theresa Tran, Joy Rivers, Katherine E Fleming-Dutra, Yuan Li, Lesley Mcgee, Bernard Beall

Faculty, Staff and Student Publications

All known group A streptococci [GAS] are susceptible to β-lactam antibiotics. We recently identified an invasive GAS (iGAS) variant (emm43.4/PBP2x-T553K) with unusually high minimum inhibitory concentrations (MICs) for ampicillin and amoxicillin, although clinically susceptible to β-lactams. We aimed to quantitate PBP2x variants, small changes in β-lactam MICs, and lineages within contemporary population-based iGAS. PBP2x substitutions were comprehensively identified among 13,727 iGAS recovered during 2015-2021, in the USA. Isolates were subjected to antimicrobial susceptibility testing employing low range agar diffusion and PBP2x variants were subjected to phylogenetic analyses. Fifty-five variants were defined based upon substitutions within an assigned PBP2x …


Where Have All The Flowers Gone? A Multicenter Investigation Of Frequent Users Of Midwest Emergency Department Services During The Covid-19 Stay-At-Home Orders., Howard W Levitin, Bruce G Jones, Marie M Lockhart, Christopher M Lloyd, Meenal D Sharkey, Paul A Willette, Andrew F Kalnow Sep 2022

Where Have All The Flowers Gone? A Multicenter Investigation Of Frequent Users Of Midwest Emergency Department Services During The Covid-19 Stay-At-Home Orders., Howard W Levitin, Bruce G Jones, Marie M Lockhart, Christopher M Lloyd, Meenal D Sharkey, Paul A Willette, Andrew F Kalnow

Ambulatory and Primary Care Articles

INTRODUCTION: In this study we aimed to determine the impact of the mandatory coronavirus disease 2019 (COVID-19) pandemic stay-at-home order on the proportional makeup of emergency department (ED) visits by frequent users and super users.

METHODS: We conducted a secondary analysis of existing data using a multisite review of the medical records of 280,053 patients to measure the impact of the COVID-19 pandemic stay-at-home order on ED visits. The primary outcomes included analysis before and during the lockdown in determining ED use and unique characteristics of non-frequent, frequent, and super users of emergency services.

RESULTS: During the mandatory COVID-19 stay-at-home …


Risk And Incidence Of Head And Neck Cancers In Veterans Living With Hiv And Matched Hiv-Negative Veterans, Angela L Mazul, Christine M Hartman, Yvonne M Mowery, Jennifer R Kramer, Donna L White, Kathryn E Royse, Suchismita Raychaudhury, Vlad C Sandulache, Sarah T Ahmed, Jose P Zevallos, Peter A Richardson, Andrew G Sikora, Elizabeth Y Chiao Sep 2022

Risk And Incidence Of Head And Neck Cancers In Veterans Living With Hiv And Matched Hiv-Negative Veterans, Angela L Mazul, Christine M Hartman, Yvonne M Mowery, Jennifer R Kramer, Donna L White, Kathryn E Royse, Suchismita Raychaudhury, Vlad C Sandulache, Sarah T Ahmed, Jose P Zevallos, Peter A Richardson, Andrew G Sikora, Elizabeth Y Chiao

Faculty, Staff and Students Publications

BACKGROUND: Persons living with HIV/AIDS have a higher incidence of virus-related and tobacco/alcohol-related cancers. This study is the first to estimate the effect of HIV versus HIV-negative veterans on the risk of head and neck squamous cell carcinoma incidence in a large retrospective cohort study.

METHODS: The authors constructed a retrospective cohort study using patient data from 1999 to 2016 from the National Veterans Administration Corporate Data Warehouse and the VA Central Cancer Registry. This cohort study included 45,052 veterans living with HIV/AIDS and 162,486 HIV-negative patients matched by age, sex, and index visit (i.e., HIV diagnosis date or clinic …


American Society Of Hematology Living Guidelines On The Use Of Anticoagulation For Thromboprophylaxis For Patients With Covid-19: March 2022 Update On The Use Of Anticoagulation In Critically Ill Patients, Adam Cuker, Kristen M Sanfilippo, Et Al Sep 2022

American Society Of Hematology Living Guidelines On The Use Of Anticoagulation For Thromboprophylaxis For Patients With Covid-19: March 2022 Update On The Use Of Anticoagulation In Critically Ill Patients, Adam Cuker, Kristen M Sanfilippo, Et Al

2020-Current year OA Pubs

BACKGROUND: COVID-19-related critical illness is associated with an increased risk of venous thromboembolism (VTE).

OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for patients with COVID-19.

METHODS: ASH formed a multidisciplinary guideline panel, including 3 patient representatives, and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process, including performing systematic evidence reviews (up to January 2022). The panel prioritized clinical questions …


American Society Of Hematology Living Guidelines On The Use Of Anticoagulation For Thromboprophylaxis In Patients With Covid-19: January 2022 Update On The Use Of Therapeutic-Intensity Anticoagulation In Acutely Ill Patients, Adam Cuker, Kristen M Sanfilippo, Et Al Sep 2022

American Society Of Hematology Living Guidelines On The Use Of Anticoagulation For Thromboprophylaxis In Patients With Covid-19: January 2022 Update On The Use Of Therapeutic-Intensity Anticoagulation In Acutely Ill Patients, Adam Cuker, Kristen M Sanfilippo, Et Al

2020-Current year OA Pubs

BACKGROUND: COVID-19-related acute illness is associated with an increased risk of venous thromboembolism (VTE).

OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in making decisions about the use of anticoagulation in patients with COVID-19.

METHODS: ASH formed a multidisciplinary guideline panel that included patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process and performed systematic evidence reviews (through November 2021). The panel prioritized clinical questions and outcomes according to their importance for …


The Comparison Of The Us And Eu Agricultural Antitrust Exemptions, Martin Milán Csirszki Sep 2022

The Comparison Of The Us And Eu Agricultural Antitrust Exemptions, Martin Milán Csirszki

Yearbook of Antitrust and Regulatory Studies

The article aims to compare the sectoral antitrust exemption for agriculture that exists in the United States (US) and the European Union (EU). The roots for the privileged position of agriculture under antitrust laws date back to 1914. Section 6 of the Clayton Act was the first US law which exempted certain cooperatives. In 1922, the protection was extended to a broader range of agricultural entities by the Capper-Volstead Act. These two acts have since then determined the scope and extent of the US exemption but have evolved through judiciary interpretation. The EU has had a similar exemption for agriculture …


Exit Rates Of Accountable Care Organizations That Serve High Proportions Of Beneficiaries Of Racial And Ethnic Minority Groups, Sunny C Lin, Karen E Joynt Maddox, Andrew M Ryan, Nicholas Moloci, Addison Shay, John Malcolm Hollingsworth Sep 2022

Exit Rates Of Accountable Care Organizations That Serve High Proportions Of Beneficiaries Of Racial And Ethnic Minority Groups, Sunny C Lin, Karen E Joynt Maddox, Andrew M Ryan, Nicholas Moloci, Addison Shay, John Malcolm Hollingsworth

2020-Current year OA Pubs

Importance: The Medicare Shared Savings Program provides financial incentives for accountable care organizations (ACOs) to reduce costs of care. The structure of the shared savings program may not adequately adjust for challenges associated with caring for patients with high medical complexity and social needs, a population disproportionately made up of racial and ethnic minority groups. If so, ACOs serving racial and ethnic minority groups may be more likely to exit the program, raising concerns about the equitable distribution of potential benefits from health care delivery reform efforts.

Objective: To evaluate whether ACOs with a high proportion of beneficaries of racial …


Persistent Disparities In Colorectal Cancer Screening: A Tell-Tale Sign For Implementing New Guidelines In Younger Adults, Po-Hong Liu, Nina N Sanford, Peter S Liang, Amit G Singal, Caitlin C Murphy Sep 2022

Persistent Disparities In Colorectal Cancer Screening: A Tell-Tale Sign For Implementing New Guidelines In Younger Adults, Po-Hong Liu, Nina N Sanford, Peter S Liang, Amit G Singal, Caitlin C Murphy

Faculty, Staff and Student Publications

BACKGROUND: In May 2021, the U.S. Preventive Services Task Force began recommending initiating colorectal cancer screening at age 45 (vs. 50) years.

METHODS: We estimated prevalence of colorectal cancer screening (by colonoscopy, sigmoidoscopy, CT colonography, or stool-based tests) in adults ages 50 to 75 years using data from the National Health Interview Survey in 2000, 2003, 2005, 2008, 2010, 2013, 2015, and 2018. For each survey year, we estimated prevalence by age, race/ethnicity, educational attainment, family income, and health insurance. We also compared increases in prevalence of screening from 2000 to 2018 in 5-year age groups (50-54, 55-59, 60-64, 65-69, …


Leveraging Clinical Trial Populations And Data From The Children's Oncology Group For Cancer Survivorship Research, Eric J Chow, Lena E Winestone, Philip J Lupo, Lisa R Diller, Tara O Henderson, Nina S Kadan-Lottick, Jennifer M Levine, Kirsten K Ness, Smita Bhatia, Saro H Armenian Sep 2022

Leveraging Clinical Trial Populations And Data From The Children's Oncology Group For Cancer Survivorship Research, Eric J Chow, Lena E Winestone, Philip J Lupo, Lisa R Diller, Tara O Henderson, Nina S Kadan-Lottick, Jennifer M Levine, Kirsten K Ness, Smita Bhatia, Saro H Armenian

Center for Medical Ethics and Health Policy Staff Publications

Children and adolescents diagnosed with cancer can now expect an average 85% 5-year overall survival, with significant improvements in longer-term morbidity and mortality reported over the past several decades. However, the long-term impact of therapeutic agents and modalities introduced in recent years remains unclear and will require dedicated follow-up in the years ahead. The Children's Oncology Group (COG), a part of the NCI's National Clinical Trials Network, with over 200 sites across North America and beyond, enrolls more than 10,000 patients onto research protocols annually, inclusive of first-line clinical trials and nontherapeutic studies. COG provides a platform to conduct survivorship …


Interventions To Prevent Hypothermia In Extremely Preterm Low-Weight Infants Undergoing Cardiac Catheterisation, Eliane Alhalabi, Maria Zestos, Daisuke Kobayashi, George M. Mckelvey, Rachel A. Taylor Sep 2022

Interventions To Prevent Hypothermia In Extremely Preterm Low-Weight Infants Undergoing Cardiac Catheterisation, Eliane Alhalabi, Maria Zestos, Daisuke Kobayashi, George M. Mckelvey, Rachel A. Taylor

Anesthesiology Articles

BACKGROUND: In January 2019, a new device called the Amplatzer Piccolo Occluder was approved by the US Food and Drug Administration for percutaneous closure of patent ductus arteriosus in infants weighing more than 700 g and of postnatal age more than 3 days. Premature low-weight infants are predisposed to hypothermia when transported outside of the thermo-neutral environment. At our institution, 90% of extremely preterm low-weight infants developed transient moderate hypothermia in the cardiac catheterisation suite.

METHODS: We conducted a study testing multiple hypotheses aimed at preventing hypothermia in the cardiac catheterisation suite. Interventions included increasing ambient room temperature, reducing exposure …


The Validity Of Mcat Scores In Predicting Students' Performance And Progress In Medical School: Results From A Multisite Study, Joshua T. Hanson, Kevin Busche, Martha L. Elks, Loretta E. Jackson-Williams, Robert A. Liotta, Chad Miller, Cindy A. Morris, Barton Thiessen, Kun Yuan Sep 2022

The Validity Of Mcat Scores In Predicting Students' Performance And Progress In Medical School: Results From A Multisite Study, Joshua T. Hanson, Kevin Busche, Martha L. Elks, Loretta E. Jackson-Williams, Robert A. Liotta, Chad Miller, Cindy A. Morris, Barton Thiessen, Kun Yuan

Pathology Research and Scholarship

PURPOSE: This is the first multisite investigation of the validity of scores from the current version of the Medical College Admission Test (MCAT) in clerkship and licensure contexts. It examined the predictive validity of MCAT scores and undergraduate grade point averages (UGPAs) for performance in preclerkship and clerkship courses and on the United States Medical Licensing Examination Step 1 and Step 2 Clinical Knowledge examinations. It also studied students' progress in medical school.

METHOD: Researchers examined data from 17 U.S. and Canadian MD-granting medical schools for 2016 and 2017 entrants who volunteered for the research and applied with scores from …


Drag, Drugs, And Demonstrations: Cultural Subversion Under Capitalism, Nicholas Kade Edwards Sep 2022

Drag, Drugs, And Demonstrations: Cultural Subversion Under Capitalism, Nicholas Kade Edwards

Dissertations, Theses, and Capstone Projects

In this essay, I will define cultural institutionalization and articulate the ways in which the phenomenon modulates subversive countercultural movements and integrates them into Western, capitalist cultural structures. I will then illustrate my theory of cultural institutionalization by analyzing three historical case studies of subversive countercultural movements in the United States. The first of which will be the drag queen phenomenon, which provides the most convincing case for the theory in the artistic sphere. Secondly, I will address a more explicitly political movement, the black liberation movement and its various permutations: the civil rights movement, the black power movement and …


Regulation Weakness And Lack Of Public Awareness Has Impeded The Implementation Of Environmental Policies In Saudi Arabia, Nada Gurmalla Algamdy Sep 2022

Regulation Weakness And Lack Of Public Awareness Has Impeded The Implementation Of Environmental Policies In Saudi Arabia, Nada Gurmalla Algamdy

Dissertations & Theses

This research aimed to substantially illustrate that the weakness of environmental regulations and lack of public participation in urban planning alongside poor public awareness in Saudi Arabia has inhibited the implementation of environmental policies across this region. To study these issues, this research compared the Kingdom of Saudi Arabia (“KSA”) to the United States (“US”) building on numerous studies to illustrate how the identified weaknesses correlate with weak or ineffective environmental policies. It is well known that it would be better to use a European country “because it's known that the EU has tough environmental measures" as a model for …


Highlights From The 67th Annual Meeting Of The American Society For Artificial Internal Organs In Chicago, Il, Christopher D. Pritting, Alice L. Sweedo, Vakhtang Tchantchaleishvili, Dongfang Wang, Joseph B. Zwischenberger Sep 2022

Highlights From The 67th Annual Meeting Of The American Society For Artificial Internal Organs In Chicago, Il, Christopher D. Pritting, Alice L. Sweedo, Vakhtang Tchantchaleishvili, Dongfang Wang, Joseph B. Zwischenberger

Department of Surgery Faculty Papers

Dr. Willem J. Kolff founded the American Society for Artificial Internal Organs (ASAIO) in 1955. Each year experts in the fields of renal, pulmonary, pancreatic, cardiac, bioengineering, and orthopedic research congregate to discuss the latest developments in their respective fields. Throughout the conference's history, ASAIO has adapted to promote inquiry, ingenuity, and innovation. The congeniality partnered with the expertise of the conference's attendees has facilitated continuous progress since the conference's inception.

The 2022 ASAIO Annual Conference was held in Chicago, IL in an entirely in-person format, the first since the 65th conference in 2019. This year there were exhibits by …


Factors Associated With Severe Illness In Patients Aged <21 Years Hospitalized For Covid-19, Rewa Choudhary, Bryant J Webber, Lindsay S Womack, Hannah K Dupont, Sophia K Chiu, Valentine Wanga, Megan E Gerdes, Sophia Hsu, Dallas S Shi, Theresa M Dulski, Osatohamwen I Idubor, Arthur M Wendel, Nickolas T Agathis, Kristi Anderson, Tricia Boyles, Eleanor S Click, Juliana Da Silva, Mary E Evans, Jeremy A W Gold, Julia C Haston, Pamela Logan, Susan A Maloney, Marisol Martinez, Pavithra Natarajan, Kevin B Spicer, Mark Swancutt, Valerie A Stevens, Jessica Rogers-Brown, Gyan Chandra, Megan Light, Frederick E Barr, Jessica Snowden, Larry K Kociolek, Matthew Mchugh, David L Wessel, Joelle N Simpson, Kathleen C Gorman, Kristen A Breslin, Roberta L Debiasi, Aaron Thompson, Mark W Kline, Julie A Boom, Ila R Singh, Michael Dowlin, Mark Wietecha, Beth Schweitzer, Sapna Bamrah Morris, Emilia H Koumans, Jean Y Ko, David A Siegel, Anne A Kimball Sep 2022

Factors Associated With Severe Illness In Patients Aged <21 Years Hospitalized For Covid-19, Rewa Choudhary, Bryant J Webber, Lindsay S Womack, Hannah K Dupont, Sophia K Chiu, Valentine Wanga, Megan E Gerdes, Sophia Hsu, Dallas S Shi, Theresa M Dulski, Osatohamwen I Idubor, Arthur M Wendel, Nickolas T Agathis, Kristi Anderson, Tricia Boyles, Eleanor S Click, Juliana Da Silva, Mary E Evans, Jeremy A W Gold, Julia C Haston, Pamela Logan, Susan A Maloney, Marisol Martinez, Pavithra Natarajan, Kevin B Spicer, Mark Swancutt, Valerie A Stevens, Jessica Rogers-Brown, Gyan Chandra, Megan Light, Frederick E Barr, Jessica Snowden, Larry K Kociolek, Matthew Mchugh, David L Wessel, Joelle N Simpson, Kathleen C Gorman, Kristen A Breslin, Roberta L Debiasi, Aaron Thompson, Mark W Kline, Julie A Boom, Ila R Singh, Michael Dowlin, Mark Wietecha, Beth Schweitzer, Sapna Bamrah Morris, Emilia H Koumans, Jean Y Ko, David A Siegel, Anne A Kimball

Faculty, Staff and Students Publications

OBJECTIVES: To describe coronavirus disease 2019 (COVID-19)-related pediatric hospitalizations during a period of B.1.617.2 (Δ) variant predominance and to determine age-specific factors associated with severe illness.

METHODS: We abstracted data from medical charts to conduct a cross-sectional study of patients agedchildren's hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation.

RESULTS: Of 947 hospitalized patients, 759 …


Risk Factors And Medical Resource Utilization In Us Adults Hospitalized With Influenza Or Respiratory Syncytial Virus In The Hospitalized Acute Respiratory Tract Infection Study, Jessica Hartnett, Prina Donga, Gabriela Ispas, Yannick Vandendijck, David Anderson, Stacey House, Selim Suner Sep 2022

Risk Factors And Medical Resource Utilization In Us Adults Hospitalized With Influenza Or Respiratory Syncytial Virus In The Hospitalized Acute Respiratory Tract Infection Study, Jessica Hartnett, Prina Donga, Gabriela Ispas, Yannick Vandendijck, David Anderson, Stacey House, Selim Suner

2020-Current year OA Pubs

BACKGROUND: Influenza and respiratory syncytial virus (RSV) are associated with substantial morbidity and mortality in the United States. We assessed risk factors for severe disease and medical resource utilization (MRU) among US adults hospitalized with influenza or RSV in the Hospitalized Acute Respiratory Tract Infection (HARTI) study.

METHODS: HARTI was a prospective global (40 centers, 12 countries) epidemiological study of adults hospitalized with acute respiratory tract infections conducted across the 2017-2019 epidemic seasons. Patients with confirmed influenza or RSV were followed up to 3 months post-discharge. Baseline characteristics, prevalence of core risk factors (CRFs) for severe disease (age ≥65 years, …


Clinical Epidemiology Of Carbapenem-Resistant Enterobacterales In The Greater Houston Region Of Texas: A 6-Year Trend And Surveillance Analysis, Bekana K Tadese, Charles Darkoh, Stacia M Desantis, Osaro Mgbere, Kayo Fujimoto Sep 2022

Clinical Epidemiology Of Carbapenem-Resistant Enterobacterales In The Greater Houston Region Of Texas: A 6-Year Trend And Surveillance Analysis, Bekana K Tadese, Charles Darkoh, Stacia M Desantis, Osaro Mgbere, Kayo Fujimoto

Faculty, Staff and Student Publications

OBJECTIVES: Carbapenem-resistant Enterobacterales (CRE) remain an urgent public health priority in the United States. CRE poses a major threat to patients in healthcare and a potential risk to the community. This study examined the epidemiological trends, clinical, and microbiological data of CRE in the Greater Houston region of Texas.

METHODS: A multi-institutional retrospective observational study was conducted using surveillance data collected from 2015 to 2020. Predictors of incidence rates of CRE were determined by a negative binomial regression fit using a generalized estimation equation.

RESULTS: Over a 6-year period, 4236 CRE cases were reported, of which Klebsiella pneumoniae accounted for …


Informed Consent For Placebo-Controlled Trials: Do Ethics And Science Conflict?, Hope A Feldman, James A Feldman, Charles C Miller, Garrett Walsh, Jon E Tyson Sep 2022

Informed Consent For Placebo-Controlled Trials: Do Ethics And Science Conflict?, Hope A Feldman, James A Feldman, Charles C Miller, Garrett Walsh, Jon E Tyson

Faculty, Staff and Student Publications

The use of a placebo has been considered the best method for controlling bias in a prospective randomized clinical trial and provides the most rigorous test of treatment efficacy for evaluating a medical therapy. Placebos commonly produce clinically important effects particularly in studies where the primary outcomes are subjective. Yet the potential beneficial or harmful effects of placebos are often not addressed in designing a clinical trial, calculating the sample size, seeking consent, or interpreting clinical trial results. In this manuscript, we use an actual study to indicate three approaches that might be considered in seeking informed consent for placebo-controlled …


Trends In The Diversity Of Pediatric Faculty: 2000 To 2020, Emma A Omoruyi, Colin J Orr, Greg Russell, Kimberly Montez Sep 2022

Trends In The Diversity Of Pediatric Faculty: 2000 To 2020, Emma A Omoruyi, Colin J Orr, Greg Russell, Kimberly Montez

Faculty, Staff and Student Publications

OBJECTIVE: Academic medicine diversity is important for addressing health disparities and training the next generation. A recent study highlighted the lack of diversity among pediatric trainees over time. However, trends in US pediatric faculty diversity have not been clearly illuminated. The aim of this study is to evaluate pediatric faculty diversity trends and compare racial/ethnic representation between pediatric faculty and the US population.

METHODS: Repeat cross-sectional study of the Association of American Medical Colleges Faculty Roster of pediatric faculty from 2000 to 2020. Trends in sex, race, ethnicity, and rank were compared with the Cochran-Armitage test. Data on faculty race/ethnicity …


Ugrc 2021 Recommendations On Gme Transition: Pros And Cons, Opportunities And Limitations, John R Gimpel, Jennifer L Swails, Jessica L Bienstock, Grant L Lin, Michelle A Roett, Juhee K Patel, Daniel W Giang Sep 2022

Ugrc 2021 Recommendations On Gme Transition: Pros And Cons, Opportunities And Limitations, John R Gimpel, Jennifer L Swails, Jessica L Bienstock, Grant L Lin, Michelle A Roett, Juhee K Patel, Daniel W Giang

Faculty, Staff and Student Publications

The Coalition for Physician Accountability's Undergraduate Medical Education-Graduate Medical Education (UME-GME) Review Committee (UGRC): Recommendations for Comprehensive Improvement of the UME-GME Transition final report includes a total of 34 recommendations and outlines opportunities to transform the current processes of learner transition from a US-based MD- or DO-granting medical school or international medical education pathway into residency training in the United States. This review provides a reflection on the recommendations from the authors, all members of the UGRC, describing the pros and cons and the opportunities and limitations, in the hopes that they might inspire readers to dig deeper into the …


Aapm Medical Physics Practice Guideline 5b: Commissioning And Qa Of Treatment Planning Dose Calculations-Megavoltage Photon And Electron Beams, Mark W Geurts, Dustin J Jacqmin, Lindsay E Jones, Stephen F Kry, Dimitris N Mihailidis, Jared D Ohrt, Timothy Ritter, Jennifer B Smilowitz, Nicholai E Wingreen Sep 2022

Aapm Medical Physics Practice Guideline 5b: Commissioning And Qa Of Treatment Planning Dose Calculations-Megavoltage Photon And Electron Beams, Mark W Geurts, Dustin J Jacqmin, Lindsay E Jones, Stephen F Kry, Dimitris N Mihailidis, Jared D Ohrt, Timothy Ritter, Jennifer B Smilowitz, Nicholai E Wingreen

Faculty, Staff and Student Publications

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth …


Will Anti-Vaccine Activism In The Usa Reverse Global Goals?, Peter J Hotez Sep 2022

Will Anti-Vaccine Activism In The Usa Reverse Global Goals?, Peter J Hotez

Center for Medical Ethics and Health Policy Staff Publications

In the time of the COVID-19 pandemic, anti-vaccine activism in the USA accelerated, amplified and formed an alliance with political groups and even extremists. An organized, well-funded and empowered anti-science movement now threatens to spill over and threaten all childhood immunizations in the USA and globally.


Trends In Matriculation From Neurological Surgery Training Programs Into Academic Versus Private Practice, Neha Siddiqui, Vamsi P. Reddy, James L. Rogers, Donald K. E. Detchou, Imaima Casubhoy, Rhea Gopali, Subhang Bhalla, Mika Janbahan, Emily Morris, Meghna Priyanka Peesapati, Nitin Agarwal Sep 2022

Trends In Matriculation From Neurological Surgery Training Programs Into Academic Versus Private Practice, Neha Siddiqui, Vamsi P. Reddy, James L. Rogers, Donald K. E. Detchou, Imaima Casubhoy, Rhea Gopali, Subhang Bhalla, Mika Janbahan, Emily Morris, Meghna Priyanka Peesapati, Nitin Agarwal

2020-Current year OA Pubs

OBJECTIVE: A career in academic neurosurgery is an arduous endeavor. Specific factors influencing physician practice preferences remain unclear. This study analyzes data from the American Association of Neurological Surgeons membership identifying the impact of several demographic and educational characteristics influencing neurosurgical career choices centered on academia, private practice, or a combination in the United States.

METHODS: A list of all current neurosurgeons was obtained from the American Association of Neurological Surgeons membership, and information on physician characteristics was collected via internet searches and institutional databases. The practice type of all neurosurgeons considered in this study were categorized as follows: private …


Real-World Evidence Of Axicabtagene Ciloleucel For The Treatment Of Large B Cell Lymphoma In The United States, Caron A Jacobson, Armin Ghobadi, Et Al. Sep 2022

Real-World Evidence Of Axicabtagene Ciloleucel For The Treatment Of Large B Cell Lymphoma In The United States, Caron A Jacobson, Armin Ghobadi, Et Al.

2020-Current year OA Pubs

Axicabtagene ciloleucel (axi-cel) is a standard-of-care for patients with relapsed or refractory (r/r) large B cell lymphoma who have received 2 or more lines of prior therapy. Patients receiving axi-cel in the real world could have broader a demographic, disease, and treatment profile compared with that of the cohort in the pivotal ZUMA-1 trial. The present study was conducted to evaluate the outcomes of axi-cel therapy in the real-world setting. A total of 1297 patients receiving commercial axi-cel between 2017 and 2020 were selected from the Center for International Blood and Marrow Transplant Research's data registry, of whom 739 (57%) …