Digital Commons Network^™

Increased Risk Of Sarcomas In Children With Congenital Anomalies: Findings From The Genetic Overlap Between Anomalies And Cancer In Kids (Goback) Registry Linkage Study, Russ Wolters, Ji Yun Tark, Tiffany M Chambers, Tania A Desrosiers, Michael E Scheurer, Charles Shumate, Wendy N Nembhard, Mahsa M Yazdy, Eirini Nestoridi, Amanda E Janitz, Jean Paul Tanner, Russell S Kirby, Jason L Salemi, Yao Yu, Chad D Huff, Sharon E Plon, Philip J Lupo, Jeremy M Schraw

Faculty, Staff and Students Publications

Background: Pediatric sarcomas are a heterogeneous group of tumors that contribute disproportionately to cancer mortality in children. Although congenital anomalies are among the strongest known risk factors for childhood cancer, the risk of specific sarcoma subtypes among affected individuals has not yet been thoroughly evaluated.

Procedure: We obtained data on maternal and perinatal characteristics, congenital anomalies, and pediatric sarcoma diagnoses for all live births in nine states. We used Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence interval (CI) of sarcoma (overall and by subtype) among children with non-syndromic congenital anomalies. We considered all non-syndromic …

Linkage And Alcohol Use Outcomes Of A Screening, Brief Intervention, And Referral To Treatment (Sbirt) Program For Alcohol-Related Liver Disease: A Retrospective Cohort Study From India, Abhishek Ghosh, Nipun Verma, Harsh A Thappa, Surabhi Gupta, Renjith R Pillai, Shalini Naik, Arka De, Madhumita Premkumar, B N Subodh, Sunil Taneja, Debasish Basu, Ajay Duseja

Faculty, Staff and Students Publications

Background: Alcohol-related liver disease (ArLD) and alcohol use disorder remain undertreated. Collaborative care embedding addiction services within medical settings have shown promise.

Aim: We evaluated the linkage and alcohol use outcomes of an SBIRT-based collaborative care clinic at a public sector hospital in India, examining rates of linkage to addiction treatment, alcohol use outcomes at follow-up, and factors associated with successful linkage.

Methods: A retrospective cohort study of 500 consecutively enrolled patients was conducted over January 2023-July 2024. Patients with ArLD were systematically screened using the Alcohol Use Disorders Identification Test (AUDIT) and risk-stratified into brief advice, brief counselling, or …

Editorial: Spontaneous Bacterial Peritonitis-Redrawing Empiric Therapy In The Era Of Multidrug Resistance. Authors' Reply, Rohit Mehtani, Nipun Verma

Faculty, Staff and Students Publications

No abstract provided.

Vitamin B6 Predicts Poor Outcomes In Geographically Distinct Populations With Primary Sclerosing Cholangitis, Peder R Braadland, Ahmad H Ali, Philip Puchas, Brian D Juran, Elizabeth J Atkinson, Erik M Schlicht, Jackie K Bianchi, Bryan M Mccauley, Sara K V Tjønnfjord, Hólmfríður Helgadottir, Per M Ueland, Arve Ulvik, Peter Sauer, Trine Folseraas, Tom H Karlsen, Mette Vesterhus, Michael T Dill, Konstantinos N Lazaridis, Johannes R Hov

Faculty, Staff and Students Publications

Background & aims: Primary sclerosing cholangitis (PSC) has a variable disease course, complicating patient counseling and the timing of liver transplantation. Vitamin B6 deficiency predicts reduced liver transplantation-free survival in Scandinavian PSC cohorts. Here, we aimed to validate this observation in US and German PSC cohorts and to expand our analyses to include hepatic decompensation as a clinical outcome.

Methods: Serum active vitamin B6 (pyridoxal 5'-phosphate [PLP]) was analyzed using liquid chromatography-tandem mass spectrometry in retrospective cohorts of people with PSC from Norway (n = 315), the USA (n = 756), and Germany (n = 149). Cox proportional hazards and …

Long-Term Outcomes In Seronegative Rheumatoid Arthritis, Bradly A Kimbrough, Roslin Jose George, Cynthia S Crowson, Sara J Achenbach, Elizabeth J Atkinson, Vanessa L Kronzer, John M Davis, Elena Myasoedova

Faculty, Staff and Students Publications

Objective: The purpose of this study was to determine the cumulative incidence of diagnosis switching, drug-free remission, and initiation of a biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) in individuals with seronegative rheumatoid arthritis (RA).

Methods: Adult residents of Olmsted County, Minnesota, with incident seronegative (rheumatoid factor negative/anti-cyclic citrullinated peptide antibody negative) RA meeting the 1987 and/or 2010 American College of Rheumatology classification criteria were included. Data were collected from January 1, 2005, to December 31, 2023, through manual chart review. Drug-free remission was defined as a period of at least six months where the individual was no longer …

Deep Learning-Based Comparison Of Knee Minimum Joint Space Width In Patients With Rheumatoid Arthritis And Osteoarthritis Before Total Knee Arthroplasty, Miguel M Girod, Monty Khela, Sami Saniei, Kellen L Mulford, Cassondra A Hulshizer, Elizabeth J Atkinson, Cody C Wyles, John M Davis, Gavin A Mckenzie, Cynthia S Crowson

Faculty, Staff and Students Publications

Objective: Although both osteoarthritis (OA) and rheumatoid arthritis (RA) can necessitate total knee arthroplasty (TKA), their mechanisms and radiographic patterns of joint space narrowing (JSN) differ. Deep learning (DL) enables compartment-specific measurement of minimum joint space width (mJSW). This study compared JSN patterns between patients with RA and OA undergoing TKA and evaluated the associations between mJSW and RA disease activity.

Methods: In this retrospective study, 409 patients with RA undergoing TKA (2000-2021) were age- and sex-matched with OA patients. A validated DL model quantified medial and lateral mJSW from anteroposterior knee radiographs at 2 timepoints: early (> 2 years …

Adrenal Crises And Quality Of Life After Bilateral Adrenalectomy Vs Primary Autoimmune Adrenal Insufficiency, Alexandra N Bancos, Raul Gregg-Garcia, Natalia Genere, Sanan Mahrokhian, Sara J Achenbach, Elizabeth J Atkinson, Anand Vaidya, Irina Bancos

Faculty, Staff and Students Publications

Context: Bilateral adrenalectomy (BLA) and autoimmune adrenal insufficiency (AAI) are 2 major causes of primary adrenal insufficiency (PAI). Comparative data between etiologies are limited.

Objective: To compare management, quality of life (QoL), and frequency of adrenal crises between participants post-BLA vs AAI.

Methods: We conducted a dual-center, cross-sectional study of adults with AAI or BLA between 2018 and 2025. All participants completed questionnaires on management, adrenal crises, and the Addison Disease-specific QoL Questionnaire (AddiQoL).

Results: Of 343 participants, 203 had AAI (median age 54 years, 72% women) and 139 had BLA (median age 57 years, 76% women). AddiQoL scores were …

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 …

Future Prospects Of Pediatric Lung Transplantation, Ernestina Melicoff, David Moreno Mcneill, Christian Benden

Faculty, Staff and Students Publications

This special issue of the Journal of Heart Transplantation Open is dedicated to Pediatric Thoracic Transplantation. The authors will discuss subjects related to pediatric lung transplantation such as access to donor organs, allograft dysfunction and role of functional status in outcomes.

Indications, Techniques, And Safety Of Cryotherapy And Cryobiopsy Via Flexible Bronchoscopy In Pediatric Patients, Alex J Katz, Haley Haskett, Kubra M Bozkanat, Aoife Corcoran, Lauren M C Grant, Antoinette Wannes Daou, Sin Tran, Esra Caylan, Alfin Vicencio, Dan T Benscoter, Cherie A Torres-Silva, Sara M Zak, Gregory Burg, Lisa R Young, Pelton Phinizy, Shailendra Das, Richard Paul Boesch, Erik B Hysinger, Joseph Piccione

Faculty, Staff and Students Publications

Rationale: Cryotherapy and its diagnostic analogue, cryobiopsy, are emerging techniques via bronchoscopy with a wide range of clinical applications. While the use of cryotherapy and cryobiopsy has been established in adult pulmonary medicine, pediatric data describing the indications, procedural specifics, outcomes, and complications are limited.

Objective: To describe the indications, procedural specifics, outcomes, and complications of cryotherapy and cryobiopsy use in pediatric bronchoscopy.

Methods: A multicenter retrospective observational study was conducted at 5 pediatric hospitals in the United States. Patients aged 0 to 21 years who underwent cryotherapy or cryobiopsy via bronchoscopy between January 2017 and January 2025 were included. …

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 …

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. …

Nutrition Considerations In Youth With Type 2 Diabetes Using Glucagon-Like Peptide-1 Receptor Agonists: A Commentary, Maria E Diaz, Grace Kim, Mili Vakharia

Faculty, Staff and Students Publications

No abstract provided.

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 …

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 …

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 …

Opening The Lantern: The Leiden Declaration, Mark Huber

Journal of Humanistic Mathematics

The Leiden Declaration on Artificial Intelligence and Mathematics provides insight into how mathematicians view their discipline. However, when positioning mathematics against AI, the declaration falls short in recognizing recent advances. This column introduces the reader who might be unfamiliar with these new methods through the formal language Lean and discusses how these new abilities might change the way journals operate.

Wanted: A Book Reviews Editor For The Journal Of Humanistic Mathematics, Mark Huber, Gizem Karaali

Journal of Humanistic Mathematics

To help us procure regular book review submissions and ensure that we can indeed include a solid book review in each upcoming issue, we would like to have an enthusiastic book worm join our small editorial team. In other words, we are looking for a book reviews editor.

We will review all applications that have been submitted by October 15, 2026. We hope to have our new book reviews editor start their term by January 2027.

Visualizing Irrationality: Digit Mosaics In Okabe–Ito, Raven Quilestino-Olario

Journal of Humanistic Mathematics

Five visual mosaics translate 10,000-digit segments of well-known mathematical constants into color. For each constant, the digits are placed in a 100×100 grid read left to right and top to bottom, including the digit before the decimal point, and each digit (0–9) is mapped to a color in the Okabe–Ito palette. A matching bar chart shows the digit counts within the same window, allowing quick comparison of how evenly digits appear. The series includes π, e, √2, φ, and the Euler–Mascheroni constant γ. Together, the mosaics and counts turn numerical randomness into visual harmony while keeping the work readable for …

The Pi-Royal Tire, Erik Talvila

Journal of Humanistic Mathematics

In this humorous story, the half-wit proprietor of a tire manufacturing company thinks knowing pi to more digits will allow the production of rounder tires. An applied mathematician is recruited to fulfill a ridiculous industrial research agenda.

Riding The Rails Of Reason: A Dialogue On Truth, Logic, And Proof, Surinder Pal Singh Kainth

Journal of Humanistic Mathematics

On a quiet train ride, I found myself in conversation with Noor, an inquisitive teenager with sharp questions about truth, logic, and mathematical proof. As we talked, I used the train itself as a metaphor to explain how mathematical proofs provide certainty, far beyond what repetitive verification alone can offer. Our discussion ranged from common misconceptions about the foundations of logic to the need for clear definitions and axioms. We also touched on fundamental ideas such as the challenges posed by the Axiom of Choice and the limitations revealed by Gödel’s incompleteness theorem.

In Praise Of Smaller Models, Pedro Poitevin

Journal of Humanistic Mathematics

No abstract provided.

Count, Robin Young

Journal of Humanistic Mathematics

It's the thought that counts? No, it's this canzone that counts! This poem explores the philosophy of counting through five stanzas from shoreline pebbles to Godel's incompleteness theorems. Counting becomes our guide through Zeno's paradoxes, irrational numbers, Cantor's infinities, and quantum measurement problems. The poem counts, recounts, and discovers that some things simply cannot be counted.

Group Theory For Poets, Holley Friedlander

Journal of Humanistic Mathematics

This poem instructs the reader on how to put a group structure on an arbitrarily chosen set. Through accentual, rhyming verse, it playfully discusses the beauty and utility of groups as a mathematical concept via examples and applications. This work is inspired by the Patricia Toht book, Pick a Pine Tree.

My Journey To Mathematics, Thao Thuan Vu Ho

Journal of Humanistic Mathematics

No abstract provided.

A Lament For Linear Algebra, Jasmine A. Elmrabti

Journal of Humanistic Mathematics

What assumptions underlie our axiomatic definitions? A meditation on the nature of linear algebra and its metaphysical implications during use, this poem is a reflection on the markedness of discrete entities upon which we rely to utilize the axioms of linear algebra.

Mathematics As Creative Structure: A Review Of Marcus Du Sautoy’S Blueprints, Sangeetha Balakrishnan, Latha R

Journal of Humanistic Mathematics

Marcus du Sautoy’s Blueprints: How Mathematics Shapes Creativity (2025) makes a provocative claim that creativity emerges not in opposition to constraint, but through it. Working through nine mathematical “blueprints” — symmetry, randomness, the Fibonacci sequence, among others — du Sautoy traces recurring structural patterns across artistic practice, natural phenomena, and mathematical thought. The argument is ambitious and persuasive. In this review we consider what the book adds to longstanding conversations about the relationship between scientific and humanistic ways of knowing, and reflect on what it means to reframe mathematics as an imaginative and exploratory enterprise rather than a purely technical …

The Logic Of Leaves: Mathematical Poems And Graphs, Ksawery Tomczak

Journal of Humanistic Mathematics

This collection explores the intersection of mathematics and poetry through six original works that blend formal rigor with lyrical expression. Each poem draws from a distinct mathematical concept—proof, set theory, combinatorics, graph theory, and cardinality—reframing it through metaphoric and aesthetic lenses. From the lyrical contemplation of infinite sets to the emotive longing of a graph in love, the verses reveal the emotional resonance and philosophical depth embedded in mathematical thought. The collection culminates in a visual piece rendered in \LaTeX and TikZ, illustrating all integer partitions of the number five as a branching tree, accompanied by a poem that sings …

College Algebra: A Key Element To Degree Completion, Christopher Charlie Jett, Gregory Downing

Journal of Humanistic Mathematics

College Algebra is often under scrutiny because it serves as a critical gateway to graduation for students enrolled in our nation’s undergraduate degree programs. In this paper, we problematize the authority typically ascribed to this course and discuss meeting students’ discipline-specific needs in core mathematics courses such as it. To help facilitate college student success with respect to mathematics course requirements, we recommend that educational constituents and leaders expand dual-enrollment opportunities, infuse culturally relevant practices, and leverage other core mathematics courses as alternatives to College Algebra. In doing so, we add to the ongoing conversation about addressing this issue in …

An Essay On Teaching And Learning Mathematics: Through The Lens Of Artificial Intelligence, Music, And Sports, James Diederich

Journal of Humanistic Mathematics

This essay is aimed at a wide audience: anyone who has engaged in learning or teaching math. It provides a unique perspective drawn from a mathematician’s interests in working with K-12 teachers, familiarity with artificial intelligence (AI), and amateur pursuits of learning to play an instrument and of learning a difficult sport. While I delve into these topics, no special background is needed in the slightest. In particular, I draw lessons from some failures in AI that reflect on why the conventional procedural approach to teaching and learning math fails many students. I also provide insight into how we learn …