Digital Commons Network^™

An Intelligent Healthcare System For Rare Disease Diagnosis Utilizing Electronic Health Records Based On A Knowledge-Guided Multimodal Transformer Framework, Ahed Abugabah, Prashant Kumar Shukla, Piyush Kumar Shukla, Ankur Pandey

All Works

Rare diseases are a common problem with millions of patients globally, but their diagnosis is difficult because of varied clinical presentations, small sample size, and disparate biomedical data sources. Current diagnostic tools are not able to combine multimodal information effectively, which results in a timely or wrong diagnosis. To fill this gap, this paper suggests a smart multimodal healthcare framework integrating electronic health records (EHRs), genomic sequences, and medical imaging to improve the detection of rare diseases. The framework uses Swin Transformer to extract hierarchical visual features in radiographic scans, Med-BERT and Transformer-XL to learn semantic and long-term temporal relations …

Genomic And Functional Characterisation Of Endophytic Bacterium Bacillus Cereus Strain E1 Alleviating Salt Stress And Enhancing Tomato Physiology And Spectral Indices, Balamurugan Sadaiappan, Tanveer Alam Khan, Qurban Ali, Sulamita Santos Correa, Mahideen Afridi, Soumaya Tounsi Hammami, Munawwar Ali Khan, Sunil Mundra

All Works

Mangroves in arid environments represent unique ecological niches that support a diverse range of microorganisms. Endophytic bacteria residing within host plants play a crucial role in promoting plant growth by enhancing pathogen resistance and alleviating environmental stress. Identifying novel stress-tolerant strains, specific to arid environments, is essential for expanding the repertoire of plant growth-promoting bacteria (PGPB). In this study, we investigated the saline tolerance of the endophytic bacterium strain E1, previously isolated from the root of Avicenna marina (grey mangrove). Whole-genome sequence (WGS), phylogenetics and average nucleotide identity (ANI) analysis were performed. The strain exhibited high salinity tolerance, growing in …

Reinforcement Learning Based Intelligent Optimisation For Bin Packing Problems: A Review, Nadia Dahmani, Amril Nazir, Ikbal Taleb, Syed M.Salman Bukhari

All Works

The convergence of Reinforcement Learning (RL) and Bin Packing Problems (BPP) is a critical field of study that has profound ramifications in logistics, manufacturing, computer, and retail industries. This paper thoroughly examines the progression from simple rule-based tactics to advanced Deep Reinforcement Learning (DRL) techniques in solving BPPs. By conducting a thorough review of 231 papers conducted between 2019 and 2024, we address and provide answers to important research inquiries, such as “To what extent has academic research explored the use of RL for BPP during this time frame?” and “Which specific areas of application and methodologies have been predominantly …

Artificial Intelligence In Waste Management Systems: Applications, Challenges, And Prospects, Imane Belyamani

All Works

Despite global recognition of the climate crisis, greenhouse gas emissions are projected to rise by 8.8 % by 2030, primarily due to inadequate planning, poor implementation, and insufficient financial support. While international initiatives such as the ’Waste to Zero’ coalition launched at the 28th Conference of the Parties to the UNFCCC (COP 28) highlight the urgency of advancing decarbonization and the circularity of waste systems, this review focuses on how artificial intelligence (AI) can accelerate that transformation. It systematically explores the role of AI in advancing waste management practices, with a focus on predictive analytics, route optimization, and machine learning-based …

Efficacy Of Zinc Oxide Nanoaciculates As Antagonists Against Meloidogyne Javanica On Phaseolus Abyssinicus, Manar Fawzi Bani Mfarrej, Faheem Ahmad, Amir Khan, Mohd Sajid Ali, Hamad A. Al-Lohedan, Arshad Iqbal, Khalid Umar, Gulam Rabbani, Mohd Farhan Khan

All Works

This work investigates the synthesis of zinc oxide nanoaciculates (ZNA) using the Sol–gel method and their potential as a long-term bio-control agent against Meloidogyne javanica, a root-knot nematode that causes severe damage to Phaseolus abyssinicus. The produced ZNA were evaluated using SEM–EDS, X-ray diffraction (XRD), and UV–Vis spectroscopy to ensure precise evaluation of their nanoscale characteristics. Bio-efficacy assays were carried out at four concentrations (125, 250, 375, and 500 mg/L) to evaluate nematicidal activity on juvenile nematodes (J2) and M. javanica egg masses. The results showed that ZNA had significant toxicity at all doses, with the highest efficacy observed at …

The Contribution Of Audition And Proprioception In Unisensory And Multisensory Target Reaching, Ivan Camponogara

All Works

Everyday actions often involve reaching for targets sensed by auditory and proprioceptive senses (reaching a ringing smartphone in the dark or tapping on it while holding it with the other hand). However, it is still unclear whether reaching performance toward auditory and proprioceptive targets is modality-specific and whether performance improves under multisensory compared to unisensory conditions. Here, we addressed these questions by measuring reaching performance toward auditory, proprioceptive, and combined audio-proprioceptive targets along the azimuth and depth dimensions. Accuracy was similar along the azimuth dimension, whereas precision was generally lower for auditory targets compared to proprioceptive and audio-proprioceptive targets. A …

A Deep Learning Framework For Automated Breast Cancer Diagnosis Using Intelligent Segmentation And Classification, Ahed Abugabah

All Works

Breast cancer is the most commonly diagnosed cancer among women worldwide, accounting for a significant proportion of new cases. Deep learning (DL) has emerged as a powerful tool for the detection and diagnosis of breast cancer, particularly through the analysis of histological images, a critical component of automated diagnostic systems that directly impact patient management. The BreakHis dataset and the Wisconsin Breast Cancer Database (WBCD) are widely used publicly available resources for deep learning–based analyses of breast cancer histological images in cross-disciplinary healthcare research. A computer-assisted approach employs colour normalisation to reduce the effects of the differences in the distribution …

Loss Of The Lysosomal Protein Cln3 Triggers C-Abl-Dependent Yap1 Pro-Apoptotic Signaling, Neuza Domingues, Alessia Calcagni', Sofia Freire, Joana Pires, Ricardo Casqueiro, Ivan L Salazar, Niculin Joachim Herz, Tuong Huynh, Katarzyna Wieciorek, Tiago Fleming Outeiro, Henrique Girão, Ira Milosevic, Andrea Ballabio, Nuno Raimundo

Duncan NRI Faculty and Staff Publications

Batten disease is characterized by early-onset blindness, juvenile dementia and death within the second decade of life. The most common genetic cause are mutations in CLN3, encoding a lysosomal protein. Currently, no therapies targeting disease progression are available, largely because its molecular mechanisms remain poorly understood. To understand how CLN3 loss affects cellular signaling, we generated human CLN3 knock-out cells (CLN3-KO) and performed RNA-seq analysis. Our multi-dimensional analysis reveals the transcriptional regulator YAP1 as a key factor in remodeling the transcriptome in CLN3-KO cells. YAP1-mediated pro-apoptotic signaling is also increased as a consequence of CLN3 functional loss in retinal pigment …

From Bladder To Brain: How You Know When It’S Time To Go, Anne M J Verstegen, Kara L Marshall

Duncan NRI Faculty and Staff Publications

The decision to urinate relies on assessing bladder fullness and context to determine an appropriate time and place to go. Any disruption in this interoceptive process results in frequent and sometimes debilitating consequences in daily life. Recent work has uncovered key pathways and brain regions that contribute to the sense of bladder stretch and the control of urinary reflexes, but many open questions remain. Here, we review the known mechanisms that convey sensory information from the bladder to the brain and back down again, and we highlight the knowledge gaps and opportunities for better understanding this system, which will be …

A Critical Policy Analysis Of Dual Language Education Policies On The Equity And Opportunity Of Participation And Access For Multilingual Learners, Justin A. Andersen

All Graduate Theses and Dissertations, Fall 2023 to Present

Dual Language Immersion programs help students become fluent in two languages while achieving academic success. Originally designed to support students who speak languages other than English at home, these programs have grown rapidly across Utah and the U.S. However, they increasingly serve white, English-speaking families seeking enrichment opportunities, while multilingual students who could benefit most remain underrepresented.

This study examined recruitment and admissions policies in two Utah school districts’ dual language programs. By comparing policy documents, analyzing enrollment data, and interviewing district staff, school leaders, and parents, the research revealed significant implementation differences despite identical statewide program requirements.

One district …

Breaking The Silence With Routine Genitourinary Syndrome Of Menopause Screening: A Quality Improvement Project, Ashley R. Noel

Electronic Theses and Dissertations

Affecting upwards of 87% of women in post menopause, genitourinary syndrome of menopause is greatly under-diagnosed, and consequently, under-treated. Genitourinary syndrome of menopause refers to health conditions impacted by hypoestrogenic state experienced in menopause. Common symptoms of GSM include vaginal dryness, irritation, clitoral or labial atrophy, dyspareunia, decreased libido, anorgasmia, dysuria, recurrent UTI, urinary incontinence (Kaufman et al., 2025). Despite the burdensome consequences of GSM, women are unlikely to vocalize their symptoms and seek treatment. Additionally, societal beliefs of shame surrounding sexual health impede patients and clinicians from addressing GSM specifically (Mili et al., 2021). As a result, the North …

Improving Intimate Partner Violence Screening In Telehealth Mental Health Settings, Marina Oliynyk

Electronic Theses and Dissertations

Intimate partner violence (IPV) is a pervasive yet frequently underrecognized public health concern, particularly within telehealth psychiatric care, where nonverbal cues may be absent. This quality improvement (QI) project aimed to improve the identification and response to IPV by implementing a standardized, evidence-based screening protocol in a private telepsychiatry practice. Guided by the Plan-Do-Study-Act (PDSA) framework, the validated E-HITS screening tool was introduced, along with structured trauma-informed care training, to six psychiatric-mental health nurse practitioners (PMHNPs). Six PMHNPs completed pre/post-confidence surveys (5-point Likert) and tracked screening activity across 100 telehealth encounters (98 of 100 visit were eligible). Over a three-month …

Enhanced Photovoltaic Performance Of Silicon Solar Cells Via Plasma-Deposited Antireflective Titanium Dioxide Coatings, Saad Tuama, Omar Abdulrazzaq, Noor Nasir, Alaa Saloom, Muatez Mohammed

Journal of Applied Sciences and Nanotechnology

A cost-effective DC glow discharge plasma system was used to deposit a 75 nm titanium dioxide (TiO2) antireflective coating on 5 cm2 crystalline silicon solar cells (initial efficiency 10.13%). The plasma-deposited TiO2 film was nanocrystalline: X-ray diffraction revealed mixed anatase/rutile phases with an average crystallite size of ≈17.6 nm and an optical band gap Eg ≈ 3.5 eV. Atomic force microscopy (AFM) showed a granular surface with average roughness Ra ≈50.7 nm (Rq ≈ 67.7 nm) and grain size ≈ 13.1 nm. Optical reflectance measurements indicated a significant reduction in surface reflectance across the visible spectrum after coating, consistent with …

Electrochemical Aspect Of Protection Reinforced Steel Bar By Copper Coating Via Modified Rolling Technique, Sana Hameed, Rana Anaee, Ahmed Al-Ghaban, Hussain Yousif

Journal of Applied Sciences and Nanotechnology

This study investigates the corrosion resistance of copper-coated reinforcing steel bars embedded in concrete and exposed to a simulated marine environment for (28, 56, and 90 days) at temperatures of (298, 308, and 318 Kelvin). A novel thermal spray technique was integrated into the hot rolling process to deposit copper powder onto heated steel bars. The coated bars were characterized using X-ray diffraction (XRD), scanning electron microscopy with energy-dispersive spectroscopy (SEM/EDS), and atomic force microscopy (AFM), revealing a dense, uniform microstructure with reduced surface roughness (63.99 nm) and increased particle density (〖30.2 ×10〗^6 particles/mm²) compared to the uncoated steel bar. …

An Attack-Centric Approach To Security, Privacy, And Legal Challenges In Virtual Healthcare, Suvineetha Herath

Masters Theses & Doctoral Dissertations

As the U.S. healthcare sector continues to evolve, the adoption of virtual care delivery systems has expanded rapidly. This digital transformation has intensified concerns regarding the security and privacy of Protected Health Information (PHI). To address these challenges, this study employed a sequential, exploratory mixed-methods approach to examine the evolving threat landscape and to develop an attack-centric threat model for virtual healthcare environments. In the first phase, a qualitative analysis of regulatory enforcement and legal effectiveness was conducted to examine compliance gaps, privacy risks, and legal consequences within virtual healthcare systems. Building on the qualitative findings, the second phase quantitatively …

Applying Ni-Wc As A Composite Coating Combines Both Protective And Repair Functions By Thermal Spray For Hptb Applications, Alaa Dahesh, Ahmed Hassan, Hussain Yousif

Journal of Applied Sciences and Nanotechnology

This work presents a solution to repair the deteriorating High-Pressure Turbine Blades (HPTB) instead of costly replacement by implementing a two-coating layer system for protection and repair. The first layer is a Bonding Coating (BC) that is made from a nickel-based alloy (NiCrBSi); the second layer is a Top Coating (TC), which is composed of a nickel-based composite material that contains tungsten carbide (WC) particles. Both layers were applied to a nickel-based substrate using a flame thermal spraying (FTHS) technique, with the spray parameters chosen based on the Taguchi method. The results were analyzed using optical microscopy, scanning electron microscopy …

Sztuczna Inteligencja W Systemach Informatycznych Zarządzania W Środowisku Procesowym, Małgorzata Oleś-Filiks

Monografie/Monographs

Współczesne systemy informacyjne zarządzania wraz z procesami biznesowymi odgrywają kluczową rolę w funkcjonowaniu organizacji, wspierając zarówno codzienne operacje, jak i podejmowanie strategicznych decyzji. Monografia przybliża problematykę integracji sztucznej inteligencji z wybranymi typami systemów informatycznych zarządzania ze szczególnym uwzględnieniem Business Process Management jako środowiska sprzyjającego implementacji sztucznej inteligencji jako narzędzia wspomagającego sterowanie, analizę i optymalizację procesów biznesowych. Szeroko prezentuje m.in. typy systemów informacyjnych zarządzania, w których wdrożenie AI przynosi największe korzyści, ze szczególnym uwzględnieniem Business Process Management jako środowiska, w którym sztuczna inteligencja może być skutecznie osadzona jako komponent sterujący i analityczny.

Artificial Intelligence in IT Management Systems in a Process …

Lstm Network-Based Scheme For Automatic Characterization Of Power Quality Disturbances, Akram Elmitwally, Mohamed Nader

Mansoura Engineering Journal

Recognition of power quality (PQ) troubles is a critical task in the electrical power industry. Most previous works solve the classification problem using separate feature extraction phase and classification phase. Each phase has its own techniques, and consumes a computation time. This study proposes to utilize the long short-term memory (LSTM) network as a deep learning model to classify the PQ events in one shot. The LSTM network uses its particular processing to classify a PQ event signal directly by reading its time-sequence data. Then, a dedicated post-classification algorithm (PCA) extracts start time, end time, duration, amplitude, and total harmonic …

Heartmath: A Stress Reduction Program For Healthcare Providers In An Addiction Treatment Setting, Dihana C. Ruiz

Electronic Theses and Dissertations

Work-related stress significantly impacts the well-being of healthcare providers, specifically nurses and nurse practitioners, in addiction treatment facilities. This Quality Improvement (QI) project implemented the HeartMath Quick Coherence Technique to reduce stress and enhance resilience among staff, thereby improving the well-being of healthcare providers and the quality of care. The project utilized a pre- and post-intervention design with five participants, two registered nurses, and three nurse practitioners. Participants received training on HeartMath techniques, the EmWave Pro sensor, and the InnerBalance smartphone application. Over a six-week period, participants practiced Quick Coherence meditation for five minutes, twice daily, to achieve heart rate …

Safety In Stability: A Cdc-Guided Evaluation Of Hospital Fall Prevention Practices, Matthew C. Dougherty

Electronic Theses and Dissertations

Hospital falls remain a persistent and preventable cause of patient harm, emphasizing the need for continuous evaluation of fall prevention practices. This project assessed the effectiveness of AdventHealth Orlando’s fall prevention policy using the Centers for Disease Control and Prevention (CDC) Program Evaluation Framework. A mixed-methods design incorporated quantitative analysis of 12 months of fall data and qualitative feedback from frontline staff surveys and discussions. Results demonstrated a decrease in total falls from 549 in the previous year to 528 in the current year, indicating early progress despite the incomplete reporting period. Unit-level analysis showed a mean improvement of 16.9% …

Enhancing Provider Knowledge And Implementation Of Medication For Opioid Use Disorder (Moud) To Improve Treatment Outcomes: A Quality Improvement Project., Motunrayo Abigael Ibraheem

Electronic Theses and Dissertations

This quality improvement project sought to enhance healthcare providers' knowledge and attitudes toward Medication for Opioid Use Disorder (MOUD) at Galt Ocean Rehab Center to improve treatment outcomes for patients with opioid use disorder. Despite evidence supporting the efficacy of MOUD, significant knowledge gaps and stigmatizing attitudes among providers create barriers to optimal care. Sixteen healthcare providers participated in a comprehensive educational intervention grounded in Jean Watson's Theory of Transpersonal Caring and the Institute for Healthcare Improvement's Model for Improvement. The intervention consisted of a 4-hour workshop, six weekly reinforcement sessions, and the implementation of standardized buprenorphine management protocols. Pre- …

Enhancing Td Screening With The Aims Scale: A Quality Improvement Project, Dionne Smith

Electronic Theses and Dissertations

Tardive dyskinesia (TD) is a persistent, often irreversible movement disorder associated with long-term use of dopamine receptor–blocking agents. Early identification is critical to prevent progression and minimize functional impairment; however, routine TD screening remains inconsistent in many clinical settings despite the availability of the Abnormal Involuntary Movement Scale (AIMS), the evidence-based gold-standard tool. This quality improvement project aimed to enhance TD screening in an outpatient psychiatric setting through an educational intervention designed to improve provider knowledge of risk factors, diagnostic criteria, and screening guidelines. Data were collected retrospectively and prospectively from patient encounters, with 33 pre-intervention and 35 post-interventions. AIMS …

Assembling Life From Death: Examining The Archaeological Fauna Of Jupiter Inlet Lighthouse’S Past To Preserve Biodiversity For The Future, Victoria Sherwood

Electronic Theses and Dissertations

This project utilizes an assemblage of faunal remains from a precontact midden at the Jupiter Inlet Lighthouse archaeological site in northern Palm Beach County, Florida. The assemblage was identified and analyzed through the lenses of resource use and paleoenvironmental changes. The Indigenous groups in the area heavily utilized estuarine resources such as fish and marine turtles. The archaeological assemblage was compared to a modern survey of species present at the site. The species identified in the precontact collection are present in the surrounding area today. The archaeological assemblage matching up with modern species speaks to the success of Loxahatchee River …

Antipsychotic Misuse: A Silent But Growing Public Health Hazard, Sumeet Bhardwaj, Karisma Pathak, Myra Mclenon, Steven Spector, Kevin Tu

Student Publications

Antipsychotic drugs are essential in the management of schizophrenia, bipolar disorder, and other psychiatric illnesses, but their use is closely linked to cardiometabolic side effects. Cardiometabolic side effects include weight gain, dyslipidemia, glucose intolerance, and increased cardiovascular morbidity and mortality. Mechanisms of cardiometabolic side effects involve disruption of the central nervous system’s ability to regulate appetite, peripheral metabolic effects, which are changes in metabolism outside the CNS, and receptor-level interactions, with second-generation antipsychotics generally posing a greater risk than first-generation agents. This review addresses current evidence on the cardiometabolic consequences of antipsychotic therapy, increasing inappropriate off-label use of antipsychotic drugs, …

The George-Anne Daily, Georgia Southern University

George-Anne Media Group: Newsletters & Magazines

No abstract provided.

High-Risk Medications In Pediatric Dentistry: Patterns, Outcomes, And Clinical Implications, Yilei Liu, Kawtar Zouaidi, Colin C Hubbard, Muhammad F Walji, Matthew R Cooke, Donald B Rindal, Kristin N Ray, Elsbeth Kalenderian, Katie J Suda

Faculty, Staff and Student Publications

Background: High-risk medications such as opioids and benzodiazepines are frequently prescribed in pediatric dental care, yet their prescribing patterns and associated adverse outcomes remain poorly understood. The aim of this study was to determine the extent of such prescribing to pediatric patients and factors associated with adverse outcomes.

Methods: MarketScan data for patients younger than 18 years with a dental visit from 2014 through 2019 were analyzed. High-risk medications included benzodiazepines, barbiturates, and opioids. Composite outcomes included hospitalization, emergency department visit, or urgent care visit within 7 days after the dental visit. Opioid-attributable outcomes included opioid-related overdose within 7 days …

Alk5 Inhibitor Impact On Bleomycin-Induced Systemic Sclerosis Mouse Model Via Multifunctional Optical Coherence Tomography, Pavel V Nikitin, Harshdeep S Chawla, Jessica Gutierrez, Geethangili Madamanchi, Manmohan Singh, Salavat R Aglyamov, Minghua Wu, Jerry Alonso, Matthew Fronheiser, Juliana Coculo, Shuyan Du, Shervin Assassi, Kirill V Larin

Faculty, Staff and Student Publications

Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis, vascular dysfunction, and immune dysregulation, leading to significant morbidity and mortality. Noninvasive imaging techniques are critical for monitoring disease progression and evaluating therapeutic interventions. This study investigates the technical feasibility of multifunctional optical coherence tomography (OCT)-based methods for longitudinal assessment of skin thickness, stiffness, and microvasculature in a murine SSc model as a translational, noninvasive, and quantitative method to study disease progression and treatment response. Our findings demonstrate significant structural, biomechanical, and vascular changes in the skin's stiffness, indicative of fibrosis, a hallmark of SSc. The application of SB …

Fam13a Polymorphism Is Associated With A Usual Interstitial Pneumonia Pattern In Patients With Systemic Sclerosis-Associated Interstitial Lung Disease, Elana J Bernstein, Francesco Boin, Brett Elicker, Yiming Luo, Yawen Ren, Meng Zhang, John Varga, Shervin Assassi

Faculty, Staff and Student Publications

Objectives: The MUC5B promoter single nucleotide polymorphism (SNP) rs35705950 has been associated with idiopathic pulmonary fibrosis (IPF) and RA-related interstitial lung disease (ILD), but not with SSc-ILD. We hypothesized that the MUC5B promoter polymorphism or other IPF susceptibility loci are associated with an increased risk for the uncommon SSc-usual interstitial pneumonia (UIP) endophenotype, rather than SSc-ILD in general.

Methods: We performed a cross-sectional study of SSc-ILD patients from four US Scleroderma Programs to investigate the frequency of MUC5B rs35705950 and 12 additional IPF susceptibility loci. SSc-ILD patients were stratified by high resolution chest CT (HRCT) imaging findings into UIP and …

Nocturnal Oxygen Therapy For Central Sleep Apnea In Patients With Heart Failure: A Multisite, Double-Blind, Sham-Controlled Randomized Clinical Trial (Loft-Hf), Susan Redline, Dongdong Li, Shahrokh Javaheri, Sanjay R Patel, Sairam Parthasarathy, James C Fang, Lee K Brown, Mark Dunlap, M Safwan Badr, Neomi Shah, Luqi Chi, Ruckshanda Majid, Mihaela Teodorescu, Garrick Stewart, Eileen Hsich, Tamar Polonsky, Justin Vader, Maryl R Johnson, Dennis Auckley, Henry Klar Yaggi, Andrew Kao, Ali Azarbarzin, Raichel Alex, Michael Rueschman, Lisa Wolfe, Daniel J Gottlieb, Scott A Sands, Phyllis C Zee, Reena Mehra, Babak Mokhlesi, Rami Khayat, Eldrin F Lewis, William T Abraham, Rui Wang

Faculty, Staff and Student Publications

Rationale: There are insufficient data to inform the management of central sleep apnea (CSA) in patients with heart failure with reduced ejection fraction (HFrEF). Nocturnal oxygen therapy (NOT) has been postulated to benefit CSA patients with HFrEF but has not been rigorously studied. Objectives: To compare NOT with sham NOT (control) in heart failure (HF) patients receiving guideline-based HF therapy on the composite outcome of first occurrence of either mortality due to any cause, a lifesaving cardiovascular intervention, or an unplanned hospitalization for worsening HF, together with other secondary outcomes.

Methods: A multisite, double-blind, sham-controlled randomized clinical trial was conducted …

Combining Pirfenidone With Mycophenolate Mofetil For Systemic Sclerosis-Related Interstitial Lung Disease (Scleroderma Lung Study Iii): An Investigator-Initiated, Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial, Dinesh Khanna, Cathie Spino, Donald P Tashkin, Elana J Bernstein, Jonathan Goldin, Eric C Kleerup, Airi Harui, Grace Ibrahim, Grace Hyun J Kim, Suiyuan Huang, Richard Mclain, Yi-Hsuan Tu, Vivek Nagaraja, Richard M Silver, Virginia D Steen, S Samuel Weigt, Joyce S Lee, Aryeh Fischer, Mary Beth Scholand, Jessica K Gordon, Paul F Dellaripa, Ivan O Rosas, Gary M Hunninghake, Marcin A Trojanowski, Robert W Simms, Jane E Dematte, Vivien M Hsu, Robyn T Domsic, Ganesh Raghu, Maureen D Mayes, Ryan D Boente, Michael D Roth

Faculty, Staff and Student Publications

Objective: Mycophenolate mofetil (MMF) can stabilize or improve lung function in systemic sclerosis-related interstitial lung disease (SSc-ILD). We hypothesized that combining MMF with pirfenidone (PFD) would produce a significantly more rapid and/or greater improvement in lung function.

Methods: A randomized (1:1), double-blind, placebo (PLA)-controlled phase 2 trial was conducted in SSc-ILD in which patients received PFD or PLA (801 mg three times daily) along with MMF (1,500 mg twice daily) for 18 months. The primary outcome was change in percent predicted forced vital capacity (FVC-%). Linear mixed-effects models assessed treatment differences in a modified intention-to-treat population.

Results: Only fifty-one of …