Digital Commons Network^™

Extending Genome-Wide Association Studies To Admixed Cohorts With High Degrees Of Relatedness, Taotao Tan, Alejandra Vergara-Lope, José Jaime Martínez-Magaña, Nirav N Shah, Yi-Sian Lin, Kai Yuan, Jaime Berumen, Jesus Alegre-Díaz, Pablo Kuri-Morales, Roberto Tapia-Conyer, Joel Gelenter, Janitza L Montalvo-Ortiz, Wei Zhou, Jason M Torres, Elizabeth G Atkinson

Duncan NRI Faculty and Staff Publications

Admixed populations comprise a large portion of the human population worldwide, but are often excluded from genome-wide association studies (GWASs) due to analytic challenges. Our group developed Tractor, a local-ancestry-informed GWAS tool designed for admixed samples that produces accurate ancestry-specific effect sizes and boosts the discovery power to identify ancestry-enriched loci. However, Tractor operates under an assumption of unrelated samples. Here, to address this gap, we propose Tractor-Mix, which allows for well-calibrated association studies in datasets containing admixed samples with relatedness. Extensive simulations show that this method is competitive with other state-of-the-art approaches that do not produce ancestry-specific results. Empirical …

Navigating Undone Science: The Search For Adequate Endometriosis Care, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Endometriosis is an estrogen-dependent disease in which tissue similar to the lining of the uterus grows elsewhere in the body leading to a variety of symptoms including heavy and prolonged menstruation, chronic pain, cysts, infertility, and gastrointestinal issues. Despite being one of the most common gynecologic conditions, much remains unknown about potential risk factors for endometriosis, its etiology, and treatment options. First and second-line biomedical treatment options, complementary and alternative medicine, and lifestyle changes are all treatment options that people living with endometriosis (PLE) leverage to manage their symptoms. This article draws on in-depth interviews with 52 people living with …

Decision-Making Criteria In Polygenic Embryo Screening: A Survey Of Reproductive Medicine Physicians, Rémy A Furrer, Aayushi Gandhi, Dorit Barlevy, Shai Carmi, Todd Lencz, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) examines embryos for their genetic likelihood of developing complex conditions and traits. The commercialization of PES places reproductive endocrinologists and infertility specialists (REIs) as the primary decision-makers in its use, despite professional guidelines cautioning that PES is not ready for clinical use.

Methods: This survey examines how 152 US REIs perceive and approach potential clinical decision-making scenarios regarding the use of PES.

Results: REIs were more likely to offer PES for medical conditions (up to 62% for cancer) than for traits (eg, 0% for skin color, 10% for body mass index). When evaluating 11 potential …

Diabetter Together: Outcomes Of A Randomized Controlled Trial Evaluating A Peer Mentor Behavioral Intervention For Young Adults With Type 1 Diabetes During The Transfer From Pediatric To Adult Care, Marisa E Hilliard, Charles G Minard, Samantha A Carreon, Wendy L Levy, Sarah K Lyons, Randi Streisand, Tricia S Tang, Siripoom V Mckay, Sridevi Devaraj, Barbara J Anderson

Faculty, Staff and Students Publications

Objective: Transition between pediatric and adult health care is complex, with high risk for loss to follow-up and suboptimal health outcomes for young adults with type 1 diabetes. This trial evaluated the efficacy of DiaBetter Together, a 12-month strengths-based behavioral intervention delivered by trained peer mentors. The intervention aimed to help young adults navigate the transfer process to promote optimal glycemic outcomes, shorten time to adult care follow-up, and improve psychosocial outcomes.

Research design and methods: Using a single-site randomized clinical trial design, we compared the 12-month intervention to usual care among n = 100 young adults aged 17-25 years …

Quantitative Imaging Of Pyruvate Metabolism In A Patient With Anaplastic Thyroid Cancer, James A Bankson, Joshua S Niedzielski, Collin J Harlan, Yunyun Chen, Christopher M Walker, Philip L Lorenzi, Lin Tan, Vikas Kundra, Matthew E Merritt, Mukundan Ragavan, Dawid Schellingerhout, Renjie He, Yao Ding, Sahana Datar, Qing Wang, Christine B Peterson, Clifton D Fuller, Vlad C Sandulache, Stephen Y Lai

Faculty, Staff and Students Publications

Purpose: Magnetic resonance imaging using hyperpolarized (HP) [1-13C]-pyruvate enables assessment of pyruvate metabolism in vivo and offers new insight into metabolic changes in response to cancer therapy. Widely used semi-quantitative metrics of pyruvate metabolism can be affected by physiological factors that are extrinsic to intracellular metabolism. A validated pharmacokinetic (PK) model for analysis of intracellular pyruvate metabolism is needed to enhance the accuracy of quantitative metrics and clinical translation of metabolic MRI using HP pyruvate.

Methods: A PK model with two physical compartments and two chemical pools was developed to analyze the conversion of labeled pyruvate into lactate in vitro. …

Dupilumab Versus Placebo In Adults And Adolescents With Eosinophilic Gastritis (Degas): A Double-Blind, Placebo-Controlled, Phase 2, Multicentre, Randomised Controlled Trial, Nirmala P Gonsalves, Evan S Dellon, Kara L Kliewer, Tetsuo Shoda, Regina Yearout, Seema S Aceves, Nicoleta C Arva, John A Besse, Julie M Caldwell, Mirna Chehade, Amaziah Coleman, Margaret H Collins, Sara Anvari, Gary W Falk, Sandeep K Gupta, Girish Hiremath, David A Katzka, Paneez Khoury, John Leung, Calies Menard-Katcher, Paul Menard-Katcher, Kathryn A Peterson, Maria A Pletneva, Amanda K Rudman Spergel, Jonathan M Spergel, Tatyana Vaysman, Joshua B Wechsler, Benjamin L Wright, Guang-Yu Yang, Xue Zhang, Meijian Zhou, Ashish Bansal, Bram P Raphael, Amr Radwan, Jennifer Maloney, Antonio Martin, Yamo Deniz, Glenn T Furuta, Lisa J Martin, Marc E Rothenberg

Faculty, Staff and Students Publications

Background: Eosinophilic gastritis currently has no approved treatments and is postulated to be driven by type 2 inflammation. Dupilumab blocks type 2 cytokines IL-4 and IL-13 and has efficacy in multiple diseases characterised by type 2 inflammation, including eosinophilic oesophagitis. We aimed to assess the efficacy and safety of dupilumab in patients with eosinophilic gastritis.

Methods: DEGAS was a proof-of-concept, phase 2, multicentre, randomised controlled trial consisting of a 12-week, double-blind, placebo-controlled period, followed by a 24-week open-label extension period. Patients aged 12-70 years from 11 hospitals in the USA with histologically active eosinophilic gastritis (≥30 eosinophils per high-power field …

Colocalization Of Eqtls With Type 2 Diabetes And Glycemic Traits Using Whole-Genome Sequences In Diverse Populations From The Nhlbi Trans-Omics In Precision Medicine (Topmed) Program, Ningyuan Wang, Daniel A Dicorpo, Yixin Zhang, Erica Kleinbrink, Donna K Arnett, John Barnard, John Blangero, Donald W Bowden, April P Carson, Yii-Der Ida Chen, Mina K Chung, Joanne E Curran, Dawood Darbar, Ravindranath Duggirala, Patrick T Ellinor, Diane Fatkin, Myriam Fornage, Nancy Heard-Costa, Jiang He, Lifang Hou, Sharon L R Kardia, Charles Kooperberg, Ruth J F Loos, David D Mcmanus, Braxton D Mitchell, Ryan L Minster, Kari E North, Bruce M Psaty, Laura M Raffield, Susan Redline, Stephen S Rich, Dan Roden, Jerome I Rotter, Moore B Shoemaker, Jonathan D Smith, David R Van Wagoner, Francois Aguet, Kristin Ardlie, Joshua C Bis, Jennifer A Brody, Brian E Cade, Clary B Clish, Paul S De Vries, James S Floyd, Barry I Freedman, Stacey Gabriel, Robert E Gerzsten, Mark O Goodarzi, Charles Gu, Xiuqing Guo, Namrata Gupta, Susan R Heckbert, Sarah Hsu, Yi-Jen Hung, Rita R Kalyani, Tanika N Kelly, Gregory L Kinney, Changwei Li, Simin Liu, Yongmei Liu, Donald M Lloyd-Jones, Joann E Manson, Rasika A Mathias, Josep M Mercader, Alanna C Morrison, Take Naseri, Suna Onengut, Nicholette D Palmer, Patricia A Peyser, Qibin Qi, Sridharan Raghavan, Alex P Reiner, Mary R Rooney, Magdalena Sevilla-Gonzalez, Chloe Sarnowski, Joshua D Smith, Jennifer A Smith, Nicole L Spartano, Usman Tahir, Kent D Taylor, Deirdre K Tobias, Russel P Tracy, Satupa'itea Viali, Heming Wang, Alexis C Wood, Lisa R Yanek, Wei Zhao, Yinan Zheng, Josée Dupuis, Ching-Ti Liu, Robert Sladek, Jennifer Wessel, James B Meigs, Alisa K Manning, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium

Faculty, Staff and Students Publications

Large-scale multiancestry genome-wide association studies have identified hundreds of loci associated with type 2 diabetes (T2D) and glycemic traits, yet imputed genotyping arrays limit the detection of low-frequency and rare variants. Whole-genome sequencing (WGS) offers a more complete view of genetic variation, especially across diverse populations. We analyzed high-coverage (38×) WGS data from 21,913 T2D case subjects, 61,036 control subjects, and up to 50,011 individuals with no diabetes with fasting glucose, fasting insulin, and HbA1c from the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine Program. We performed single-variant association testing, conditional analysis, fine-mapping, and Bayesian colocalization to …

Proteomic Signatures Of 3-Year Progression From Impaired Fasting Glucose To Diabetes: The Atherosclerosis Risk In Communities (Aric) Study, Mary R Rooney, Justin B Echouffo Tcheugui, Jingsha Chen, Keenan A Walker, Christie M Ballantyne, Eric Boerwinkle, Tanika N Kelly, Chiadi E Ndumele, James S Pankow, Morgan E Grams, Wendy S Post, Peter J Ganz, Alexis C Wood, Jerome I Rotter, Elizabeth Selvin, Josef Coresh

Faculty, Staff and Students Publications

Objective: To identify proteomic signatures underlying 3-year progression from impaired fasting glucose (IFG) to diabetes.

Research design and methods: We examined IFG progression in the Atherosclerosis Risk in Communities (ARIC) study from visit 2 (1990-1992) to visit 3 (1993-1995). We tested associations of 4,955 plasma proteins (SomaScan version 4.0) with ∼3-year progression from IFG (FG 100-125 mg/dL without diabetes) to diabetes (diagnosis, medication, or FG ≥126 mg/dL) using logistic regression models adjusted for demographics, cardiometabolic risk factors, and baseline glucose with Bonferroni correction (P < 10-5). We explored biological pathways enriched among the top proteins and calculated improvements in prediction (ΔAUC and net reclassification using 3-year risk thresholds of 6% and 15% in 80% training and 20% internal validation subsamples). We validated results in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.

Results: There were 3,786 ARIC participants with IFG (mean [SD] age 57 [6] years, 52% female, …

Rates Of, Reasons For, And Reactions To Discontinuation Of Glp-1 Receptor Agonists: A Narrative Review, Henry D Heisey, L Parker Gregg, Christopher D Verrico, Dennis T Villareal, Terri L Fletcher

Faculty, Staff and Students Publications

GLP-1RAs are increasingly used for their glucose-lowering and weight-management effects, but many patients discontinue them. In this narrative review we aim to review real-world, quantitative and qualitative GLP-1RA discontinuation, adherence, and persistence evidence as it aligns with an established conceptual framework for understanding medication adherence in noncommunicable chronic disease. Many inconsistencies exist in how discontinuation, adherence, and persistence are studied in this literature. Few qualitative studies have focused on discontinuation of GLP-1RAs. Quantitative approaches often focus on medication-related factors and more superficial aspects of socioeconomic and condition-related factors. Very few studies encompass all 5 dimensions of the medication adherence conceptual …

De Novo Complex Genomic Rearrangement Spanning 2q31.1 In A Proband With Congenital Malformations: Genotype-Phenotype Correlation And Development Of A Cgr Detection Pipeline, Katherine Helle, Jesse D Bengtsson, Mira Gandhi, Christopher M Grochowski, Ming Yin Lun, Neha Sudhir, Shalini N Jhangiani, Fritz J Sedlazeck, Seema R Lalani, Neil A Hanchard, Claudia M B Carvalho

Faculty, Staff and Students Publications

The 2q31 region is commonly associated with pathogenic alleles of the HOXD cluster leading to various clinical phenotypes related to skeletal development. We present a proband with tetralogy of Fallot and multiple congenital anomalies. Genomic variant screening including an in-house CGR detection pipeline pairing genome sequencing (GS) structural variant calls with read-depth data revealed a de novo complex genomic rearrangement (CGR) spanning 2.7 Mb across 2q31 characterized by a series of duplications and triplications including the HOXD gene cluster. The genomic structure was assembled by applying combined methodologies including short-read and long-read GS, and optical genome mapping (OGM). This in-house …

Cost-Effectiveness Of Hes V2.0 And Galad For Hepatocellular Carcinoma Surveillance In Patients With Cirrhosis, Mert Sahinkoc, Gizem S Nemutlu, Hashem B El-Serag, Mary Linton B Peters, Ali Hajjar, Anthony E Samir, Leigh Anne Dageforde, Fasiha Kanwal, Jagpreet Chhatwal

Faculty, Staff and Students Publications

Background: Ultrasound-based surveillance for HCC is limited by suboptimal sensitivity and low adherence. Blood-based biomarkers are potential alternatives for routine HCC surveillance. We aimed to define optimal sensitivity, specificity, and cost parameters under which blood-based biomarkers could serve as cost-effective alternatives in patients with cirrhosis.

Methods: We developed a microsimulation model of the natural history of HCC in individuals with compensated cirrhosis. We compared the cost-effectiveness of biannual surveillance using 2 blood-based biomarkers-HES V2.0 and GALAD-versus ultrasound-based surveillance across a range of sensitivity, specificity, test costs, and adherence levels. Outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios …

Transforming The Lives Of Adolescent Girls In West And Central Africa, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

The Girls’ Futures in Focus: Evidence from West and Central Africa series examines the challenges facing adolescent girls in the region and highlights evidence-informed approaches to improving their lives. The series focuses on eight countries that span the Sahel, coastal West Africa, and Central Africa and that reflect a range of fragility, conflict, and development contexts, allowing the GIRL Center’s findings to speak to adolescent girls’ compounded and diverse experiences across the region: Burkina Faso, Cameroon, Central African Republic, Democratic Republic of Congo, Guinea, Côte d’Ivoire, Niger, and Senegal. This series overview brief investigates their education, economic empowerment, mental health, …

Accélérer Les Progrès Pour Les Adolescentes Dans Les Contextes Humanitaires En Afrique De L’Ouest Et Du Centre, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

La série « L’avenir des filles en point de mire : données probantes d’Afrique de l’Ouest et du Centre » examine les défis auxquels font face les adolescentes de la région et met en lumière des approches éclairées par les données probantes pour améliorer leurs conditions de vie. Cette note résume les données disponibles sur les conséquences des crises humanitaires pour la sécurité immédiate des filles, la continuité des services et leurs perspectives d’avenir à long terme en Afrique de l’Ouest et du Centre (AOC), en particulier dans les pays prioritaires du GIRL Center. Elle examine les violences sexuelles et …

Transformer La Santé Et Les Droits Sexuels Et Reproductifs Des Adolescentes En Afrique De L’Ouest Et Du Centre, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

La série « L’avenir des filles en point de mire : données probantes d’Afrique de l’Ouest et du Centre » examine les défis auxquels font face les adolescentes de la région et met en lumière des approches éclairées par les données probantes pour améliorer leurs conditions de vie. La série couvre huit pays répartis entre le Sahel, l’Afrique de l’Ouest côtière et l’Afrique centrale, représentatifs d’une diversité de contextes de fragilité, de conflit et de développement, ce qui permet aux constats du GIRL Center de refléter les expériences à la fois diverses et cumulées des adolescentes à travers la région …

Adolescentes En Afrique De L’Ouest Et Du Centre : Trajectoires, Risques Et Leviers De Changement, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

La série « L’avenir des filles en point de mire : données probantes d’Afrique de l’Ouest et du Centre » examine les défis auxquels sont confrontées les adolescentes de la région et met en lumière des approches fondées sur des données probantes pour améliorer leur quotidien. Cette note de synthèse examine leur éducation, leur autonomisation économique, leur santé mentale, leur santé sexuelle et reproductive, leur accès au numérique et leurs usages technologiques, ainsi que leurs besoins face au changement climatique et dans des contextes humanitaires. En s’appuyant sur des données issues des pays prioritaires du GIRL Center, elle identifie les …

Factors Influencing Employee Engagement And Performance In Hybrid Work Environments, Saif Alblooshi

Theses

The widespread adoption of hybrid work arrangements, in which employees divide their working time between remote and office-based settings, has fundamentally altered how organisations manage, measure, and sustain workforce engagement and performance. While hybrid models offer tangible benefits such as increased autonomy, reduced commuting burden, and greater scheduling flexibility, they simultaneously introduce a set of organisational challenges that conventional management frameworks were not designed to address. Chief among these challenges is the difficulty of maintaining consistent levels of employee engagement across distributed work settings, where informal communication, social connection, and direct managerial oversight are structurally constrained. The absence of robust, …

Impact Of Prematurity On Nutrient Signaling And Protein Synthesis In Skeletal Muscle, Antonio C Ramos Dos Santos, Ki Beom Jang, Marta L Fiorotto, Teresa A Davis

Faculty, Staff and Students Publications

Preterm birth disrupts nutrient-responsive signaling pathways critical for skeletal muscle growth and long-term metabolic health. Despite improvements in neonatal care, preterm infants often experience postnatal growth failure marked by impaired lean mass accretion. This review examines how prematurity intrinsically alters insulin and amino acid signaling to mechanistic target of rapamycin complex 1 (mTORC1), a central regulator of translation initiation and protein synthesis. Evidence from translational models reveals blunted activation of mTORC1 and its downstream effectors, independent of birth weight or comorbidities. Defects in insulin-PDK1/mTORC2-Akt signaling and amino acid sensing, particularly leucine sensing, contribute to impaired mTORC1-dependent translation initiation and reduced …

A Comparison Of Ahdrift And Pitfall Traps For Surveying Small Vertebrates, Gabrielle Risko

All-Inclusive List of Electronic Theses and Dissertations

Understanding species occupancy is necessary to inform wildlife management and conservation decisions. To minimize the invasiveness of occupancy studies, some wildlife researchers have deployed game cameras to detect the presence of small vertebrates instead of utilizing stressful traditional live-capture methods. The Adapted Hunt Drift Fence Technique (AHDriFT) is an increasingly popular method for modifying and deploying camera traps to detect small vertebrates; however, no studies have directly compared AHDriFT to traditional pitfall traps operating at the exact same time, even though both are deployed along drift fences to capture small vertebrates. I compared these two methods (pitfall trapping and AHDriFT …

“We Want To Make You A Better Man”: African American Men With Dual Membership In Black Greek Letter Organizations And Prince Hall Masonic Lodges, Lakesha Rae Denton

All-Inclusive List of Electronic Theses and Dissertations

This dissertation examines the rationale and experiences of Black men who have initial membership within a black Greek letter organization as an undergraduate, who also join Masonic Lodges. The study was guided by one research question: 1) what the rationale is pertaining to Black men, who are initially members of Black Greek letter organizations as an undergraduate, that also join a Masonic lodge, therefore granting them dual membership status. The study was important because the value of BGLO’s has declined due to hazing and lack of leadership and guidance. Black men are not being developed as they should and while …

Forest Cover Effects On Canopy Interception Loss, Evapotranspiration, And Soil Infiltration On Stormwater Detention Basins, Alexandria N. C. Perez

Electronic Theses and Dissertations

Developing cities and increased impervious surfaces has resulted in more surface runoff and severe flooding. Harris County, Texas has experienced major flooding events, such as Hurricane Harvey in 2017 which was estimated to be a 9,000-year flood event. The Harris County Flood Control District (HCFCD) is dedicated to creating, maintaining, and finding new ways to reduce flooding damage such as the use of detention basins as green infrastructure. These basins are either populated by grass or are planted with various tree species. This study will identify the planted trees’ canopy interception loss, reference evapotranspiration, and enhanced soil infiltration effects within …

Examining Pain Catastrophizing, Mental Toughness, Self-Efficacy, And Perceived Pain In The Performance Of Female Athletes During Their Menstrual Cycle, Carissa R. Martinez

Electronic Theses and Dissertations

Pain is a universal unpleasant or negative experience influenced by physiological, psychological, and environmental factors. Disruption in the neural pathways of pain can affect athletic performance and lead to injury risks. Both negative attributes, such as stress, anxiety, and depression, and positive attributes, such as mental toughness and self-efficacy, contribute to pain perception and catastrophic thinking. The menstrual cycle also plays a critical role in pain catastrophizing, as hormonal fluctuations across different phases may hinder pain perception and performance in female athletes. However, research lacks the inclusion of how these factors impact female athletes. Using a non-experimental quantitative analysis, this …

The Rise Of Emergent Bilingual Students In Texas School Districts: A Longitudinal Analysis Of Outcomes, Resources, And Conditions, Ashley Ivy

Electronic Theses and Dissertations

This study examined district-level changes associated with rapid growth in Emergent Bilingual (EB) enrollment across 53 Texas public school districts between the 2012-2013 and 2022-2023 academic years. Using a quantitative, nonexperimental, longitudinal descriptive-comparative design, secondary data from the Texas Education Agency (TEA) were analyzed to assess changes in district demographics, staffing patterns, bilingual/ESL expenditures, academic achievement, graduation rates, and college readiness outcomes. Paired-samples t-tests were conducted to determine statistically significant mean differences across the 10-year period. Findings revealed significant increases in EB enrollment, Hispanic enrollment, and economically disadvantaged enrollment, indicating that participating districts served increasingly diverse student populations with …

From The Band Hall To The Classroom: A Qualitative Study On Curriculum Design In Successful Texas Bands To Support Student Success, Amy R. Bennett

Electronic Theses and Dissertations

Texas band programs have captured national attention for student achievement. This qualitative study examined curricular elements shared among perennially successful Texas band programs to explore whether these practices could inform curriculum development in other academic settings to support student success in indicators such as student academic achievement, behavior, and attendance. The data collection phase consisted of semi-structured interviews with fine arts administrators, campus administrators, and band directors associated with school districts of multiple perennially successful band programs. Through thematic analysis, collaboration and observation emerged as themes that influenced curriculum development among the participants; a focus on student experience, written curriculum, …

Professional Learning Communities In Virtual K-12 Schools: Survey Evidence From Texas, Charles L. Tracy Jr

Electronic Theses and Dissertations

Professional Learning Communities (PLCs) have been viewed as a tool for improving teacher practices and student outcomes in schools for more than thirty years. Much of the existing research on their effectiveness has focused on the traditional school setting. With the explosion of virtual K-12 schools, less is known about how PLCs function in the fully online environment and how teachers perceive their overall effectiveness. The purpose of this study was to explore the perceptions of teachers working in a full-time virtual school with regard to their participation in Professional Learning Communities. A review of the literature examined the importance …

The Tension Of Retention And Retirement: A Narrative Study Of Full-Time Nursing Faculty Within Five Years Of Retirement At Public, Four-Year Institutions In Texas, Shelley Hunt

Electronic Theses and Dissertations

This narrative inquiry, qualitative study explored the retirement decision-making process of nursing faculty at public, four-year institutions who were within five years of retirement. Through purposive sampling, 11 participants across eight institutions consented to participate and were interviewed via Zoom. Due to the nursing faculty shortage, the researcher hypothesized that nursing faculty nearing retirement may be retiring not only as a natural progression of their career but also because of factors that lead other early and mid-career faculty members to leave academia. Through thematic analysis, four themes emerged: Finding Meaning and Fulfillment in the Nurse Faculty Role, Institutional Factors Shaping …

A Multistate Analysis Of Longitudinal Care Outcomes Among People Newly Linked To Human Immunodeficiency Virus Care In Missouri, Aditi Ramakrishnan, Daniel Vo, Ernie-Paul Barrette, Rachel M Presti, William G Powderly, Anne Trolard, Corey Grejtak-Heaps, Elvin H Geng, Aaloke Mody, Lindsey M Filiatreau

2020-Current year OA Pubs

BACKGROUND: Advancing the HIV response in Missouri, an Ending the HIV Epidemic priority state, requires stronger characterization of treatment gaps. Routine cross-sectional reporting may fail to capture important gaps in care that longitudinal methods can reveal.

METHODS: We characterized clinic engagement and viral suppression among people with Human Immunodeficiency Virus (HIV) aged ≥18 years who were newly linked to clinic in St Louis, Missouri, between 1 January 2015 and 15 March 2020. Using multistate analytic methods that capture change over time, we estimated the prevalence of individuals in 9 mutually exclusive and exhaustive states over 3 years following linkage to …

Financial Toxicity And Cost-Related Imaging Nonadherence In Pediatric Outpatient Imaging, Shireen E Hayatghaibi, Gregory L Jordan, Tucker Hansen, Amy E Ensing, Aditi Gupta, Evan A Mihalakakos, Bin Zhang, Pradipta Debnath, Carrie C Coughlin

2020-Current year OA Pubs

RATIONALE AND OBJECTIVES: Financial toxicity, defined as the financial burden and stress experienced due to medical costs, is increasingly recognized as a key patient-reported outcome and has been linked to cost-related non-adherence in adult populations. However, its prevalence and impact in pediatric imaging are unknown. We examined the prevalence and predictors of financial toxicity among families of children undergoing outpatient imaging and its association with imaging non-adherence.

MATERIALS AND METHODS: We conducted a prospective cross-sectional survey of parental caregivers of children (< 18 years of age) undergoing outpatient imaging at two free standing children's hospitals in the U.S. (July 2024-May 2025). Financial toxicity was measured using the adapted FACIT-COST instrument and scores < 26 indicated high financial toxicity. Multivariable logistic regression examined associations between family characteristics and high financial toxicity.

RESULTS: Among 399 caregivers, the mean FACIT-COST score was 24.6 (SD 10.2), and 49% were categorized as having …

Kirschner Wire Skeletal Fixation In The Hand And Wrist: Risk Of Infection And Predictors Of Progression To Major Complications, Mitchell S Mologne, Julia M Perugini, Nicholas A Calotta, Lindley B Wall, Charles A Goldfarb

2020-Current year OA Pubs

PURPOSE: Kirschner wire (K-wire) infections continue to be a challenge in hand surgery. Our purpose was to quantify the frequency of K-wire site infections of the hand and wrist, to tabulate major and minor infectious manifestations, to identify factors that may predispose a patient to major complications, and to generate an updated algorithm for prognostication and treatment of K-wire site infections.

METHODS: Patients treated with K-wires in the fingers, hand, and wrist who developed infections between 2018 and 2024 at our institution were identified. Information regarding patient factors, injury, treatment, and subsequent infectious complications was collected. Variables from single variable …

Language And Sound Exposure Across Neonatal Intensive Care Hospitalization And Relationships With Early Outcome, R Pineda, L J Woodward, Z A Vesoulis, C D Smyser, T E Inder, A M Mathur, B L Schlaggar

2020-Current year OA Pubs

OBJECTIVES: Examine relationships between quantitative measures of language and sound exposure in the NICU and infant neurobehavior.

STUDY DESIGN: Sixty-four preterm infants (≤28 weeks of gestation) had language and sound exposure measured across four time points: within two weeks of birth and at 30, 34, and 35-41 weeks postmenstrual age (PMA). Neurobehavior was assessed at 35-41 weeks PMA using the NICU Network Neurobehavioral Scales.

RESULTS: Higher average decibel levels in the NICU environment were associated with lower infant orientation scores (p = 0.04, β = -0.33). Higher peak decibel levels were associated with greater hypertonia (p = 0.01, β = …

Molecular Basis For The Regulation Of Membrane Proteins Through Preferential Lipid Solvation, Nathan Bernhardt, Tugba N Ozturk, Shan Zhang, Noah Schwartz, Rahul Chadda, Alejandro Gil-Ley, Janice L Robertson, José D Faraldo-Gómez

2020-Current year OA Pubs

The mechanism by which lipids regulate membrane proteins remains an open question. While many protein structures reveal associated lipids, neither binding nor regulatory mechanisms can be gleaned from frozen static snapshots, as these processes occur in the context of a dynamic membrane at equilibrium. In this study, we combine single-molecule experiments with computational analyses of lipid dynamics and lipid-solvation energetics to understand how changes in the lipid composition of the membrane influence the dimerization of the CLC-ec1 chloride/proton antiporter. We find this influence does not result from long-lived lipid binding at specific sites, but instead from an inherently dynamic effect …