Digital Commons Network^™

The Symptom Burden Of Women With A Known Risk Of Breast Cancer Receiving Risk Reducing Medication, Meagan S Whisenant, Jessica Treviño Jones, Anneliese O Gonzalez, Therese Bartholomew Bevers, Kelly Brassil, Darcy A Ponce, Sharvari Kamat, Emily Solis, Ann Maliackal, Hannah Warlick, Amie Walters, Chloe Denham, Loretta A Williams

Faculty, Staff and Student Publications

Background: For the estimated 10 million women in the United States who meet the high-risk criteria for breast cancer, evidence-based interventions may reduce the risk of breast cancer by 50-65 %. Even with substantial evidence supporting preventive medication for risk reduction, there is significant lack of uptake and adherence. The purpose of this study was to characterize the experience of women at high risk for breast cancer and define the content domain for a patient-reported outcomes (PRO) measure of symptom burden from breast cancer risk and risk reducing medication.

Methods: Thirty women at high risk for breast cancer and receiving …

Steroids For Viral Meningitis: A Foe Or A Friend?, Rodrigo Hasbun

Faculty, Staff and Student Publications

No abstract provided.

Radiographic Axial Spondyloarthritis (Ankylosing Spondylitis) Commencing Late In Life, Mark C Hwang, Karim Doughem, Minjae Lee, Lianne S Gensler, Mariko L Ishimori, Michael M Ward, Matthew A Brown, Amirali Tahanan, Michael H Weisman, Mohammad H Rahbar, John D Reveille

Faculty, Staff and Student Publications

No abstract provided.

Giant Cell Tumor Of The Bone With Fatal Pulmonary Metastasis: A Case Report, Mohamad Taha, Saadia A Faiz, Pushan Jani, Jing Liu, Yasir D Ali, Mohammad Asim Amjad

Faculty, Staff and Student Publications

Giant cell tumors of the bone are typically benign, locally aggressive lesions that rarely metastasize. In this report, we describe the case of a 48-year-old woman presenting with a giant cell tumor of the bone of the hip joint, which demonstrated aggressive histological features and recurrent behavior. The patient developed multiple unresectable pulmonary metastases despite several wide local excisions. Although pulmonary metastases from giant cell tumors of the bone are usually associated with a relatively favorable prognosis, guidelines for the optimal treatment of metastatic giant cell tumors of the bone remain limited. This case highlights the unpredictable nature of giant …

Use Of Hookah And Age Of Asthma Onset Among Us Adults, Adriana Pérez, Sarah Valencia, Pushan P Jani, Melissa B Harrell

Faculty, Staff and Student Publications

Objective: To explore the association of hookah use on the age of asthma onset among adults who were asthma/COPD free and who did not use cigarettes, cigars, electronic cigarettes or smokeless tobacco prior to asthma onset.

Methods: Secondary data analyses were conducted of the waves 1-6 (2013-2021) of the US nationally representative Population Assessment of Tobacco and Health Study among adults (>18 years). The four hookahs use exposures evaluated were (1) past 30-day (P30D) hookah use at the first wave of participation, (2) total number of waves before asthma onset in which adults reported P30D hookah use, (3) total …

Thrombotic Storm With Antiphospholipid Syndrome In The Setting Of Relapsing Evans Syndrome And Systemic Lupus Erythematosus: A Case Report, Som Singh, Sergio Abraham Candiales, Zachary Hunzeker, Cristina Olivo Freites, Modupe Idowu

Faculty, Staff and Student Publications

Background: There are few cases that report the presence of lupus anticoagulant and antiphospholipid antibodies between Evans syndrome and the presence of lupus anticoagulant. However, differentiating between primary and secondary causes of Evans syndrome remains challenging.

Case description: A 31-year-old female with a medical history of autism spectrum disorder, antiphospholipid syndrome (APS), complete systemic lupus erythematosus (SLE), and Evans syndrome was admitted for cholecystitis requiring laparoscopic cholecystectomy. In the setting of her acute illness, her thrombocytopenia worsened. Her hospital course was then complicated by the development of a left adrenal hematoma and venous thrombosis. Anticoagulation therapy was conservatively held due …

Changes In Medication Complexity And Post-Hospitalization Outcomes In Older Adults Hospitalized For Heart Failure, Aayush Visaria, William Mcdonald, John Mancini, Andrew P Ambrosy, Min Ji Kwak, Ashkan Hashemi, Mark S Lachs, Andrew R Zullo, Monika Safford, Emily B Levitan, Parag Goyal

Faculty, Staff and Student Publications

Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.

Methods: This retrospective cohort study included Reasons for Geographic and Racial Differences in Stroke (REGARDS) participants aged at least 65 years hospitalized for heart failure between 2003 and 2014. We calculated changes between hospital admission and discharge in medication count (Δcount) and …

Editorial: Women In Brain Imaging And Stimulation, Volume Ii: 2024, Molly S Hermiller, Ruogu Fang, Wen Li

Faculty, Staff and Student Publications

No abstract provided.

An Ontology-Based Method For Formalizing And Encoding Patient Colonoscopy Preparation Using Bpmn And Owl2 For Automated Tool Development, Muhammad Amith, Yue Yu, Yuheng Shi, Brooks Cash, Barani Mayilvaganan, Anirudh Babu, Yang Gong

Faculty, Staff and Student Publications

Colonoscopy is a proven procedure for mitigating the incidence of colorectal cancers in late adulthood. Despite its effectiveness, colonoscopy preparation presents several challenges for patients, including issues with adherence and misunderstanding. Information and communication technology (ICT) tools may offer valuable support for modern patients. To enable such tools, computable knowledge bases are essential. In this paper, we describe the development of an ontology-based knowledge graph representing four laxative-based pre-colonoscopy procedures. We used the business process modeling and notation and OWL2 formalisms to manifest machine-readable artifacts that model processes of colonoscopy preparation. Future work will focus on integrating extended knowledge bases …

Esomeprazole Inhibits Proliferation Of Scleroderma Fibroblasts Via Cell Cycle Regulation, Mohammad A Khan, Shaheer Koniyan, Manisha Ahir, Anil G Jegga, Maureen D Mayes, David Gius, Justin Leung, Mark D Bonnen, Sydney B Montesi, Yohannes T Ghebre

Faculty, Staff and Student Publications

Background: Scleroderma is a complex autoimmune disease characterized by abnormal fibroblast proliferation and excessive collagen deposits in the skin and internal organs. We previously showed that esomeprazole, an FDA-approved drug for gastric disorders, may prevent dermal fibrosis.

Methods: To test this, we evaluated the antiproliferative effect of esomeprazole and the underlying molecular mechanisms using primary fibroblasts derived from patients with scleroderma. BrdU incorporation, flow cytometry, immunofluorescence, Western blot analysis, RNA sequencing, and functional enrichment analysis were performed.

Results: Esomeprazole inhibited the proliferation of scleroderma fibroblasts in a dose-dependent manner, as measured by BrdU incorporation and Ki-67 marker. Intriguingly, esomeprazole arrested …

Invasive Fungal Disease In Solid Organ And Hematopoietic Cell Transplant Recipients, United States, Jeremy A W Gold, Kaitlin Benedict, Elizabeth Sajewski, Tom Chiller, Meghan Lyman, Mitsuru Toda, Jessica S Little, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Background: Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.

Methods: We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.

Results: Overall, 9143 patients received …

Rezafungin For Suppressive Therapy Of Candida Auris In A Patient With A Left Ventricular Assist Device (Lvad), Matthew A Stack, Luis Ostrosky-Zeichner, Rodrigo Hasbun, Sun O Park, Jessica Babic, Mona Kapadia

Faculty, Staff and Student Publications

Introduction: Invasive candidiasis is a common healthcare-associated infection with significant morbidity and mortality. Candida auris in particular has emerged as a problematic and challenging healthcare-associated infection, especially with regards to infections involving left ventricular assist devices (LVADs). There is a paucity of evidence on the best management of these particular types of infections. Rezafungin is a newly-approved echinocandin and an important new tool in the management of invasive candidiasis. We report the novel use of rezafungin for suppressive therapy in a patient with an LVAD-associated C. auris infection.

Case: The patient is a 57-year-old male with a past medical history …

National Healthcare Safety Network… We Need To Talk…., Misti Ellsworth, Luis Zeichner Ostrosky, Bela Patel, Robert Yetman, Phillip Chang

Faculty, Staff and Student Publications

No abstract provided.

Long-Term Dynamic Profiles Of Cognitive Kinases Induced By Different Learning Protocols, Yili Zhang, Rong-Yu Liu, Paul Smolen, John H Byrne

Faculty, Staff and Student Publications

Learning is associated with activation of multiple protein kinases, but few details are known about the activation dynamics in response to different learning protocols. We addressed this issue by examining the long-term dynamics of kinases critical for long term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse. Three serotonin (5-HT) protocols have been found to induce LTF with distinct effectiveness: the five-pulse regular-spaced Standard protocol; the five-pulse irregular-spaced Enhanced protocol; and the two-pulse protocol with an interval of 45 min. We previously compared long-term dynamics of the mitogen-activated protein kinase (MAPK) isoform ERK after these protocols. Here we examined the …

Quantitatively Assessing The Impact Of The Quality Of Snomed Ct Subtype Hierarchy On Cohort Queries, Xubing Hao, Xiaojin Li, Yan Huang, Jay Shi, Rashmie Abeysinghe, Cui Tao, Kirk Roberts, Guo-Qiang Zhang, Licong Cui

Faculty, Staff and Student Publications

Objective: SNOMED CT provides a standardized terminology for clinical concepts, allowing cohort queries over heterogeneous clinical data including Electronic Health Records (EHRs). While it is intuitive that missing and inaccurate subtype (or is-a) relations in SNOMED CT reduce the recall and precision of cohort queries, the extent of these impacts has not been formally assessed. This study fills this gap by developing quantitative metrics to measure these impacts and performing statistical analysis on their significance.

Material and methods: We used the Optum de-identified COVID-19 Electronic Health Record dataset. We defined micro-averaged and macro-averaged recall and precision metrics to assess the …

In-Hospital Mortality And Hemorrhagic Risks In Traumatic Brain Injury Patients With Early Vs. Late Venous Thromboembolism, Sophie Samuel, Jalon Barnes, Lynn Yamane, Eugene Uh, Cyprian C Afunugo, Bosco Seong Kyu Yang, Huimahn Alex Choi

Faculty, Staff and Student Publications

Objective: This study reviewed the management and outcomes of traumatic brain injury (TBI) patients who developed venous thromboembolism (VTE) during hospitalization, focusing on the timing of VTE diagnosis and anticoagulation initiation.

Methods: This retrospective, single-center study utilized data from the University of Texas Trauma Database. Patients were categorized based on VTE diagnosis timing (early ≤7 days, late >7 days). The primary outcome was in-hospital mortality. Secondary outcomes included mortality specifically among patients who were receiving anticoagulation treatment, hemorrhagic complications, predictors associated with early anticoagulation initiation (defined as ≤ 7 days from VTE diagnosis), and whether anticoagulation timing influenced mortality.

Results: …

Polygenic Scores Contribution To Parkinson’S Disease Comorbidities, Carlos F Hernández, Camilo Villaman, Cristian Tejos, Gabriela M Repetto, Costin Leu, Dennis Lal, Ignacio F Mata, Andrés D Klein, Eduardo Pérez-Palma

Faculty, Staff and Student Publications

Comorbidities are common in Parkinson’s disease and significantly impact the disease progression and management. While polygenic scores have been widely used to assess genetic risk for complex diseases, their role in comorbidity presentation in Parkinson’s disease remains unclear. This study investigates whether genetic predisposition to comorbidities, as measured by polygenic scores, differs between individuals with Parkinson’s disease and the general population and explores how genetic risk influences disease onset and sex-related differences. We analysed data from 4144 individuals with Parkinson’s disease and 370 480 individuals from the general population in the UK Biobank, focusing on four comorbidities with high-quality genome-wide …

What Time Is It? It Is 8 And 1/2 Time: A Rare Case Of Ischemic Stroke Consistent With Eight-And-A-Half Syndrome, Jessica Daza, Marcelo Bedoya-Sommerkamp, Eunbee Cho, Celia Daza, Francisco Gomez, Fatimah Bello, Jia Lin

Faculty, Staff and Student Publications

Eight-and-a-half syndrome is a rare neuro-ophthalmic syndrome characterized by conjugate horizontal gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral facial nerve palsy. It results from a lesion affecting the paramedian pontine reticular formation, the medial longitudinal fasciculus, and the abducens nucleus of the same side, at the level of the lower pons. We present a case of a 49-year-old man with 2-week diplopia and 3-day right-sided facial droop, drooling, and dysarthria. CT angiography of the head and neck revealed atherosclerotic disease, with decreased caliber of the basilar artery at the level of the pons. Brain MRI showed a subacute ischemic lesion …

Middle Meningeal Artery Embolization Does Not Confer Protection Against Symptomatic Recurrence In Patients With Early Antithrombotic Therapy Following Surgery For Chronic Subdural Hematomas, Hussein A Zeineddine, Bryden H Dawes, William W Wroe, Bronson Ciavarra, Salvatore A D'Amato, Hyun Woo Kim, Nimer Adeeb, Gabriel Galan Castro, Michael I Nahhas, Peng Roc Chen, Spiros L Blackburn, Sunil A Sheth, Ching-Jen Chen, Ryan S Kitagawa, Mark J Dannenbaum, Juan Carlos Martinez-Gutierrez

Faculty, Staff and Student Publications

Objective: Middle meningeal artery embolization (MMAE) has emerged as a promising treatment, both as an adjunct to surgery and as a primary treatment for chronic subdural hematoma (cSDH). Here, we evaluate the efficacy of MMAE following surgery in reducing the likelihood of reoperation in patients requiring early introduction of antithrombotics.

Methods: From our prospectively collected registry of patients with cSDH, we identified patients treated with surgical evacuation, either in combination with or without MMAE. Patients were included if they had a clinical indication requiring early antithrombotics within 7 days of surgery. The primary outcome was the rate of reoperation. The …

The Future Of Parkinson’S Care: A Need To Expand Access, Sana Aslam, Anjail Z Sharrief, Samantha K Holden, Michelle Fullard, Jodi S Holtrop, Anna M Maw, Amy W Amara

Faculty, Staff and Student Publications

Parkinson's disease (PD) affects over one million Americans, with prevalence expected to double by 2040, creating rising challenges for healthcare systems. While neurologist-led care, particularly by movement disorder specialists (MDS), is associated with improved patient outcomes, only a small fraction of PD patients access this level of expertise. Many, various, barriers lead to delays or missed opportunities for advanced treatments such as deep brain stimulation and infusion therapies. This Perspective article issues a call to action for improving referral pathways and care coordination in PD, addressing both clinical and systems-level gaps. We propose several pragmatic strategies, including the development of …

Predictors And Outcomes Of Hematoma Expansion And Neurological Decline In Intracerebral Hemorrhage: A Multisite Mobile Stroke Unit Study, Asish K Gulati, Tianwen Ma, Isaiah Rolle, Ryan Peterson, Bianca Pirlog, Justine Chen, Megan Heckathorn, Jonathan Ratcliff, Nicolas Bianchi, Carol Fleming, Michael Frankel, James Grotta, Ritvij Bowry, Stephanie Parker, William Hicks, Digvijaya Navalkele

Faculty, Staff and Student Publications

Background: Hemorrhagic stroke, particularly intracerebral hemorrhage, is one of the leading causes of permanent disability worldwide. Early hematoma expansion (HE) is a key factor in neurological deterioration (ND) and functional outcomes post intracerebral hemorrhage. This observational cohort study examines the predictors and outcomes of HE and ND in spontaneous intracerebral hemorrhage patients using data from 3 Mobile Stroke Units (MSUs) in the United States.

Methods: Patients diagnosed with spontaneous intracerebral hemorrhage within 4 hours of last known well were included. Data collection involved initial and follow-up non-contrast (computerized tomography) CT scans from MSUs and emergency departments, from which the rate …

Editorial: Understanding The Mechanism Of Dynamic Cell Communications: A Much Needed Angle For Cell Motility And Barrier Functions, Virag Vas, Zhen Xu, Pasquale Cervero

Faculty, Staff and Student Publications

No abstract provided.

Neutrophils Unveiled In Chronic Lymphocytic Leukemia, Sheighlah Mcmanus, Priyanka Khare, Maria Teresa S Bertilaccio

Faculty, Staff and Student Publications

This review explores neutrophils' roles in chronic lymphocytic leukemia (CLL), highlighting their functions within the immune system. While neutrophils are known for fighting infections, their altered behavior in CLL significantly impacts disease progression. This review notes the reduced phagocytic abilities of neutrophils and the increased formation of neutrophil extracellular traps (NETs) in patients with CLL. It also examines the effects of CLL treatments, including chemotherapy, immunotherapy and targeted therapies, on neutrophils' count and function, stressing the need for improved strategies to manage therapy-induced immune dysfunction. This review also provides detailed information about the interactions between neutrophils and other immune elements …

Microbial Imprints On Colorectal Cancer: The Epigenetic Silencing Of Phlpp1 As A Prognostic Nexus, Xiangsheng Huang, Faraz Bishehsari

Faculty, Staff and Student Publications

No abstract provided.

Editorial: Protein Regulation By Lipids, Mikhail V Bogdanov, Elena G Govorunova

Faculty, Staff and Student Publications

No abstract provided.

Protecting Organs-At-Risk In Cancer Therapies Through Temporary Organ Displacement: A Comprehensive Review, Rance B Tino, Michael Li, Amirreza Heshmat, Ayush Suresh, Anasimone Guillaume, Kristy K Brock, Bruno C Odisio, Eugene J Koay

Faculty, Staff and Student Publications

Radiation therapy (RT) and locoregional ablation are cornerstones of modern oncology, yet their therapeutic potential is frequently limited by the challenge of sparing healthy organs-at-risk (OARs) from treatment-related complications. Temporary organ displacement (TOD) techniques directly address this issue by creating a physical separation using 'spacers' during treatment, thereby minimizing collateral damage while enhancing therapeutic precision. The clinical benefits, including improved tumor control, reduced morbidity, and enhanced survival, are documented across malignancies of the head and neck, thorax, abdomen, and pelvis. To create a unified framework for this evolving field, this comprehensive review provides a systematic classification of TOD techniques based …

Nutritional Management Of The Child With Chronic Kidney Disease And On Dialysis., Vanessa Shaw, Caroline Anderson, An Desloovere, Larry A. Greenbaum, Lyndsay Harshman, Christina L. Nelms, Pearl Pugh, Nonnie Polderman, José Renken-Terhaerdt, Evelien Snauwaert, Stella Stabouli, Jetta Tuokkola, Johan Vande Walle, Bradley A. Warady, Fabio Paglialonga, Rukshana Shroff

Manuscripts, Articles, Book Chapters and Other Papers

While it is widely accepted that the nutritional management of the infant with chronic kidney disease (CKD) is paramount to achieve normal growth and development, nutritional management is also of importance beyond 1 year of age, particularly in toddlers, to support the delayed infantile stage of growth that may extend to 2-3 years of age. Puberty is also a vulnerable period when nutritional needs are higher to support the expected growth spurt. Inadequate nutritional intake throughout childhood can result in failure to achieve full adult height potential, and there is an increased risk for abnormal neurodevelopment. Conversely, the rising prevalence …

Digital Twins In Healthcare: A Comprehensive Review And Future Directions, Hamid Khoshfekr Rudsari, Becky Tseng, Hongxu Zhu, Lulu Song, Chunhui Gu, Abhishikta Roy, Ehsan Irajizad, Joseph Butner, James Long, Kim-Anh Do

Faculty, Staff and Student Publications

Digital Twin (DT) technology has emerged as a transformative force in healthcare, offering unprecedented opportunities for personalized medicine, treatment optimization, and disease prevention. This comprehensive review examines the current state of DTs in healthcare, analyzing their implementation across different physiological levels-from cellular to whole-body systems. We systematically review the latest developments, methodologies, and applications while identifying challenges and opportunities. Our analysis encompasses technical frameworks for cardiovascular, neurological, respiratory, metabolic, hepatic, oncological, and cellular DTs, highlighting significant achievements such as population-scale cardiac modeling (3,461 patient cohort), reduced atrial fibrillation recurrence rates through patient-specific cardiac models, improved brain tumor radiotherapy planning, advanced …

Self-Perceived Importance And Confidence Of Adolescents Transitioning To Adult Care., Lisa Lestishock, Carrie Cuomo, Teresa Hickam, Tisa Johnson-Hooper, Michele H. Maddux, Evan Muzzall, Margaret Mcmanus, Patience White

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: Motivational interviewing (MI) techniques are used by health care teams to engage adolescents and young adults (AYAs) in health care self-management and pediatric to adult health care transition (HCT) planning efforts. The aim of this study was to assess the initial level of motivation of AYAs prior to receipt of HCT anticipatory guidance and to determine associations with demographic and health coverage factors.

METHODS: This retrospective study included 5112 AYAs, aged 12-26 years, from four health systems. All AYAs completed the Got Transition readiness assessment that includes MI questions on importance and confidence related to the move to an …

Role Of Mir-204 In Controlling Metabolic Functions Of The Subretinal Microglia, Yan Chen, Sarah E Bounds, Neloy Kundu, James Regun Karmoker, Yin Liu, Dongin Kim, Jiyang Cai

Faculty, Staff and Student Publications

Rationale: MicroRNA-204 (miR-204) is one of the most abundant miRNA species in the retinal pigment epithelium (RPE) and RPE-derived extracellular vesicles (EVs). Knockout (KO) of miR-204 leads to dysfunction and degeneration of both the RPE and the retina. In addition to previously reported retinal pathologies, we observed the accumulation of lipid-laden subretinal microglia in miR-204 KO mice. This study aimed to identify potential molecular targets of miR-204 involved in microglia lipid processing and to determine whether RPE-derived EVs can improve the function of miR-204-deficient retinal microglia.

Methods: Lipid accumulation in microglia was detected by staining with LipidTox, a fluorescent dye …